Effect of residential wood-burning air pollution on pre-eclampsia in Temuco, Chile

Abstract

TPS 722: Low and middle income countries: indoor air pollutants, Exhibition Hall, Ground floor, August 28, 2019, 3:00 PM - 4:30 PM Hypertensive disorders of pregnancy are the leading of maternal mortality, contributing to perinatal death, placental abruption, preterm birth and intra-uterine growth restriction, with pre-eclampsia being the most common hypertensive. Clinical risk factors for pre-eclampsia are well-documented, and include advanced maternal age, family history and among others, but identification of populationally preventable risk factors have been more challenging. The aim of this study is to explore the effect of PM2.5 attributed to residential wood-burning on hypertensive disorders of pregnancy and pre-eclampsia, in a retrospective cohort of pregnant women in Temuco, Chile. To assess the association between residential wood-burning exposures and pregnancy disorders, we designed a retrospective cohort study. The cohort was conformed from a database of pregnant women attending the Obstetric Department database of the Dr Hernán Henríquez Aravena Hospital between 2009 and 2015. To estimate individual exposures to PM2.5, LUR models were implemented. Women residence and time of pregnancy were used as input to the models to predict individual exposures to PM2.5 and wood-tracers. Estimates were obtained by trimester of pregnancy and for the whole period. The effects of air pollution were studied using multivariate logistic regression models adjusted for potential confounders. Sensitivity analysis were carried out. In total, 23,175 births were registered in the Dr Hernán Henriquez Hospital during the study period. The prevalence of gestational diabetes was 5.9%, hypertensive disorders of pregnancy was 9.9 and pre-eclampsia 3.4%. The median exposure levels of PM2.5 in the city was 65.1 ug/m3 (IQR:58.2) over the study period. Multivariates models are being built and it will be ready by end of April. Our study shows a city heavily impacted for air pollution due to residential wood-burning. This is the first study about hypertensive disorders of pregnancy in Chile. Also, the first in evaluating the impact of air pollution on reproductive outcomes.