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      Fine Particulate Air Pollution and Adverse Birth Outcomes: Effect Modification by Regional Nonvolatile Oxidative Potential

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          Abstract

          Background:

          Prenatal exposure to fine particulate matter air pollution with aerodynamic diameter 2.5μm ( PM2.5 ) has been associated with preterm delivery and low birth weight (LBW), but few studies have examined possible effect modification by PM2.5 oxidative potential.

          Objectives:

          The aim of this study was to evaluate if regional differences in the oxidative potential of PM2.5 modify the relationship between PM2.5 and adverse birth outcomes.

          Methods:

          A retrospective cohort study was conducted using 196,171 singleton births that occurred in 31 cities in the province of Ontario, Canada, from 2006 to 2012. Daily air pollution data were collected from ground monitors, and city-level PM2.5 oxidative potential was measured. We used random-effects meta-analysis to combine the estimates of effect from regression models across cities on preterm birth, term LBW, and term birth weight and used meta-regression to evaluate the modifying effect of PM2.5 oxidative potential.

          Results:

          An interquartile increase ( 2.6μg/m3 ) in first-trimester PM2.5 was positively associated with term LBW among women in the highest quartile of glutathione (GSH)-related oxidative potential [ oddsratio(OR)=1.28 ; 95% confidence interval (CI): 1.10, 1.48], but not the lowest quartile ( OR=0.99 ; 95% CI: 0.87, 1.14; p-interaction=0.03 ). PM2.5 on the day of delivery also was associated with preterm birth among women in the highest quartile of GSH-related oxidative potential [ hazardratio(HR)=1.02 ; 95% CI: 1.01, 1.04], but not the lowest quartile [ HR=0.97 ; 95% CI: 0.95, 1.00; p-interaction=0.04 ]. Between-city differences in ascorbate (AA)-related oxidative potential did not significantly modify associations with PM2.5 .

          Conclusions:

          Between-city differences in GSH-related oxidative potential may modify the impact of PM2.5 on the risk of term LBW and preterm birth. https://doi.org/10.1289/EHP2535

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          Most cited references41

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          A new and improved population-based Canadian reference for birth weight for gestational age.

          Existing fetal growth references all suffer from 1 or more major methodologic problems, including errors in reported gestational age, biologically implausible birth weight for gestational age, insufficient sample sizes at low gestational age, single-hospital or other non-population-based samples, and inadequate statistical modeling techniques. We used the newly developed Canadian national linked file of singleton births and infant deaths for births between 1994 and 1996, for which gestational age is largely based on early ultrasound estimates. Assuming a normal distribution for birth weight at each gestational age, we used the expectation-maximization algorithm to exclude infants with gestational ages that were more consistent with 40-week births than with the observed gestational age. Distributions of birth weight at the corrected gestational ages were then statistically smoothed. The resulting male and female curves provide smooth and biologically plausible means, standard deviations, and percentile cutoffs for defining small- and large-for-gestational-age births. Large-for-gestational age cutoffs (90th percentile) at low gestational ages are considerably lower than those of existing references, whereas small-for-gestational-age cutoffs (10th percentile) postterm are higher. For example, compared with the current World Health Organization reference from California (Williams et al, 1982) and a recently proposed US national reference (Alexander et al, 1996), the 90th percentiles for singleton males at 30 weeks are 1837 versus 2159 and 2710 g. The corresponding 10th percentiles at 42 weeks are 3233 versus 3086 and 2998 g. This new sex-specific, population-based reference should improve clinical assessment of growth in individual newborns, population-based surveillance of geographic and temporal trends in birth weight for gestational age, and evaluation of clinical or public health interventions to enhance fetal growth. fetal growth, birth weight, gestational age, preterm birth, postterm birth.
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            Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis.

            Low birth weight and preterm birth have a substantial public health impact. Studies examining their association with outdoor air pollution were identified using searches of bibliographic databases and reference lists of relevant papers. Pooled estimates of effect were calculated, heterogeneity was quantified, meta-regression was conducted and publication bias was examined. Sixty-two studies met the inclusion criteria. The majority of studies reported reduced birth weight and increased odds of low birth weight in relation to exposure to carbon monoxide (CO), nitrogen dioxide (NO(2)) and particulate matter less than 10 and 2.5 microns (PM(10) and PM(2.5)). Effect estimates based on entire pregnancy exposure were generally largest. Pooled estimates of decrease in birth weight ranged from 11.4 g (95% confidence interval -6.9-29.7) per 1 ppm CO to 28.1g (11.5-44.8) per 20 ppb NO(2), and pooled odds ratios for low birth weight ranged from 1.05 (0.99-1.12) per 10 μg/m(3) PM(2.5) to 1.10 (1.05-1.15) per 20 μg/m(3) PM(10) based on entire pregnancy exposure. Fewer effect estimates were available for preterm birth and results were mixed. Pooled odds ratios based on 3rd trimester exposures were generally most precise, ranging from 1.04 (1.02-1.06) per 1 ppm CO to 1.06 (1.03-1.11) per 20 μg/m(3) PM(10). Results were less consistent for ozone and sulfur dioxide for all outcomes. Heterogeneity between studies varied widely between pollutants and outcomes, and meta-regression suggested that heterogeneity could be partially explained by methodological differences between studies. While there is a large evidence base which is indicative of associations between CO, NO(2), PM and pregnancy outcome, variation in effects by exposure period and sources of heterogeneity between studies should be further explored. Crown Copyright © 2012. Published by Elsevier Inc. All rights reserved.
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              Oxidative stress: its role in air pollution and adverse health effects.

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                Author and article information

                Journal
                Environ Health Perspect
                Environ. Health Perspect
                EHP
                Environmental Health Perspectives
                Environmental Health Perspectives
                0091-6765
                1552-9924
                31 July 2018
                July 2018
                : 126
                : 7
                : 077012
                Affiliations
                [ 1 ]Health Canada , Ottawa, Ontario, Canada
                [ 2 ]School of Epidemiology and Public Health, University of Ottawa , Ottawa, Ontario, Canada
                [ 3 ]University of Toronto , Toronto, Canada
                [ 4 ]University of Massachusetts , Amherst, Massachusetts, USA
                [ 5 ]Public Health Ontario , Toronto, Ontario, Canada
                [ 6 ]Dalla Lana School of Public Health, University of Toronto , Toronto, Ontario, Canada
                [ 7 ]Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
                [ 8 ]Department of Epidemiology, Biostatistics and Occupational Health, McGill University , Montreal, Quebec, Canada
                Author notes
                Address correspondence to E. Lavigne, MSc, PhD, Air Health Science Division, Health Canada, 269 Laurier Avenue West, Mail Stop 4903B, Ottawa, Ontario, Canada, K1A 0K9. Telephone: (613) 948-3686. Email: eric.lavigne@ 123456hc-sc.gc.ca
                Article
                EHP2535
                10.1289/EHP2535
                6108848
                30073952
                61838c23-e047-46c0-b1e3-89fac7e58d1b

                EHP is an open-access journal published with support from the National Institute of Environmental Health Sciences, National Institutes of Health. All content is public domain unless otherwise noted.

                History
                : 17 July 2017
                : 03 July 2018
                : 03 July 2018
                Categories
                Research

                Public health
                Public health

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