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Synergic effects of PM1 and thermal inversion on the incidence of small for gestational age infants: a weekly-based assessment

Journal of Exposure Science & Environmental Epidemiology volume 33, pages 652–662 (2023)Cite this article

Abstract

Background

The synergic effects of thermal inversion (TI) and particulate matter with an aerodynamic diameter ≤1 μm (PM1) exposure and incidence of small for gestational age (SGA) was not clear.

Objective

We aimed to explore the independent effects of prenatal TI and PM1 exposure on incidence of SGA and their potential interactive effects.

Methods

A total of 27,990 pregnant women who delivered in Wuhan Children’s Hospital from 2017 to 2020 were included. The daily mean concentration of PM1 was obtained from ChinaHighAirPollutants (CHAP) and matched with the residential address of each woman. Data on TI was derived from National Aeronautics and Space Administration (NASA). The independent effects of PM1 and TI exposures on SGA in each gestational week were estimated by the distributed lag model (DLM) nested in Cox regression model, and the potential interactive effects of PM1 and TI on SGA were investigated by adapting the relative excess risk due to interaction (RERI) index.

Results

Per 10 μg/m3 increase in PM1 was associated with an increase in the risk of SGA at 1–3 and 17–23 gestational weeks, with the strongest effect at the first gestational week (HR = 1.043, 95%CI: 1.008, 1.078). Significant links between one day increase of TI and SGA were found at the 1–4 and 13–23 gestational weeks and the largest effects were observed at the 17th gestational week (HR = 1.018, 95%CI: 1.009, 1.027). Synergistic effects of PM1 and TI on SGA were detected in the 20th gestational week, with RERI of 0.208 (95%CI: 0.033,0.383).

Impact statement

Both prebirth PM1 and TI exposure were significantly associated with SGA. Simultaneous exposure to PM1 and TI might have synergistic effect on SGA. The second trimester seems to be a sensitive window of environmental and air pollution exposure.

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Fig. 1: Flow chart of the cohort study population selection.
Fig. 2: The locations of residences of SGA gravidas and AGA gravidas.
Fig. 3: Hazard ratios (95% CI) for SGA with per 1 μg/m3 increase of PM1 during 1–26 gestational weeks in Wuhan, 2017–2020.
Fig. 4: Hazard ratios (95% CI) for SGA with per one day increased in thermal inversion (TI) during 1–26 gestational weeks in Wuhan, 2017–2020.
Fig. 5: Hazard ratios (95% CI) of one-week effects for SGA with per 10 μg/m3 increase of PM1 concentration or per 1day increase of TI in different newborn gender.

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Data availability

The datasets generated during and/or analysed during the current study are not publicly available but are available from the corresponding author on reasonable request.

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Funding

This study was funded by grants from the Fundamental Research Funds for the Central Universities (204202021kf0044).

Author information

Author notes

  1. These authors contributed equally: Xupeng Zhang, Faxue Zhang and Yan Gao.

Authors and Affiliations

  1. Department of Public Health, School of Public Health, Wuhan University, Wuhan, 430071, China

    Xupeng Zhang, Gaichan Zhao & Dejia Li

  2. Department of Occupational and Environmental Health, School of Public Health, Wuhan University, Wuhan, 430071, China

    Faxue Zhang, Shijie Zhu, Xiaowei Zhang, Tianzhou Li, Wei Zhu & Dejia Li

  3. Department of Neonatology, Lianyungang Maternal and Child Health Hospital, Lianyungang, 222006, China

    Yan Gao

  4. Department of Obstetrics and Gynecology, Wuhan Children’s Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430014, China

    Yuanyuan Zhong & Yan Zhang

  5. Department of Global Health, School of Public Health, Wuhan University, Wuhan, 430071, China

    Bingbing Chen

  6. Department of Preventive Medicine, School of Public Health, Wuhan University, Wuhan, 430071, China

    Aojing Han

  7. Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD, 20740, USA

    Jing Wei

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Contributions

JW, WZ and DL conceived and designed the study; YZhang, YZhong, GZ, SZ, Xiaowei Zhang, TL, BC and AH collected and cleaned the data; Xupeng Zhang and FZ performed the data analysis and drafted the manuscript. YG helped revise the manuscript. All authors read and approved the final manuscript.

Corresponding authors

Correspondence to Jing Wei, Wei Zhu or Dejia Li.

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The authors declare no competing interests.

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This study was approved by the Ethics Committee of Wuhan Children’s Hospital (2021R139-F01).

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Zhang, X., Zhang, F., Gao, Y. et al. Synergic effects of PM1 and thermal inversion on the incidence of small for gestational age infants: a weekly-based assessment. J Expo Sci Environ Epidemiol 33, 652–662 (2023). https://doi.org/10.1038/s41370-023-00542-0

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  • DOI: https://doi.org/10.1038/s41370-023-00542-0

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