Ambient air pollution and low birth weight: are some women more vulnerable than others?

TY - JOUR

T1 - Ambient air pollution and low birth weight

T2 - are some women more vulnerable than others?

AU - Westergaard, Nadja

AU - Gehring, Ulrike

AU - Slama, Rémy

AU - Pedersen, Marie

PY - 2017/7

Y1 - 2017/7

N2 - Background and objectives: Ambient air pollution is controllable, and it is one of the greatest environmental threats to human health. Studies conducted worldwide have provided evidence that maternal exposure to ambient air pollution during pregnancy enhances the risk of low birth weight at term (TLBW, < 2500 g among infants born ≥ 37 completed weeks of gestation), a maker of intrauterine growth restriction (IUGR), and suggest that some subgroups of pregnant women who are smoking, of low or high body-mass index (BMI), low socioeconomic status (SES) or asthma are more vulnerable towards the effect of ambient air pollution. The aim of this commentary is to review the published literature on the association between ambient air pollution and TLBW regarding increased vulnerability for the above-mentioned subgroups. Results: Although more than fifty epidemiological studies have examined the associations between ambient air pollution and TLBW to date, we only identified six studies that examined the potential effect modification of the association between ambient air pollution and TLBW by the above listed maternal risk factors. Two studies assessed effect modification caused by smoking on the association between ambient air pollution and TLBW. The adjusted odds ratio (OR) for TLBW associated with exposure to ambient air pollution were in one study higher among women who smoked during pregnancy, as compared to the OR of non-smoking women, while in the other study the association was in the opposite direction. The association of ambient air pollution and TLBW were higher among women characterized by extreme BMI (two studies) and low SES compared to non-obese women or women of higher SES (four studies), respectively. Only one study reported the estimated effects among asthmatic and non-asthmatic women and no statistically significant effect modification was evident for the risk of TLBW associated with ambient air pollution. Conclusion and recommendations: The current epidemiologic evidence is scarce, but suggests that pregnant women who are smoking, being underweight, overweight/obese or having lower SES are a vulnerable subpopulation when exposed to ambient air pollution, with and increased risk of having a child with TLBW. The limited evidence precludes for definitive conclusions and further studies are recommended.

AB - Background and objectives: Ambient air pollution is controllable, and it is one of the greatest environmental threats to human health. Studies conducted worldwide have provided evidence that maternal exposure to ambient air pollution during pregnancy enhances the risk of low birth weight at term (TLBW, < 2500 g among infants born ≥ 37 completed weeks of gestation), a maker of intrauterine growth restriction (IUGR), and suggest that some subgroups of pregnant women who are smoking, of low or high body-mass index (BMI), low socioeconomic status (SES) or asthma are more vulnerable towards the effect of ambient air pollution. The aim of this commentary is to review the published literature on the association between ambient air pollution and TLBW regarding increased vulnerability for the above-mentioned subgroups. Results: Although more than fifty epidemiological studies have examined the associations between ambient air pollution and TLBW to date, we only identified six studies that examined the potential effect modification of the association between ambient air pollution and TLBW by the above listed maternal risk factors. Two studies assessed effect modification caused by smoking on the association between ambient air pollution and TLBW. The adjusted odds ratio (OR) for TLBW associated with exposure to ambient air pollution were in one study higher among women who smoked during pregnancy, as compared to the OR of non-smoking women, while in the other study the association was in the opposite direction. The association of ambient air pollution and TLBW were higher among women characterized by extreme BMI (two studies) and low SES compared to non-obese women or women of higher SES (four studies), respectively. Only one study reported the estimated effects among asthmatic and non-asthmatic women and no statistically significant effect modification was evident for the risk of TLBW associated with ambient air pollution. Conclusion and recommendations: The current epidemiologic evidence is scarce, but suggests that pregnant women who are smoking, being underweight, overweight/obese or having lower SES are a vulnerable subpopulation when exposed to ambient air pollution, with and increased risk of having a child with TLBW. The limited evidence precludes for definitive conclusions and further studies are recommended.

KW - Ambient air pollution

KW - Maternal asthma

KW - Maternal obesity

KW - Maternal smoking and socioeconomic status

KW - Term low birth weight

UR - http://www.scopus.com/inward/record.url?scp=85017147429&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2017.03.026

DO - 10.1016/j.envint.2017.03.026

M3 - Journal article

C2 - 28390661

AN - SCOPUS:85017147429

SN - 0160-4120

VL - 104

SP - 146

EP - 154

JO - Environment international

JF - Environment international

ER -