Prenatal exposure to particulate air pollution and gestational age at delivery in Massachusetts neonates 2001-2015: A perspective of causal modeling and health disparities
- PMID:33154990
- PMCID: PMC7595249
- DOI: 10.1097/EE9.0000000000000113
Prenatal exposure to particulate air pollution and gestational age at delivery in Massachusetts neonates 2001-2015: A perspective of causal modeling and health disparities
Abstract
There is a lack of evidence on causal effects of air pollution on gestational age (GA) at delivery.
Methods: Inverse probability weighting (IPW) quantile regression was applied to derive causal marginal population-level GA reduction for GA percentiles associated with increased ambient particulate matter with diameter <2.5 μm (PM2.5) levels at maternal residential address for each trimester and the month preceding delivery using Massachusetts birth registry 2001 to 2015. Stratified analyses were conducted for neonatal sex, maternal age/race/education, and extreme ambient temperature conditions.
Results: For neonates at 2.5th, 10th, 25th, 50th, 75th, and 97.5th percentiles of GA at delivery, we estimated an adjusted GA reduction of 4.2 days (95% confidence interval [CI] = 3.4, 5.0), 1.9 days (1.6, 2.1), 1.2 days (1.0, 1.4), 0.82 days (0.72, 0.92), 0.74 days (0.54, 0.94), and 0.54 days (0.15, 0.93) for each 5 μg/m3 increment in third trimester average PM2.5 levels. Final gestational month average exposure yielded a similar effect with greater magnitude. Male neonates and neonates of younger (younger than 35 years) and African American mothers as well as with high/low extreme temperature exposure in third trimester were more affected. Estimates were consistently higher at lower GA percentiles, indicating preterm/early-term births being more affected. Low-exposure analyses yielded similar results, restricting to areas with PM2.5 levels under US ambient annual standard of 12 μg/m3.
Conclusions: Prenatal exposure to PM2.5 in late pregnancy reduced GA at delivery among Massachusetts neonates, especially among preterm/early-term births, male neonates, and neonates of younger and African American mothers. Exposure to extremely high/low temperature amplifies the effect of PM2.5 on GA.
Keywords: Air pollution; Gestational age; Health disparity; Inverse probability weighting; Quantile regression; Temperature.
Copyright © 2020 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The Environmental Epidemiology. All rights reserved.
Conflict of interest statement
The authors declare that they have no conflicts of interest with regard to the content of this report. This study was supported by the National Institutes of Health (NIH) grant (R01 ES024332-01A1, ES-000002). This publication was made possible also by US Environmental Protection Agency (EPA) grant (RD-835872-01). Its contents are solely the responsibility of the grantee and do not necessarily represent the official views of the US EPA. Further, US EPA does not endorse the purchase of any commercial products or services mentioned in the publication. The funders had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication. The funding sources support open access publishing.Sponsorships or competing interests that may be relevant to content are disclosed at the end of the article.
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