TY - JOUR

T1 - Ambient air pollution and low birthweight

T2 - a European cohort study (ESCAPE)

AU - Pedersen, Marie

AU - Giorgis-Allemand, Lise

AU - Bernard, Claire

AU - Aguilera, Inmaculada

AU - Andersen, Anne-Marie Nybo

AU - Ballester, Ferran

AU - Beelen, Rob M J

AU - Chatzi, Leda

AU - Cirach, Marta

AU - Danileviciute, Asta

AU - Dedele, Audrius

AU - Eijsden, Manon van

AU - Estarlich, Marisa

AU - Fernández-Somoano, Ana

AU - Fernández, Mariana F

AU - Forastiere, Francesco

AU - Gehring, Ulrike

AU - Grazuleviciene, Regina

AU - Gruzieva, Olena

AU - Heude, Barbara

AU - Hoek, Gerard

AU - de Hoogh, Kees

AU - van den Hooven, Edith H

AU - Håberg, Siri E

AU - Jaddoe, Vincent W V

AU - Klümper, Claudia

AU - Korek, Michal

AU - Krämer, Ursula

AU - Lerchundi, Aitana

AU - Lepeule, Johanna

AU - Nafstad, Per

AU - Nystad, Wenche

AU - Patelarou, Evridiki

AU - Porta, Daniela

AU - Postma, Dirkje

AU - Raaschou-Nielsen, Ole

AU - Rudnai, Peter

AU - Sunyer, Jordi

AU - Stephanou, Euripides

AU - Sørensen, Mette

AU - Thiering, Elisabeth

AU - Tuffnell, Derek

AU - Varró, Mihály J

AU - Vrijkotte, Tanja G M

AU - Wijga, Alet

AU - Wilhelm, Michael

AU - Wright, John

AU - Nieuwenhuijsen, Mark J

AU - Pershagen, Göran

AU - Brunekreef, Bert

AU - Kogevinas, Manolis

AU - Slama, Rémy

N1 - Copyright © 2013 Elsevier Ltd. All rights reserved.

PY - 2013/11

Y1 - 2013/11

N2 - BACKGROUND: Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution on birthweight.METHODS: We pooled data from 14 population-based mother-child cohort studies in 12 European countries. Overall, the study population included 74 178 women who had singleton deliveries between Feb 11, 1994, and June 2, 2011, and for whom information about infant birthweight, gestational age, and sex was available. The primary outcome of interest was low birthweight at term (weight <2500 g at birth after 37 weeks of gestation). Mean concentrations of particulate matter with an aerodynamic diameter of less than 2·5 μm (PM2·5), less than 10 μm (PM10), and between 2·5 μm and 10 μm during pregnancy were estimated at maternal home addresses with temporally adjusted land-use regression models, as was PM2·5 absorbance and concentrations of nitrogen dioxide (NO2) and nitrogen oxides. We also investigated traffic density on the nearest road and total traffic load. We calculated pooled effect estimates with random-effects models.FINDINGS: A 5 μg/m(3) increase in concentration of PM2·5 during pregnancy was associated with an increased risk of low birthweight at term (adjusted odds ratio [OR] 1·18, 95% CI 1·06-1·33). An increased risk was also recorded for pregnancy concentrations lower than the present European Union annual PM2·5 limit of 25 μg/m(3) (OR for 5 μg/m(3) increase in participants exposed to concentrations of less than 20 μg/m(3) 1·41, 95% CI 1·20-1·65). PM10 (OR for 10 μg/m(3) increase 1·16, 95% CI 1·00-1·35), NO2 (OR for 10 μg/m(3) increase 1·09, 1·00-1·19), and traffic density on nearest street (OR for increase of 5000 vehicles per day 1·06, 1·01-1·11) were also associated with increased risk of low birthweight at term. The population attributable risk estimated for a reduction in PM2·5 concentration to 10 μg/m(3) during pregnancy corresponded to a decrease of 22% (95% CI 8-33%) in cases of low birthweight at term.INTERPRETATION: Exposure to ambient air pollutants and traffic during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced.FUNDING: The European Union.

AB - BACKGROUND: Ambient air pollution has been associated with restricted fetal growth, which is linked with adverse respiratory health in childhood. We assessed the effect of maternal exposure to low concentrations of ambient air pollution on birthweight.METHODS: We pooled data from 14 population-based mother-child cohort studies in 12 European countries. Overall, the study population included 74 178 women who had singleton deliveries between Feb 11, 1994, and June 2, 2011, and for whom information about infant birthweight, gestational age, and sex was available. The primary outcome of interest was low birthweight at term (weight <2500 g at birth after 37 weeks of gestation). Mean concentrations of particulate matter with an aerodynamic diameter of less than 2·5 μm (PM2·5), less than 10 μm (PM10), and between 2·5 μm and 10 μm during pregnancy were estimated at maternal home addresses with temporally adjusted land-use regression models, as was PM2·5 absorbance and concentrations of nitrogen dioxide (NO2) and nitrogen oxides. We also investigated traffic density on the nearest road and total traffic load. We calculated pooled effect estimates with random-effects models.FINDINGS: A 5 μg/m(3) increase in concentration of PM2·5 during pregnancy was associated with an increased risk of low birthweight at term (adjusted odds ratio [OR] 1·18, 95% CI 1·06-1·33). An increased risk was also recorded for pregnancy concentrations lower than the present European Union annual PM2·5 limit of 25 μg/m(3) (OR for 5 μg/m(3) increase in participants exposed to concentrations of less than 20 μg/m(3) 1·41, 95% CI 1·20-1·65). PM10 (OR for 10 μg/m(3) increase 1·16, 95% CI 1·00-1·35), NO2 (OR for 10 μg/m(3) increase 1·09, 1·00-1·19), and traffic density on nearest street (OR for increase of 5000 vehicles per day 1·06, 1·01-1·11) were also associated with increased risk of low birthweight at term. The population attributable risk estimated for a reduction in PM2·5 concentration to 10 μg/m(3) during pregnancy corresponded to a decrease of 22% (95% CI 8-33%) in cases of low birthweight at term.INTERPRETATION: Exposure to ambient air pollutants and traffic during pregnancy is associated with restricted fetal growth. A substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution was reduced.FUNDING: The European Union.

KW - Adult

KW - Air Pollution

KW - Birth Weight

KW - Environmental Exposure

KW - Environmental Illness

KW - Environmental Monitoring

KW - Europe

KW - Female

KW - Humans

KW - Incidence

KW - Infant, Low Birth Weight

KW - Infant, Newborn

KW - Male

KW - Maternal Exposure

KW - Particulate Matter

KW - Pregnancy

KW - Young Adult

U2 - 10.1016/S2213-2600(13)70192-9

DO - 10.1016/S2213-2600(13)70192-9

M3 - Journal article

C2 - 24429273

VL - 1

SP - 695

EP - 704

JO - The Lancet Respiratory Medicine

JF - The Lancet Respiratory Medicine

SN - 2213-2600

IS - 9

ER -