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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 2004 Jan;58(1):11–17. doi: 10.1136/jech.58.1.11

Association between ambient air pollution and birth weight in São Paulo, Brazil

N Gouveia 1, S Bremner 1, H Novaes 1
PMCID: PMC1757020  PMID: 14684720

Abstract

Objectives: Previous studies have implicated air pollution in increased mortality and morbidity, especially in the elderly population and children. More recently, associations with mortality in infants and with some reproductive outcomes have also been reported. The aim of this study is to explore the association between exposure to outdoor air pollution during pregnancy and birth weight.

Design: Cross sectional study using data on all singleton full term live births during a one year period. For each individual birth, information on gestational age, type of delivery, birth weight, sex, maternal education, maternal age, place of residence, and parity was available. Daily mean levels of PM10, sulphur dioxide, nitrogen dioxide, carbon monoxide, and ozone were also gathered. The association between birth weight and air pollution was assessed in regression models with exposure averaged over each trimester of pregnancy.

Setting: São Paulo city, Brazil.

Results: Birth weight was shown to be associated with length of gestation, maternal age and instruction, infant gender, number of antenatal care visits, parity, and type of delivery. On adjusting for these variables negative effects of exposure to PM10 and carbon monoxide during the first trimester were observed. This effect seemed to be more robust for carbon monoxide. For a 1 ppm increase in mean exposure to carbon monoxide during the first trimester a reduction of 23 g in birth weight was estimated.

Conclusions: The results are consistent in revealing that exposure to air pollution during pregnancy may interfere with weight gain in the fetus. Given the poorer outlook for low birthweight babies on a number of health outcomes, this finding is important from the public health perspective.

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Selected References

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  1. Alderman B. W., Baron A. E., Savitz D. A. Maternal exposure to neighborhood carbon monoxide and risk of low infant birth weight. Public Health Rep. 1987 Jul-Aug;102(4):410–414. [PMC free article] [PubMed] [Google Scholar]
  2. Ballester F., Corella D., Pérez-Hoyos S., Hervás A. Air pollution and mortality in Valencia, Spain: a study using the APHEA methodology. J Epidemiol Community Health. 1996 Oct;50(5):527–533. doi: 10.1136/jech.50.5.527. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Barbieri M. A., Silva A. A., Bettiol H., Gomes U. A. Risk factors for the increasing trend in low birth weight among live births born by vaginal delivery, Brazil. Rev Saude Publica. 2000 Dec;34(6):596–602. doi: 10.1590/s0034-89102000000600006. [DOI] [PubMed] [Google Scholar]
  4. Bobak M., Leon D. A. Air pollution and infant mortality in the Czech Republic, 1986-88. Lancet. 1992 Oct 24;340(8826):1010–1014. doi: 10.1016/0140-6736(92)93017-h. [DOI] [PubMed] [Google Scholar]
  5. 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]
  6. Bobak M. Outdoor air pollution, low birth weight, and prematurity. Environ Health Perspect. 2000 Feb;108(2):173–176. doi: 10.1289/ehp.00108173. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Boy Erick, Bruce Nigel, Delgado Hernán. Birth weight and exposure to kitchen wood smoke during pregnancy in rural Guatemala. Environ Health Perspect. 2002 Jan;110(1):109–114. doi: 10.1289/ehp.02110109. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Branum Amy M., Schoendorf Kenneth C. Changing patterns of low birthweight and preterm birth in the United States, 1981-98. Paediatr Perinat Epidemiol. 2002 Jan;16(1):8–15. doi: 10.1046/j.1365-3016.2002.00394.x. [DOI] [PubMed] [Google Scholar]
  9. 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]
  10. Dominici Francesca, McDermott Aidan, Zeger Scott L., Samet Jonathan M. On the use of generalized additive models in time-series studies of air pollution and health. Am J Epidemiol. 2002 Aug 1;156(3):193–203. doi: 10.1093/aje/kwf062. [DOI] [PubMed] [Google Scholar]
  11. Fried P. A. Prenatal exposure to tobacco and marijuana: effects during pregnancy, infancy, and early childhood. Clin Obstet Gynecol. 1993 Jun;36(2):319–337. doi: 10.1097/00003081-199306000-00011. [DOI] [PubMed] [Google Scholar]
  12. Gouveia N., Fletcher T. Time series analysis of air pollution and mortality: effects by cause, age and socioeconomic status. J Epidemiol Community Health. 2000 Oct;54(10):750–755. doi: 10.1136/jech.54.10.750. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Ha E. H., Hong Y. C., Lee B. E., Woo B. H., Schwartz J., Christiani D. C. Is air pollution a risk factor for low birth weight in Seoul? Epidemiology. 2001 Nov;12(6):643–648. doi: 10.1097/00001648-200111000-00011. [DOI] [PubMed] [Google Scholar]
  14. Hack M., Fanaroff A. A. Outcomes of children of extremely low birthweight and gestational age in the 1990's. Early Hum Dev. 1999 Jan;53(3):193–218. doi: 10.1016/s0378-3782(98)00052-8. [DOI] [PubMed] [Google Scholar]
  15. Keirse M. J. International variations in intrauterine growth. Eur J Obstet Gynecol Reprod Biol. 2000 Sep;92(1):21–28. doi: 10.1016/s0301-2115(00)00454-1. [DOI] [PubMed] [Google Scholar]
  16. Kramer M. S. Intrauterine growth and gestational duration determinants. Pediatrics. 1987 Oct;80(4):502–511. [PubMed] [Google Scholar]
  17. Landgren O. Environmental pollution and delivery outcome in southern Sweden: a study with central registries. Acta Paediatr. 1996 Nov;85(11):1361–1364. doi: 10.1111/j.1651-2227.1996.tb13926.x. [DOI] [PubMed] [Google Scholar]
  18. Lin C. C., Santolaya-Forgas J. Current concepts of fetal growth restriction: part I. Causes, classification, and pathophysiology. Obstet Gynecol. 1998 Dec;92(6):1044–1055. doi: 10.1016/s0029-7844(98)00328-7. [DOI] [PubMed] [Google Scholar]
  19. Maisonet M., Bush T. J., Correa A., Jaakkola J. J. Relation between ambient air pollution and low birth weight in the Northeastern United States. Environ Health Perspect. 2001 Jun;109 (Suppl 3):351–356. doi: 10.1289/ehp.01109s3351. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. McCormick M. C. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med. 1985 Jan 10;312(2):82–90. doi: 10.1056/NEJM198501103120204. [DOI] [PubMed] [Google Scholar]
  21. Mongelli M., Biswas A. A fetal growth standard derived from multiple modalities. Early Hum Dev. 2001 Jan;60(3):171–177. doi: 10.1016/s0378-3782(00)00112-2. [DOI] [PubMed] [Google Scholar]
  22. Monteiro C. A., Benicio M. H., Ortiz L. P. Tendência secular do peso ao nascer na cidade de São Paulo (1976-1998). Rev Saude Publica. 2000 Dec;34(6 Suppl):26–40. [PubMed] [Google Scholar]
  23. Pereira L. A., Loomis D., Conceiço G. M., Braga A. L., Arcas R. M., Kishi H. S., Singer J. M., Böhm G. M., Saldiva P. H. Association between air pollution and intrauterine mortality in São Paulo, Brazil. Environ Health Perspect. 1998 Jun;106(6):325–329. doi: 10.1289/ehp.98106325. [DOI] [PMC free article] [PubMed] [Google Scholar]
  24. 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]
  25. 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]
  26. Srám R. J., Binková B., Rössner P., Rubes J., Topinka J., Dejmek J. Adverse reproductive outcomes from exposure to environmental mutagens. Mutat Res. 1999 Jul 16;428(1-2):203–215. doi: 10.1016/s1383-5742(99)00048-4. [DOI] [PubMed] [Google Scholar]
  27. Verhoeff A. P., Hoek G., Schwartz J., van Wijnen J. H. Air pollution and daily mortality in Amsterdam. Epidemiology. 1996 May;7(3):225–230. doi: 10.1097/00001648-199605000-00002. [DOI] [PubMed] [Google Scholar]
  28. 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]
  29. 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]

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