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Assessing exposure metrics for PM and birth weight models

Abstract

The link between air pollution exposure and adverse birth outcomes is of public health concern due to the relationship between poor pregnancy outcomes and the onset of childhood and adult diseases. As personal exposure measurements are difficult and expensive to obtain, proximate measures of air pollution exposure are traditionally used. We explored how different air pollution exposure metrics affect birth weight regression models. We examined the effect of maternal exposure to ambient levels of particulate matter <10, <2.5 μm in aerodynamic diameter (PM10, PM2.5) on birth weight among infants in North Carolina. We linked maternal residence to the closest monitor during pregnancy for 2000–2002 (n=350,754). County-level averages of air pollution concentrations were estimated for the entire pregnancy and each trimester. For a finer spatially resolved metric, we calculated exposure averages for women living within 20, 10, and 5 km of a monitor. Multiple linear regression was used to determine the association between exposure and birth weight, adjusting for standard covariates. In the county-level model, an interquartile increase in PM10 and PM2.5 during the entire gestational period reduced the birth weight by 5.3 g (95% CI: 3.3–7.4) and 4.6 g (95% CI: 2.3–6.8), respectively. This model also showed a reduction in birth weight for PM10 (7.1 g, 95% CI: 1.0–13.2) and PM2.5 (10.4 g, 95% CI: 6.4–14.4) during the third trimester. Proximity models for 20, 10, and 5 km distances showed results similar to the county-level models. County-level models assume that exposure is spatially homogeneous over a larger surface area than proximity models. Sensitivity analysis showed that at varying spatial resolutions, there is still a stable and negative association between air pollution and birth weight, despite North Carolina's consistent attainment of federal air quality standards.

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References

  • Alexander G., Himes J., Kaufman R., Mor J., and Kogan M. A United States National Reference for Fetal Growth. Obstetrics & Gynecology 1996: 87 (2): 163–168.

    Article  CAS  Google Scholar 

  • Ashdown-Lambert J.R. A review of low birth weight: predictors, precursors, and morbidity outcomes. J R Soc Promot Health 2005: 125 (2): 76–83.

    Article  PubMed  Google Scholar 

  • Basu R., Woodruff T.J., Parker J.D., Saulnier L., and Schoendorf K.C. Comparing exposure metrics in the relationship between PM&lt;sub&gt;2 5&lt sub&gt; and birth weight in California. J Expo Anal Environ Epidemiol 2004: 14 (5): 391–396.

    Article  CAS  PubMed  Google Scholar 

  • Bell M.L., Ebisu K., and Belanger K. Ambient air pollution and low birth weight in Connecticut and Massachusetts. Environ Health Perspect 2007: 115 (7): 1118–1124.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Bobak M. Outdoor air pollution, low birth weight, and prematurity. Environ Health Perspect 2000: 108 (2): 173–176.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Chen L., Yang W., Jennison B.L., Goodrich A., and Omaye S.T. Air pollution and birth weight in Northern Nevada, 1991–1999. Inhal Toxicol 2002: 14: 141–157.

    Article  CAS  PubMed  Google Scholar 

  • Crofts B.J., King R., and Johnson A. The contribution of low birth weight to severe vision loss in a geographically defined population. Br J Ophthalmol 1998: 82 (1): 9–13.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Dominici F., Sheppard L., and Clyde M. Health effects of air pollution: A statistical review. Int Stat Rev 2003: 71 (2): 243–276.

    Article  Google Scholar 

  • Dockery D.W., Pope C.A., Xu X., Spengler J.D., Ware J.H., and Fay M.E., et al. An association between air pollution and mortality in six US cities. N Engl J Med 1993: 329 (24): 1754–1759.

    Article  Google Scholar 

  • Dugandzic R., Dodds L., Stieb D., and Smith-Doiron M. The association between low level exposures to ambient air pollution and term low birth weight: a retrospective cohort study. Environ Health 2006: 5 (1): 3.

    Article  PubMed  PubMed Central  Google Scholar 

  • Glinianaia S.V., Rankin J., Bell R., Pless-Mulloli T., and Howel D. Particulate air pollution and fetal health a systematic review of the epidemiologic evidence. Epidemiology 2004: 15 (1): 36–45.

    Article  PubMed  Google Scholar 

  • Gouveia N., Bremner S.A., and Novaes H.M. Association between ambient air pollution and birth weight in Sao Paulo, Brazil. J Epidemiol Community Health 2004: 58 (1): 11–17.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Hansen C.A., Barnett A.G., and Pritchard G. The effect of ambient air pollution during early pregnancy on fetal ultrasonic measurements during mid-pregnancy. Environ Health Perspect 2008: 116 (3): 362–369.

    Article  PubMed  Google Scholar 

  • Ha E-H., Hong Y-C., Lee B-E., Woo B-H., Schwartz J., and Christiani D.C. Is air pollution a risk factor for low birth weight in Seoul? Epidemiology 2001: 12 (6): 643–648.

    Article  CAS  PubMed  Google Scholar 

  • Hack M., Klein N.K., and Taylor H.G. Long-term developmental outcomes of low birth weight infants. Future Child 1995: 5 (1): 176–196.

    Article  CAS  PubMed  Google Scholar 

  • Jerrett M., Arain A., Kanaroglou P., Beckerman B., Potoglou D., and Sahsuvaroglu T., et al. A review and evaluation of intraurban air pollution exposure models. J Expo Anal Environ Epidemiol 2005: 15 (2): 185–204.

    Article  CAS  PubMed  Google Scholar 

  • Kuban K.C., and Leviton A. Cerebral Palsy. N Engl J Med 1994: 330 (3): 188–195.

    Article  CAS  PubMed  Google Scholar 

  • Lee B.E., Ha E.H., Park H.S., Kim Y.J., Hong Y.C., Kim H., and Lee J.T. Exposure to air pollution during different gestational phases contributes to risks of low birth weight. Hum Reprod 2003: 18 (3): 638–643.

    Article  CAS  PubMed  Google Scholar 

  • Lemons J.A., Bauer C.R., Oh W., Korones S.B., Papile L.A., Stoll B.J., Verter J., Temprosa M., Wright L.L., Ehrenkranz R.A., Fanaroff A.A., Stark A., Carlo W., Tyson J.E., Donovan E.F., Shankaran S., and Stevenson D.K. Very low birth weight outcomes of the National Institute of Child Health and Human Development Neonatal Research Network, January 1995 through December 1996. NICHD Neonatal Research Network. Pediatrics 2001: 107 (1): E1.

    Article  CAS  PubMed  Google Scholar 

  • Liu S., Krewski D., Shi Y., Chen Y., and Burnett R.T. Association between gaseous ambient air pollutants and adverse pregnancy outcomes in Vancouver, Canada. Environ Health Perspect 2003: 111 (14): 1773–1778.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Lin C.M., Li C.Y., Yang C.Y., and Mao I.F. Association between maternal exposure to elevated ambient sulfur dioxide during pregnancy and term low birth weight. Environ Res 2004: 96: 41–50.

    Article  CAS  PubMed  Google Scholar 

  • Lorenz J.M., Wooliever D.E., Jetton J.R., and Paneth N. A quantitative review of mortality and developmental disability in extremely premature newborns. Arch Pediatr Adolesc Med 1998: 152 (5): 425–435.

    Article  CAS  PubMed  Google Scholar 

  • Mannes T., Jalaludin B., Morgan G., Lincoln D., Sheppeard V., and Corbett S. Impact of ambient air pollution on birth weight in Sydney, Australia. Occup Environ Med 2005: 62: 524–530.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Maroziene L., and Grazuleviciene R. Maternal exposure to low-level air pollution and pregnancy outcomes: a population-based study. Environ Health 2002: 1 (1): 6.

    Article  PubMed  PubMed Central  Google Scholar 

  • Maisonet M., Bush T.J., Correa A., and Jaakkola J.K. Relation between ambient air pollution and low birth weight in the Northeastern United States. Environ Health Perspect 2001: 109 (3): 351–356.

    CAS  PubMed  PubMed Central  Google Scholar 

  • Mannes T., Jalaludin B., Morgan G., Lincoln D., Sheppeard V., and Corbett S. Impact of ambient air pollution on birth weight in Sydney, Australia. Occup Environ Med 2005: 62 (8): 524–530.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • McCormick M.C. The contribution of low birth weight to infant mortality and childhood morbidity. N Engl J Med 1985: 312 (2): 82–90.

    Article  CAS  PubMed  Google Scholar 

  • Myers E., McCrory D., Mills A., Price T., Swamy G., and Tantibhedhyangkul J., et al. Effectiveness of Assisted Reproductive Technology. Evidence Report/Technology Assessment No. 167 Rockville MD Agency for Healthcare Research and Quality.

  • NRC. Research Priorities for Airborne Particulate Matter, I: Immediate Priorities in a Long-Range Research Portfolio. National Academy Press, Washington, DC, 1998.

  • NRC. Research Priorities for airborne Particulate Matter, IV: Continuing Research Progress. National Academy Press, Washington, DC, 2004.

  • Perera F.P., Jedrychowski W., Rauh V., and Whyatt R.M. Molecular epidemiologic research on the effects of environmental pollutants on the fetus. Environ Health Perspect 1999: 107 Suppl 3: 451–460.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Parker J.D., Woodruff T.J., Basu R., and Schoendorf K.C. Air pollution and birth weight among term infants in California. Pediatrics 2005: 115 (1): 121–128.

    Article  PubMed  Google Scholar 

  • Parker J.D., Woodruff T.J., Basu R., and Schoendorf K.C. Air pollution and birth weight among term infants in California. Pediatrics 2005: 115 (1): 121–128.

    Article  PubMed  Google Scholar 

  • Perera F.P., Jedrychowski W., Rauh V., and Whyatt R.M. Molecular epidemiologic research on the effects of environmental pollutants on the fetus. Environ Health Perspect 1999: 107 (S3): 451–460.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Pope III C.A., Burnett R.T., Thun M., Calle E.E., Krewski D., and Ito K., et al. Lung cancer, cardiopulmonary mortality, and long-term exposure to fine particulate air pollution. J Am Med Assoc 2002: 287 (9): 1132–1141.

    Article  CAS  Google Scholar 

  • Resnick M.B., Gueorguieva R.V., Carter R.L., Ariet M., Sun Y., and Roth J., et al. The impact of low birth weight, perinatal conditions, and sociodemographic factors on educational outcome in kindergarten. Pediatrics 1999: 104 (6): e74.

    Article  CAS  PubMed  Google Scholar 

  • Resnick M.B., Gueorguieva R.V., Carter R.L., Ariet M., Sun Y., Roth J., Bucciarelli R.L., Curran J.S., and Mahan C.S. The impact of low birth weight, perinatal conditions, and sociodemographic factors on educational outcome in kindergarten. Pediatrics 1999: 104 (6): e74.

    Article  CAS  PubMed  Google Scholar 

  • Ritz B., Wilhelm M., and Zhao Y. Air pollution and infant death in Southern California, 1989-2000. Pediatrics 2006: 118: 493–502.

    Article  PubMed  Google Scholar 

  • Ritz B., Yu F., Chapa G., and Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology 2000: 11 (5): 502–511.

    Article  CAS  PubMed  Google Scholar 

  • Ritz B., Yu F., Chapa G., and Fruin S. Effect of air pollution on preterm birth among children born in Southern California between 1989 and 1993. Epidemiology 2000: 11 (5): 502–511.

    Article  CAS  PubMed  Google Scholar 

  • Ross G., Lipper E.G., and Auld P.A. Social competence and behavior problems in premature children at school age. Pediatrics 1990: 86 (3): 391–397.

    CAS  PubMed  Google Scholar 

  • Rogers J.F., and Dunlop A.L. Air pollution and very low birth weight infants: a target population? Pediatrics 2006: 118 (1): 156–164.

    Article  PubMed  Google Scholar 

  • Saigal S, Hoult L.A., Streiner D.L., Stoskopf B.L., and Rosenbaum P.L. School difficulties at adolescence in a regional cohort of children who were extremely low birth weight. Pediatrics 2000: 105 (2): 325–331.

    Article  CAS  PubMed  Google Scholar 

  • Salam M.T., Millstein J., Li Y.F., Lurmann F.W., Margolis H.G., and Gilliland F.D. Birth outcomes and prenatal exposure to ozone, carbon monoxide, and particulate matter: results from the Children′s Health Study. Environ Health Perspect 2005: 113 (11): 1638–1644.

    Article  PubMed  PubMed Central  Google Scholar 

  • Samet J.M., Dominici F., Curriero F.C., Coursac I., and Zeger S.L. Fine particulate air pollution and mortality in 20 US cities, 1987–1994. N Engl J Med 2000: 343: 1742–1749.

    Article  CAS  PubMed  Google Scholar 

  • Thomas D., Stram D., and Dwyer J. Exposure measurement error: influence on exposure-disease relationships and methods of correction. Annu Rev Public Health 1993: 14: 69–93.

    Article  CAS  PubMed  Google Scholar 

  • US Environmental Protection Agency. Air Quality System, http://www.epa.gov/ttn/airs/airsaqs/detaildata/downloadaqsdata.htm, 2006a.

  • US Environmental Protection Agency. Clean Air Scientific Advisory Committee Recommendations Concerning the Final Ambient Air Quality Standards for Particulate Matter, (EPA-CASCA-LTR- 06-03) 2006b.

  • US Environmental Protection Agency. Air Quality Criteria for Particulate Matter. US EPA, Research Triangle Park, NC, EPA/600/P-99/002aF 2004.

  • Vassilev Z.P., Robson M.G., and Klotz J.B. Associations of polycyclic organic matter in outdoor air with decreased birth weight: a pilot cross-sectional analysis. J Toxicol Environ Health 2001: 64 (Part A): 595–605.

    Article  CAS  Google Scholar 

  • Yang C-Y., Tseng Y-T., and Chang C-C. Effects of air pollution on birth weight among children born between 1995 and 1997 in Kaohsiung, Taiwan. J Toxicol Environ Health 2003: 66 (Part A): 807–816.

    Article  CAS  Google Scholar 

  • Yang C.Y.,, Tseng Y.T., and Chang C.C. Effects of air pollution on birth weight among children born between 1995 and 1997 in Kaohsiung, Taiwan. J Toxicol Environ Health 2003: 66: 807–816.

    Article  CAS  Google Scholar 

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Acknowledgements

This work is supported by the Southern Center on Environmentally-Driven Disparities in Birth Outcomes, EPA grant RD 83329301-0 and by the Center for Geospatial Medicine, NIH grant 1-P20-RR020782-01. We acknowledge important advice and guidance provided by Alan Gelfand, Martha Keating, and Kerry Williams. This research was supported by funding from the National Institutes of Health (1-P20-RR020782-01) and the Environmental Protection Agency (RD-83329301-0).

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Correspondence to Marie Lynn Miranda.

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Gray, S., Edwards, S. & Miranda, M. Assessing exposure metrics for PM and birth weight models. J Expo Sci Environ Epidemiol 20, 469–477 (2010). https://doi.org/10.1038/jes.2009.52

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