Abstract
The association between ambient air pollution and adverse health effects, such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases, has been studied extensively in many countries, including Canada. Recently, studies conducted in China, the Czech Republic, and the United States have related ambient air pollution to adverse pregnancy outcomes. In this study, we examined association between preterm birth, low birth weight, and intrauterine growth retardation (IUGR) among singleton live births and ambient concentrations of sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone in Vancouver, Canada, for 1985-1998. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for such effects. Low birth weight was associated with exposure to SO2 during the first month of pregnancy (OR = 1.11, 95% CI, 1.01-1.22, for a 5.0 ppb increase). Preterm birth was associated with exposure to SO2 (OR = 1.09, 95% CI, 1.01-1.19, for a 5.0 ppb increase) and to CO (OR = 1.08, 95% CI, 1.01-1.15, for a 1.0 ppm increase) during the last month of pregnancy. IUGR was associated with exposure to SO2 (OR = 1.07, 95% CI, 1.01-1.13, for a 5.0 ppb increase), to NO2 (OR = 1.05, 95% CI, 1.01-1.10, for a 10.0 ppb increase), and to CO (OR = 1.06, 95% CI, 1.01-1.10, for a 1.0 ppm increase) during the first month of pregnancy. In conclusion, relatively low concentrations of gaseous air pollutants are associated with adverse effects on birth outcomes in populations experiencing diverse air pollution profiles.
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- Antipenko YeN, Kogut N. N. The experience of mutation rate quantitative evaluation in connection with environmental pollution (based on studies of congenital anomalies in human populations). Mutat Res. 1993 Oct;289(2):145–155. doi: 10.1016/0027-5107(93)90064-m. [DOI] [PubMed] [Google Scholar]
- Barker D. J., Gluckman P. D., Godfrey K. M., Harding J. E., Owens J. A., Robinson J. S. Fetal nutrition and cardiovascular disease in adult life. Lancet. 1993 Apr 10;341(8850):938–941. doi: 10.1016/0140-6736(93)91224-a. [DOI] [PubMed] [Google Scholar]
- Berkowitz G. S., Papiernik E. Epidemiology of preterm birth. Epidemiol Rev. 1993;15(2):414–443. doi: 10.1093/oxfordjournals.epirev.a036128. [DOI] [PubMed] [Google Scholar]
- Bignami G., Musi B., Dell'Omo G., Laviola G., Alleva E. Limited effects of ozone exposure during pregnancy on physical and neurobehavioral development of CD-1 mice. Toxicol Appl Pharmacol. 1994 Dec;129(2):264–271. doi: 10.1006/taap.1994.1251. [DOI] [PubMed] [Google Scholar]
- Bobak M., Leon D. A. Pregnancy outcomes and outdoor air pollution: an ecological study in districts of the Czech Republic 1986-8. Occup Environ Med. 1999 Aug;56(8):539–543. doi: 10.1136/oem.56.8.539. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bobak M., Leon D. A. The effect of air pollution on infant mortality appears specific for respiratory causes in the postneonatal period. Epidemiology. 1999 Nov;10(6):666–670. [PubMed] [Google Scholar]
- Burnett R. T., Brook J. R., Yung W. T., Dales R. E., Krewski D. Association between ozone and hospitalization for respiratory diseases in 16 Canadian cities. Environ Res. 1997 Jan;72(1):24–31. doi: 10.1006/enrs.1996.3685. [DOI] [PubMed] [Google Scholar]
- Burnett R. T., Brook J., Dann T., Delocla C., Philips O., Cakmak S., Vincent R., Goldberg M. S., Krewski D. Association between particulate- and gas-phase components of urban air pollution and daily mortality in eight Canadian cities. Inhal Toxicol. 2000;12 (Suppl 4):15–39. doi: 10.1080/08958370050164851. [DOI] [PubMed] [Google Scholar]
- Burnett R. T., Cakmak S., Raizenne M. E., Stieb D., Vincent R., Krewski D., Brook J. R., Philips O., Ozkaynak H. The association between ambient carbon monoxide levels and daily mortality in Toronto, Canada. J Air Waste Manag Assoc. 1998 Aug;48(8):689–700. doi: 10.1080/10473289.1998.10463718. [DOI] [PubMed] [Google Scholar]
- Burnett R. T., Dales R. E., Brook J. R., Raizenne M. E., Krewski D. Association between ambient carbon monoxide levels and hospitalizations for congestive heart failure in the elderly in 10 Canadian cities. Epidemiology. 1997 Mar;8(2):162–167. doi: 10.1097/00001648-199703000-00007. [DOI] [PubMed] [Google Scholar]
- Dejmek J., Selevan S. G., Benes I., Solanský I., Srám R. J. Fetal growth and maternal exposure to particulate matter during pregnancy. Environ Health Perspect. 1999 Jun;107(6):475–480. doi: 10.1289/ehp.99107475. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Dolk H., Pattenden S., Vrijheid M., Thakrar B., Armstrong B. Perinatal and infant mortality and low birth weight among residents near cokeworks in Great Britain. Arch Environ Health. 2000 Jan-Feb;55(1):26–30. doi: 10.1080/00039890009603381. [DOI] [PubMed] [Google Scholar]
- Duvekot J. J., Cheriex E. C., Pieters F. A., Peeters L. L. Severely impaired fetal growth is preceded by maternal hemodynamic maladaptation in very early pregnancy. Acta Obstet Gynecol Scand. 1995 Oct;74(9):693–697. doi: 10.3109/00016349509021176. [DOI] [PubMed] [Google Scholar]
- Fair M., Cyr M. The Canadian Birth Data Base: a new research tool to study reproductive outcomes. Health Rep. 1993;5(3):281–290. [PubMed] [Google Scholar]
- Gibbs R. S., Romero R., Hillier S. L., Eschenbach D. A., Sweet R. L. A review of premature birth and subclinical infection. Am J Obstet Gynecol. 1992 May;166(5):1515–1528. doi: 10.1016/0002-9378(92)91628-n. [DOI] [PubMed] [Google Scholar]
- Godfrey K., Robinson S., Barker D. J., Osmond C., Cox V. Maternal nutrition in early and late pregnancy in relation to placental and fetal growth. BMJ. 1996 Feb 17;312(7028):410–414. doi: 10.1136/bmj.312.7028.410. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Goldberg M. S., Burnett R. T., Brook J., Bailar J. C., 3rd, Valois M. F., Vincent R. Associations between daily cause-specific mortality and concentrations of ground-level ozone in Montreal, Quebec. Am J Epidemiol. 2001 Nov 1;154(9):817–826. doi: 10.1093/aje/154.9.817. [DOI] [PubMed] [Google Scholar]
- Greisen G. Estimation of fetal weight by ultrasound. Horm Res. 1992;38(5-6):208–210. doi: 10.1159/000182544. [DOI] [PubMed] [Google Scholar]
- Hansteen I. L., Heldaas S. S., Langård S., Steen-Johnsen J., Christensen A., Heldaas K. Surveillance of pregnancies as a means of detecting environmental and occupational hazards. I. Spontaneous abortions, congenital malformations and cytogenetic abnormalities in a newborn population. Hereditas. 1987;107(2):197–203. doi: 10.1111/j.1601-5223.1987.tb00285.x. [DOI] [PubMed] [Google Scholar]
- Kavlock R. J., Meyer E., Grabowski C. T. Studies on the developmental toxicity of ozone: postnatal effects. Toxicol Lett. 1980 Jan;5(1):3–9. doi: 10.1016/0378-4274(80)90141-1. [DOI] [PubMed] [Google Scholar]
- Kavlock R., Daston G., Grabowski C. T. Studies on the developmental toxicity of ozone. I. Prenatal effects. Toxicol Appl Pharmacol. 1979 Mar 30;48(1 Pt 1):19–28. doi: 10.1016/s0041-008x(79)80004-6. [DOI] [PubMed] [Google Scholar]
- Khong T. Y., De Wolf F., Robertson W. B., Brosens I. Inadequate maternal vascular response to placentation in pregnancies complicated by pre-eclampsia and by small-for-gestational age infants. Br J Obstet Gynaecol. 1986 Oct;93(10):1049–1059. doi: 10.1111/j.1471-0528.1986.tb07830.x. [DOI] [PubMed] [Google Scholar]
- Kramer M. S., Demissie K., Yang H., Platt R. W., Sauvé R., Liston R. The contribution of mild and moderate preterm birth to infant mortality. Fetal and Infant Health Study Group of the Canadian Perinatal Surveillance System. JAMA. 2000 Aug 16;284(7):843–849. doi: 10.1001/jama.284.7.843. [DOI] [PubMed] [Google Scholar]
- Kramer M. S. Intrauterine growth and gestational duration determinants. Pediatrics. 1987 Oct;80(4):502–511. [PubMed] [Google Scholar]
- Perera F. P., Jedrychowski W., Rauh V., Whyatt R. M. Molecular epidemiologic research on the effects of environmental pollutants on the fetus. Environ Health Perspect. 1999 Jun;107 (Suppl 3):451–460. doi: 10.1289/ehp.99107s3451. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perera F. P., Whyatt R. M., Jedrychowski W., Rauh V., Manchester D., Santella R. M., Ottman R. Recent developments in molecular epidemiology: A study of the effects of environmental polycyclic aromatic hydrocarbons on birth outcomes in Poland. Am J Epidemiol. 1998 Feb 1;147(3):309–314. doi: 10.1093/oxfordjournals.aje.a009451. [DOI] [PubMed] [Google Scholar]
- Peters A., Döring A., Wichmann H. E., Koenig W. Increased plasma viscosity during an air pollution episode: a link to mortality? Lancet. 1997 May 31;349(9065):1582–1587. doi: 10.1016/S0140-6736(97)01211-7. [DOI] [PubMed] [Google Scholar]
- Petruzzelli S., Celi A., Pulerà N., Baliva F., Viegi G., Carrozzi L., Ciacchini G., Bottai M., Di Pede F., Paoletti P. Serum antibodies to benzo(a)pyrene diol epoxide-DNA adducts in the general population: effects of air pollution, tobacco smoking, and family history of lung diseases. Cancer Res. 1998 Sep 15;58(18):4122–4126. [PubMed] [Google Scholar]
- Pope C. Arden, 3rd, Burnett Richard T., Thun Michael J., Calle Eugenia E., Krewski Daniel, Ito Kazuhiko, Thurston George D. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. JAMA. 2002 Mar 6;287(9):1132–1141. doi: 10.1001/jama.287.9.1132. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ritz B., Yu F., Chapa G., Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology. 2000 Sep;11(5):502–511. doi: 10.1097/00001648-200009000-00004. [DOI] [PubMed] [Google Scholar]
- Ritz B., Yu F. The effect of ambient carbon monoxide on low birth weight among children born in southern California between 1989 and 1993. Environ Health Perspect. 1999 Jan;107(1):17–25. doi: 10.1289/ehp.9910717. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ritz Beate, Yu Fei, Fruin Scott, Chapa Guadalupe, Shaw Gary M., Harris John A. Ambient air pollution and risk of birth defects in Southern California. Am J Epidemiol. 2002 Jan 1;155(1):17–25. doi: 10.1093/aje/155.1.17. [DOI] [PubMed] [Google Scholar]
- Roberts J. M., Taylor R. N., Goldfien A. Clinical and biochemical evidence of endothelial cell dysfunction in the pregnancy syndrome preeclampsia. Am J Hypertens. 1991 Aug;4(8):700–708. doi: 10.1093/ajh/4.8.700. [DOI] [PubMed] [Google Scholar]
- Rogers J. F., Thompson S. J., Addy C. L., McKeown R. E., Cowen D. J., Decouflé P. Association of very low birth weight with exposures to environmental sulfur dioxide and total suspended particulates. Am J Epidemiol. 2000 Mar 15;151(6):602–613. doi: 10.1093/oxfordjournals.aje.a010248. [DOI] [PubMed] [Google Scholar]
- Samet J. M., Dominici F., Curriero F. C., Coursac I., Zeger S. L. Fine particulate air pollution and mortality in 20 U.S. cities, 1987-1994. N Engl J Med. 2000 Dec 14;343(24):1742–1749. doi: 10.1056/NEJM200012143432401. [DOI] [PubMed] [Google Scholar]
- Schwartz J. Air pollution and daily mortality: a review and meta analysis. Environ Res. 1994 Jan;64(1):36–52. doi: 10.1006/enrs.1994.1005. [DOI] [PubMed] [Google Scholar]
- Srám R. J., Benes I., Binková B., Dejmek J., Horstman D., Kotesovec F., Otto D., Perreault S. D., Rubes J., Selevan S. G. Teplice program--the impact of air pollution on human health. Environ Health Perspect. 1996 Aug;104 (Suppl 4):699–714. doi: 10.1289/ehp.104-1469669. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Topinka J., Binková B., Mracková G., Stávková Z., Peterka V., Benes I., Dejmek J., Lenícek J., Pilcík T., Srám R. J. Influence of GSTM1 and NAT2 genotypes on placental DNA adducts in an environmentally exposed population. Environ Mol Mutagen. 1997;30(2):184–195. [PubMed] [Google Scholar]
- Wang X., Ding H., Ryan L., Xu X. Association between air pollution and low birth weight: a community-based study. Environ Health Perspect. 1997 May;105(5):514–520. doi: 10.1289/ehp.97105514. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Windham G. C., Eaton A., Hopkins B. Evidence for an association between environmental tobacco smoke exposure and birthweight: a meta-analysis and new data. Paediatr Perinat Epidemiol. 1999 Jan;13(1):35–57. doi: 10.1046/j.1365-3016.1999.00150.x. [DOI] [PubMed] [Google Scholar]
- Windham G. C., Hopkins B., Fenster L., Swan S. H. Prenatal active or passive tobacco smoke exposure and the risk of preterm delivery or low birth weight. Epidemiology. 2000 Jul;11(4):427–433. doi: 10.1097/00001648-200007000-00011. [DOI] [PubMed] [Google Scholar]
- Woodruff T. J., Grillo J., Schoendorf K. C. The relationship between selected causes of postneonatal infant mortality and particulate air pollution in the United States. Environ Health Perspect. 1997 Jun;105(6):608–612. doi: 10.1289/ehp.97105608. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Xu X., Ding H., Wang X. Acute effects of total suspended particles and sulfur dioxides on preterm delivery: a community-based cohort study. Arch Environ Health. 1995 Nov-Dec;50(6):407–415. doi: 10.1080/00039896.1995.9935976. [DOI] [PubMed] [Google Scholar]