Spatiotemporal variation of PM2.5-related preterm birth in China and India during 1990–2019 and implications for emission controls

Abstract

Preterm birth is the leading threat to neonatal health. The variation of PM2.5-associated preterm birth in China and India from 1990 through 2019 was estimated in this study. Meanwhile, four mitigation scenarios were proposed, and the corresponding PM2.5-related preterm birth was projected for 2030. Owing to differences in emission control policies and the effects of various factors (e.g., differences in population-control policies), the PM2.5 concentration and PM2.5-associated preterm birth in the two countries presented disparate spatiotemporal characteristics and variation trends during 1990–2019. The 30-year average of annual PM2.5-associated preterm birth in India was 1018 (95% confidence interval, 718–1289) thousand, which was much larger than in China (280 [196−358] thousand). To fight air pollution, China launched several control strategies in the past two decades, and the nationwide maternal exposure risk dramatically decreased after 2010. In contrast, India’s air-pollution control measures and policies have not effectively mitigated the nationwide PM2.5 pollution. Under current mitigation measures and policies, the projected decrease in maternal exposure risk by 2030 is greater for China than India, and the scope for controlling air pollutant emissions and reducing maternal exposure risk is much large for India. The results of all four scenarios revealed that the annual PM2.5-associated preterm birth in the two countries is likely to decrease in the future. In particular, if China and India implement more robust emission control strategies than those currently, the number of associated preterm birth is projected to be more than 50% lower in 2030 compared with 2019 rates.