Ambient air pollution and low birthweight: a European cohort study (ESCAPE)

Marie Pedersen, Lise Giorgis-Allemand, Claire Bernard, Inmaculada Aguilera, Anne-Marie Nybo Andersen, Ferran Ballester, Rob M J Beelen, Leda Chatzi, Marta Cirach, Asta Danileviciute, Audrius Dedele, Manon van Eijsden, Marisa Estarlich, Ana Fernández-Somoano, Mariana F Fernández, Francesco Forastiere, Ulrike Gehring, Regina Grazuleviciene, Olena Gruzieva, Barbara HeudeGerard Hoek, Kees de Hoogh, Edith H van den Hooven, Siri E Håberg, Vincent W V Jaddoe, Claudia Klümper, Michal Korek, Ursula Krämer, Aitana Lerchundi, Johanna Lepeule, Per Nafstad, Wenche Nystad, Evridiki Patelarou, Daniela Porta, Dirkje Postma, Ole Raaschou-Nielsen, Peter Rudnai, Jordi Sunyer, Euripides Stephanou, Mette Sørensen, Elisabeth Thiering, Derek Tuffnell, Mihály J Varró, Tanja G M Vrijkotte, Alet Wijga, Michael Wilhelm, John Wright, Mark J Nieuwenhuijsen, Göran Pershagen, Bert Brunekreef, Manolis Kogevinas, Rémy Slama

345 Citations (Scopus)

Abstract

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 74178 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 25 μm (PM25), less than 10 μm (PM10), and between 25 μm and 10 μm during pregnancy were estimated at maternal home addresses with temporally adjusted land-use regression models, as was PM25 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/m3 increase in concentration of PM25 during pregnancy was associated with an increased risk of low birthweight at term (adjusted odds ratio [OR] 118, 95% CI 106-133). An increased risk was also recorded for pregnancy concentrations lower than the present European Union annual PM25 limit of 25 μg/m3 (OR for 5 μg/m3 increase in participants exposed to concentrations of less than 20 μg/m3 141, 95% CI 120-165). PM10 (OR for 10 μg/m3 increase 116, 95% CI 100-135), NO2 (OR for 10 μg/m3 increase 109, 100-119), and traffic density on nearest street (OR for increase of 5000 vehicles per day 106, 101-111) were also associated with increased risk of low birthweight at term. The population attributable risk estimated for a reduction in PM25 concentration to 10 μg/m3 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.

Original languageEnglish
JournalThe lancet. Respiratory medicine
Volume1
Issue number9
Pages (from-to)695-704
Number of pages10
ISSN2213-2600
DOIs
Publication statusPublished - Nov 2013

Keywords

  • Adult
  • Air Pollution
  • Birth Weight
  • Environmental Exposure
  • Environmental Illness
  • Environmental Monitoring
  • Europe
  • Female
  • Humans
  • Incidence
  • Infant, Low Birth Weight
  • Infant, Newborn
  • Male
  • Maternal Exposure
  • Particulate Matter
  • Pregnancy
  • Young Adult

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