Preterm birth, stillbirth and ambient air pollution in Georgia, 2006 to 2013 Öffentlichkeit

Abstract

Background: Previous epidemiologic studies suggest associations between ambient air pollution exposure during pregnancy and adverse birth outcomes, including preterm births (PTB) and stillbirth (STB); but mixed findings exist. 

 

Objective: We investigated associations between 8 ambient air pollutants over 6 exposure windows, and risks of PTB (< 37 weeks of gestation) and STB in Georgia.

 

Methods: Singleton fetal death records (n = 5,797) and live birth records (n = 1,055,744) with 20-44 weeks of gestation and estimated date of conception between 1^st January 2006, and 30^th December 2013 were obtained the State Office of Vital Records, Georgia Department of Public Health. Daily concentrations of PM2.5, CO, OC, EC, O3, NO2, NO3, and NOx were estimated by combining numerical model simulations with measurements from stationary monitors at 12-km resolution. Cox proportional hazard models with time-varying covariates were used to examine average pollutant concentration during trimester 1, trimester 2, trimester 3, the entire pregnancy, 1-week lag and 4-week lag. Models were adjusted for seasonality and year of conception, maternal race, ethnicity, marital status, median house income, tobacco usage during pregnancy, and infant sex.

 

Results: Associations (p < 0.05) were observed for several pollutants in the STB analysis for trimester 2 and pregnancy-wide average exposures. NOx, O3, and EC were found to elevate the risk of STB. For example, hazard ratios for an interquartile range increase in ozone during the second trimester and entire pregnancy were 1.15 (CI: 1.04 -1.26) and 1.12 (CI: 1:02 -1.22). Most associations between PTB and pollutants were null.

 

Conclusions: Exposure to ambient air pollutants during pregnancy may be associated with elevating the risk of STB in Georgia. 

Table of Contents

Table of Contents

1.Introduction....................................................................... ... .................................... 1

2. Method ..................................................................................................................... 3

2.1 Study Population..................................................................................................... 3

2.2 Exposure Assessment.............................................................................................. 4

2.3 Statistical Analysis.................................................................................................. 5

3. Results....................................................................................................................... 6

3.1 Ambient Air Pollution and Preterm Birth.............................................................. 10

3.2 Ambient Air Pollution and Stillbirth..................................................................... 12

4. Discussion .............................................................................................................. 14

Reference .................................................................................................................... 16

Appendix..................................................................................................................... 17

About this Master's Thesis

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School	Rollins School of Public Health
Department	Biostatistics
Subfield / Discipline	Biostatistics - MPH & MSPH
Degree	M.S.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Stichwort	Air Pollution
Committee Chair / Thesis Advisor	Howard H. Chang, Emory University
Committee Members	Matthew J. Strickland, University of Nevada

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