School of Medicine Publications and Presentations
Document Type
Article
Publication Date
8-2016
Abstract
Background: Ambient air pollutants may increase preterm birth (PTB) risk, but critical exposure windows are uncertain. The interaction of asthma and pollutant exposure is rarely studied.
Objective: We sought to assess the interaction of maternal asthma and air pollutant exposures in relation to PTB risk.
Methods: Electronic medical records for 223,502 US deliveries were linked with modified Community Multiscale Air Quality model outputs. Logistic regression with generalized estimating equations estimated the odds ratio and 95% CIs for PTB on the basis of the interaction of maternal asthma and particulate matter with aerodynamic diameter of less than 2.5 microns and particulate matter with aerodynamic diameter of less than 10 microns, ozone (O3), nitrogen oxides (NOx), sulfur dioxide (SO2), and carbon monoxide (CO) per interquartile range. For each gestational week 23 to 36, exposures among women who delivered were compared with those remaining pregnant. Three-month preconception, whole pregnancy, weeks 1 to 28, and the last 6 weeks of gestation averages were also evaluated.
Results: On assessing PTB by gestational week, we found that significant asthma interactions were sporadic before 30 weeks but more common during weeks 34 to 36, with higher risk among mothers with asthma for NOx, CO, and SO2 exposure and an inverse association with O3 in week 34. Odds of PTB were significantly higher among women with asthma for CO and NOx exposure preconception and early in pregnancy. In the last 6 weeks of pregnancy, PTB risk associated with particulate matter with aerodynamic diameter of less than 10 microns was higher among women with asthma.
Conclusions: Mothers with asthma may experience a higher risk for PTB after exposure to traffic-related pollutants such as CO and NOx, particularly for exposures 3-months preconception and in the early weeks of pregnancy.
Recommended Citation
Mendola, P., Wallace, M., Hwang, B. S., Liu, D., Robledo, C., Männistö, T., Sundaram, R., Sherman, S., Ying, Q., & Grantz, K. L. (2016). Preterm birth and air pollution: Critical windows of exposure for women with asthma. The Journal of allergy and clinical immunology, 138(2), 432–440.e5. https://doi.org/10.1016/j.jaci.2015.12.1309
Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-No Derivative Works 4.0 International License.
Publication Title
Journal of Allergy and Clinical Immunology
DOI
10.1016/j.jaci.2015.12.1309
Academic Level
faculty
Mentor/PI Department
Population Health and Biostatistics
Comments
Published by Elsevier Inc. on behalf of the American Academy of Allergy, Asthma & Immunology