Abstract

Background/Aim: Previous studies have shown associations between particulate matter (PM) air pollution and adverse birth outcomes. However, most studies focused on relatively short periods of prenatal exposure to PM and in a low to moderate polluted areas. We examined the possible impact of exposure to particulate matter with diameter ≤10 μm (PM10) and ≤2.5 μm (PM2.5) for a number of years before delivery on the occurrence of adverse birth outcomes: term low birth weight (TLBW), preterm delivery (PTB), and small for gestational age (SGA) in a region exposed to long-range dust transport. Methods: This study was based on a cohort of births (N=90,505) that occurred in Israel during 2013-2015. We calculated prenatal PM averages during 1, 5, and 10 years prior to delivery. Logistic regression models with mother-level as a random intercept were used to determine the association between exposure and adverse birth outcomes, adjusting for a priori known covariates. Results: In fully adjusted models, a 10-μg/m3 increase in PM2.5 during 1-, 5- and 10-years prior to delivery was associated with a monotonically increasing risk of TLBW [odds ratio (OR)=1.51 95% confidence interval (CI): (1.14-1.99), 1.54 (1.12-2.14) and 1.70 (1.21-2.41), respectively] and SGA [1.25 (1.03-1.49), 1.43 (1.16-1.77) and 1.45 (1.16-1.80), respectively]. ORs increased with the length of exposure period also for PM10. For example, ORs for TLBW in association with a 20-μg/m3 increase in PM10 over 1-, 5-, and 10-years prior to delivery were 1.25 (1.00-1.58), 1.32 (1.01-1.72) and 1.46 (1.11-1.90), respectively. PTB was not associated with neither PM2.5 nor PM10. For example, the OR for PTB in association with a 10-μg/m3 increase in PM2.5 over 10-years prior to delivery was 1.19 (0.91-1.52).Conclusions The magnitude of the estimated associations between maternal exposure to both PM2.5 and PM10 exposure and birth outcomes increased with the length of the exposure period.

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