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Ambient air pollution and pregnancy outcomes : a comprehensive review and identification of environmental public health challenges

Klepac, Petra and Locatelli, Igor and Korošec, Sara and Künzli, Nino and Kukec, Andreja. (2018) Ambient air pollution and pregnancy outcomes : a comprehensive review and identification of environmental public health challenges. Environmental research, 167. pp. 144-159.

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Official URL: https://edoc.unibas.ch/69279/

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Abstract

There is a growing number of studies on the association between ambient air pollution and adverse pregnancy outcomes, but their results have been inconsistent. Consequently, a comprehensive review of this research area is needed. There was a wide variability in studied pregnancy outcomes, observed gestational windows of exposure, observed ambient air pollutants, applied exposure assessment methods and statistical analysis methods Gestational duration, preterm birth, (low) birth weight, and small for gestational age/intrauterine growth restriction were most commonly investigated pregnancy outcomes. Gestational windows of exposure typically included were whole pregnancy period, 1st, 2nd, 3rd trimester, first and last gestational months. Preterm birth was the outcome most extensively studied across various gestational windows, especially at the beginning and at the end of pregnancy. Particulate matter, nitrogen dioxide, ozone, and carbon monoxide were the most commonly used markers of ambient air pollution. Continuous monitoring data were frequently combined with spatially more precisely modelled estimates of exposure. Exposure to particulate matter and ozone over the entire pregnancy was significantly associated with higher risk for preterm birth: the pooled effect estimates were 1.09 (1.03-1.16) per 10 μg/m; 3; increase in particulate matter with an aerodynamic diameter of 10 µm or less (PM; 10; ); ,; 1.24 (1.08-1.41) per 10 μg/m; 3; increase in particulate matter with an aerodynamic diameter of 2.5 µm or less (PM; 2.5; ), and 1.03 (1.01-1.04) per 10 ppb increase in ozone. For pregnancy outcomes other than PTB, ranges of observed effect estimates were reported due to smaller number of studies included in each gestational window of exposure. Further research is needed to link the routine pregnancy outcome data with spatially and temporally resolved ambient air pollution data, while adjusting for commonly defined confounders. Methods for assessing exposure to mixtures of pollutants, indoor air pollution exposure, and various other environmental exposures, need to be developed.
Faculties and Departments:09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH) > Department of Epidemiology and Public Health (EPH) > Chronic Disease Epidemiology > Air Pollution and Health (Künzli)
03 Faculty of Medicine > Departement Public Health > Sozial- und Präventivmedizin > Air Pollution and Health (Künzli)
09 Associated Institutions > Swiss Tropical and Public Health Institute (Swiss TPH)
UniBasel Contributors:Künzli, Nino
Item Type:Article, refereed
Article Subtype:Review Article
Publisher:Elsevier
ISSN:0013-9351
Note:Publication type according to Uni Basel Research Database: Journal item
Identification Number:
Last Modified:05 Mar 2019 14:52
Deposited On:05 Mar 2019 14:52

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