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Lu X, Zhang Y, Jiang R, Qin G, Ge Q, Zhou X, Zhou Z, Ni Z, Zhuang X. Interpregnancy interval, air pollution, and the risk of low birth weight: a retrospective study in China. BMC Public Health 2024; 24:2529. [PMID: 39289643 DOI: 10.1186/s12889-024-19711-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Accepted: 08/07/2024] [Indexed: 09/19/2024] Open
Abstract
BACKGROUND Both interpregnancy intervals (IPI) and environmental factors might contribute to low birth weight (LBW). However, the extent to which air pollution influences the effect of IPIs on LBW remains unclear. We aimed to investigate whether IPI and air pollution jointly affect LBW. METHODS A retrospective cohort study was designed in this study. The data of birth records was collected from the Jiangsu Maternal Child Information System, covering January 2020 to June 2021 in Nantong city, China. IPI was defined as the duration between the delivery date for last live birth and date of LMP for the subsequent birth. The maternal exposure to ambient air pollutants during pregnancy-including particulate matter (PM) with an aerodynamic diameter of ≤ 2.5 μm (PM2.5), PM10, ozone (O3), nitrogen dioxide (NO2), sulfur dioxide (SO2) and carbon monoxide (CO)-was estimated using a hybrid kriging-LUR-RF model. A novel air pollution score was proposed, assessing combined exposure to five pollutants (excluding CO) by summing their concentrations, weighted by LBW regression coefficients. Multivariate logistic regression models were used to estimate the effects of IPI, air pollution and their interactions on LBW. Relative excess risk due to interaction (RERI), attributable proportion of interaction (AP) and synergy index (S) were utilized to assess the additive interaction. RESULTS Among 10, 512 singleton live births, the LBW rate was 3.7%. The IPI-LBW risk curve exhibited an L-shaped pattern. The odds ratios (ORs) for LBW for each interquartile range increase in PM2.5, PM10, O3 and the air pollution score were 1.16 (95% CI: 1.01-1.32), 1.30 (1.06-1.59), 1.22 (1.06-1.41), and 1.32 (1.10-1.60) during the entire pregnancy, respectively. An additive interaction between IPI and PM2.5 was noted during the first trimester. Compared to records with normal IPI and low PM2.5 exposure, those with short IPI and high PM2.5 exposure had the highest risk of LBW (relative risk = 3.53, 95% CI: 1.85-6.49, first trimester). CONCLUSION The study demonstrates a synergistic effect of interpregnancy interval and air pollution on LBW, indicating that rational birth spacing and air pollution control can jointly improve LBW outcomes.
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Affiliation(s)
- Xinyu Lu
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China
| | - Yuyu Zhang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China
| | - Run Jiang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China
| | - Gang Qin
- Department of Infectious Diseases, Affiliated Hospital of Nantong University, No.20 Xisi Road, Chongchuan District, Nantong, Jiangsu, China
| | - Qiwei Ge
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China
| | - Xiaoyi Zhou
- Nantong Center for Disease Control and Prevention, 189 Gongnong South Road, Chongchuan District, Nantong, Jiangsu, China
| | - Zixiao Zhou
- Faculty of Medical and Health, the University of Sydney, Sydney, NSW, Australia
| | - Zijun Ni
- School of Science, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China
| | - Xun Zhuang
- Department of Epidemiology and Medical Statistics, School of Public Health, Nantong University, No.9 Seyuan Road, Chongchuan District, Nantong, Jiangsu, China.
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Zhu L, Yuan Y, Mayvaneh F, Sun H, Zhang Y, Hu C. Maternal ozone exposure lowers infant's birthweight: A nationwide cohort of over 4 million livebirths in Iran. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116840. [PMID: 39126814 DOI: 10.1016/j.ecoenv.2024.116840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Revised: 07/30/2024] [Accepted: 08/02/2024] [Indexed: 08/12/2024]
Abstract
BACKGROUND Nationwide evidence linking maternal ozone exposure with fetal growth restriction (FGR) was extensively scarce, especially in the Middle East with dry climate and distinct religious culture. METHODS We carried out a national retrospective birth cohort study using registry-based records from 749 hospitals across 31 provinces in Iran from 2013 to 2018. Monthly concentrations of maximum daily average 8-hour (MDA8) ozone at 0.125° × 0.125° resolution were extracted from well-validated spatiotemporal grid dataset. Linear and logistic regression models were employed to evaluate associations of maternal MDA8 ozone exposure with birthweight outcomes. Assuming causality, the comparative risk assessment framework was utilized to estimate the burden of low birthweight (LBW), small for gestational age (SGA), and birthweight loss per livebirth (BLL) attributable to ambient ozone pollution. RESULTS Of 4030383 livebirths included in the study, 264304 (6.6%) were LBW and 484405 (12.0%) were SGA. Each 10-ppb increase in MDA8 ozone exposure was associated with an odds ratio of 1.123 (95% confidence interval [CI]: 1.104 to 1.142) for LBW and 1.210 (95% CI: 1.197 to 1.223) for SGA, and a 30.5-g (95% CI: 29.0 to 32.0) reduction in birthweight. We observed approximately linear exposure-response relationships of maternal MDA8 ozone exposure with LBW (Pnonlinear= 0.786), SGA (Pnonlinear= 0.156), and birthweight reduction (Pnonlinear= 0.104). Under the premise of causal association, we estimated 6.6% (95% CI: 5.7 to 7.5) of LBW, 10.1% (95% CI: 9.6 to 10.6) of SGA, and 18.8 g (95% CI: 17.9 to 19.7) of BLL could be attributable to maternal ozone exposure in Iran. Considerably greater risk and burden of ozone-related FGR were observed among younger, less-educated, and rural-dwelling mothers. CONCLUSIONS Our study provided compelling evidence that maternal ozone exposure was associated with heightened FGR risk and burden, particularly among socioeconomically disadvantaged mothers. These findings underscored the urgent need for government to incorporate socioeconomic factors into future ozone-related health policies, not only to mitigate pollution, but also minimize inequality.
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Affiliation(s)
- Lifeng Zhu
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Yang Yuan
- Shenzhen Bao'an District Songgang People's Hospital, Shenzhen 518100, China
| | - Fatemeh Mayvaneh
- Climatology Research Group, Institute of Landscape Ecology, University of Münster, Münster 48149, Germany
| | - Haitong Sun
- Centre for Atmospheric Science, Yusuf Hamied Department of Chemistry, University of Cambridge, Cambridge, UK; Department of Paediatrics, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117609, Singapore
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Chengyang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, Hefei 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, China.
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Hu Y, Niu Z, Eckel SP, Toledo-Corral C, Yang T, Chen X, Vigil M, Pavlovic N, Lurmann F, Garcia E, Lerner D, Lurvey N, Grubbs B, Al-Marayati L, Johnston J, Dunton GF, Farzan SF, Habre R, Breton C, Bastain TM. Prenatal exposure to ambient air pollution and persistent postpartum depression. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 953:176089. [PMID: 39250973 DOI: 10.1016/j.scitotenv.2024.176089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Revised: 08/15/2024] [Accepted: 09/04/2024] [Indexed: 09/11/2024]
Abstract
BACKGROUND Ambient air pollution during pregnancy has been linked with postpartum depression up to 12 months, but few studies have investigated its impact on persistent depression beyond 12 months postpartum. This study aimed to evaluate prenatal ambient air pollution exposure and the risk of persistent depression over 3 years after childbirth and to identify windows of susceptibility. METHODS This study included 361 predominantly low-income Hispanic/Latina participants with full-term pregnancies in the Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) cohort. We estimated daily residential PM2.5, PM10, NO2, and O3 concentrations throughout 37 gestational weeks using inverse-distance squared spatial interpolation from monitoring data and calculated weekly averaged levels. Depression was assessed by the 20-item Center for Epidemiologic Studies-Depression (CES-D) scale at 12, 24, and 36 months postpartum, with persistent postpartum depression defined as a CES-D score ≥16 at any of these timepoints. We performed robust Poisson log-linear distributed lag models (DLM) via generalized estimating equations (GEE) to estimate the adjusted risk ratio (RR). RESULTS Depression was observed in 17.8 %, 17.5 %, and 13.4 % of participants at 12, 24, and 36 months, respectively. We found one IQR increase (3.9 ppb) in prenatal exposure to NO2 during the identified sensitive window of gestational weeks 13-29 was associated with a cumulative risk ratio of 3.86 (95 % CI: 3.24, 4.59) for persistent depression 1-3 years postpartum. We also found one IQR increase (7.4 μg/m3) in prenatal exposure to PM10 during gestation weeks 12-28 was associated a cumulative risk ratio of 3.88 (95 % CI: 3.04, 4.96) for persistent depression. No clear sensitive windows were identified for PM2.5 or O3. CONCLUSIONS Mid-pregnancy PM10 and NO2 exposures were associated with nearly 4-fold increased risks of persistent depression after pregnancy, which has critical implications for prevention of perinatal mental health outcomes.
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Affiliation(s)
- Yuhong Hu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia Toledo-Corral
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Xinci Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Mario Vigil
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Erika Garcia
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Brendan Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA; Spatial Sciences Institute, University of Southern California, Los Angeles, CA, USA
| | - Carrie Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
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Niu Z, Habre R, Yang T, Chen X, Vigil M, Barragan K, Lurmann F, Pavlovic NR, Grubbs BH, Toledo-Corral CM, Johnston J, Dunton GF, Lerner D, Lurvey N, Al-Marayati L, Eckel SP, Breton CV, Bastain TM, Farzan SF. Increased Risk of Gestational Hypertension by Periconceptional Exposure to Ambient Air Pollution and Effect Modification by Prenatal Depression. Hypertension 2024; 81:1285-1295. [PMID: 38533642 PMCID: PMC11096032 DOI: 10.1161/hypertensionaha.123.22272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Air pollution has been associated with gestational hypertension (GH) and preeclampsia, but susceptible windows of exposure and potential vulnerability by comorbidities, such as prenatal depression, remain unclear. METHODS We ascertained GH and preeclampsia cases in a prospective pregnancy cohort in Los Angeles, CA. Daily levels of ambient particulate matters (with a diameter of ≤10 μm [PM10] or ≤2.5 μm [PM2.5]), nitrogen dioxide, and ozone were averaged for each week from 12 weeks preconception to 20 gestational weeks. We used distributed lag models to identify susceptible exposure windows, adjusting for potential confounders. Analyses were additionally stratified by probable prenatal depression to explore population vulnerability. RESULTS Among 619 participants, 60 developed preeclampsia and 42 developed GH. We identified a susceptible window for exposure to PM2.5 from 1 week preconception to 11 weeks postconception: higher exposure (5 µg/m3) within this window was associated with an average of 8% (95% CI, 1%-15%) higher risk of GH. Among participants with probable prenatal depression (n=179; 32%), overlapping sensitive windows were observed for all pollutants from 8 weeks before to 10 weeks postconception with increased risk of GH (PM2.5, 16% [95% CI, 3%-31%]; PM10, 39% [95% CI, 13%-72%]; nitrogen dioxide, 65% [95% CI, 17%-134%]; and ozone, 45% [95% CI, 9%-93%]), while the associations were close to null among those without prenatal depression. Air pollutants were not associated with preeclampsia in any analyses. CONCLUSIONS We identified periconception through early pregnancy as a susceptible window of air pollution exposure with an increased risk of GH. Prenatal depression increases vulnerability to air pollution exposure and GH.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Xinci Chen
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Mario Vigil
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Karina Barragan
- Department of Health Sciences, California State University, Northridge (K.B., C.M.T.-C.)
| | - Fred Lurmann
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
- Sonoma Technology, Inc, Petaluma, CA (F.L., N.R.P.)
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology (B.H.G., L.A.-M.), University of Southern California, Los Angeles
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
- Department of Health Sciences, California State University, Northridge (K.B., C.M.T.-C.)
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | | | | | - Laila Al-Marayati
- Department of Obstetrics and Gynecology (B.H.G., L.A.-M.), University of Southern California, Los Angeles
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
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Watkins WJ, Course CW, Cousins M, Hart K, Kotecha SJ, Kotecha S. Impact of ambient air pollution on lung function in preterm-born school-aged children. Thorax 2024; 79:553-563. [PMID: 38359924 PMCID: PMC11137460 DOI: 10.1136/thorax-2023-220233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 02/01/2024] [Indexed: 02/17/2024]
Abstract
RATIONALE Increased outdoor air pollution worsens lung function in children. However, these associations are less well studied in preterm-born individuals. OBJECTIVES We assessed associations between ambient air pollutants and spirometry measures in preterm-born children. METHODS The Respiratory Health Outcomes in Neonates study recruited preterm-born children aged 7-12 years who were born at ≤34 week's gestation. We associated four ambient air pollutants (particulate matter with aerodynamic diameter ≤2.5 µm (PM2.5), PM10, nitrogen dioxide (NO2) and sulfur dioxide) at time of birth and spirometry assessment and averaged exposure between these two time points with spirometry measures, using linear regression analyses. Gestational age was banded into 23-28, 29-31 and 32-34 week's. Regression models estimated spirometry values against pollutant levels at birth and at the time of spirometry. MEASUREMENTS AND MAIN RESULTS From 565 preterm-born children, 542 (96%) had satisfactory data. After adjustments for early and current life factors, significant detrimental associations were noted between PM10 at birth and per cent predicted forced vital capacity (%FVC) for the 23-28 and 29-31 week's gestation groups and between current PM2.5 and NO2 exposure and %FVC for the 23-28 week's gestation group. No associations with spirometry were noted for the averaged pollution exposure between birth and spirometry. Predictive models showed 5.9% and 7.4% differences in %FVC between the highest and lowest current pollution exposures for PM2.5 and NO2, respectively, in the 23-28 week group. CONCLUSIONS Birth and current exposures to road-traffic-associated pollutants detrimentally affected %FVC in preterm-born school-aged children, who already have compromised lung function.
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Affiliation(s)
| | | | - Michael Cousins
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
- Department of Paediatrics, Cardiff & Vale University Health Board, Cardiff, UK
| | - Kylie Hart
- Department of Paediatrics, Cardiff & Vale University Health Board, Cardiff, UK
| | - Sarah J Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
| | - Sailesh Kotecha
- Department of Child Health, School of Medicine, Cardiff University, Cardiff, UK
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Li Y, Zhu L, Wei J, Wu C, Zhao Z, Norbäck D, Zhang X, Lu C, Yu W, Wang T, Zheng X, Zhang L, Zhang Y. Intrauterine and early postnatal exposures to submicron particulate matter and childhood allergic rhinitis: A multicity cross-sectional study in China. ENVIRONMENTAL RESEARCH 2024; 247:118165. [PMID: 38215923 DOI: 10.1016/j.envres.2024.118165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/11/2023] [Accepted: 01/08/2024] [Indexed: 01/14/2024]
Abstract
BACKGROUND Airborne particulate matter pollution has been linked to occurrence of childhood allergic rhinitis (AR). However, the relationships between exposure to particulate matter with an aerodynamic diameter ≤1 μm (PM1) during early life (in utero and first year of life) and the onset of childhood AR remain largely unknown. This study aims to investigate potential associations of in utero and first-year exposures to size-segregated PMs, including PM1, PM1-2.5, PM2.5, PM2.5-10, and PM10, with childhood AR. METHODS We investigated 29286 preschool children aged 3-6 years in 7 Chinese major cities during 2019-2020 as the Phase II of the China Children, Families, Health Study. Machine learning-based space-time models were utilized to estimate early-life residential exposure to PM1, PM2.5, and PM10 at 1 × 1-km resolutions. The concentrations of PM1-2.5 and PM2.5-10 were calculated by subtracting PM1 from PM2.5 and PM2.5 from PM10, respectively. Multiple mixed-effects logistic models were used to assess the odds ratios (ORs) and 95% confidence intervals (CIs) of childhood AR associated with per 10-μg/m3 increase in exposure to particulate air pollution during in utero period and the first year of life. RESULTS Among the 29286 children surveyed (mean ± standard deviation, 4.9 ± 0.9 years), 3652 (12.5%) were reported to be diagnosed with AR. Average PM1 concentrations during in utero period and the first year since birth were 36.3 ± 8.6 μg/m3 and 33.1 ± 6.9 μg/m3, respectively. Exposure to PM1 and PM2.5 during pregnancy and the first year of life was associated with an increased risk of AR in children, and the OR estimates were higher for each 10-μg/m3 increase in PM1 than for PM2.5 (e.g., 1.132 [95% CI: 1.022-1.254] vs. 1.079 [95% CI: 1.014-1.149] in pregnancy; 1.151 [95% CI: 1.014-1.306] vs. 1.095 [95% CI: 1.008-1.189] in the first year of life). No associations were observed between AR and both pre- and post-natal exposure to PM1-2.5, indicating that PM1 rather than PM1-2.5 contributed to the association between PM2.5 and childhood AR. In trimester-stratified analysis, childhood AR was only found to be associated with exposure to PM1 (OR = 1.077, 95% CI: 1.027-1.128), PM2.5 (OR = 1.048, 95% CI: 1.018-1.078), and PM10 (OR = 1.032, 95% CI: 1.007-1.058) during the third trimester of pregnancy. Subgroup analysis suggested stronger PM-AR associations among younger (<5 years old) and winter-born children. CONCLUSIONS Prenatal and postnatal exposures to ambient PM1 and PM2.5 were associated with an increased risk of childhood AR, and PM2.5-related hazards could be predominantly attributed to PM1. These findings highlighted public health significance of formulating air quality guideline for ambient PM1 in mitigating children's AR burden caused by particulate air pollution.
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Affiliation(s)
- Yachen Li
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Lifeng Zhu
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, MD 20740, USA
| | - Chuansha Wu
- Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China
| | - Zhuohui Zhao
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai 200030, China
| | - Dan Norbäck
- Department of Medical Sciences, Uppsala University, Uppsala SE 75185, Sweden
| | - Xin Zhang
- Research Centre for Environmental Science and Engineering, Shanxi University, Taiyuan 030006, China
| | - Chan Lu
- Department of Occupational and Environmental Health, School of Public Health, Xiangya Medical College, Central South University, Changsha 410078, China
| | - Wei Yu
- Joint International Research Laboratory of Green Buildings and Built Environments (Ministry of Education), Chongqing University, Chongqing 400045, China
| | - Tingting Wang
- School of Nursing and Health Management, Shanghai University of Medicine and Health Sciences, Shanghai 201318, China
| | - Xiaohong Zheng
- School of Energy and Environment, Southeast University, Nanjing 210096, China
| | - Ling Zhang
- Department of Environmental Hygiene and Occupational Medicine, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
| | - Yunquan Zhang
- Institute of Social Development and Health Management, Hubei Province Key Laboratory of Occupational Hazard Identification and Control, School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China.
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Zhang X, Colicino E, Cowell W, Enlow MB, Kloog I, Coull BA, Schwartz JD, Wright RO, Wright RJ. Prenatal exposure to air pollution and BWGA Z-score: Modifying effects of placenta leukocyte telomere length and infant sex. ENVIRONMENTAL RESEARCH 2024; 246:117986. [PMID: 38145728 DOI: 10.1016/j.envres.2023.117986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 12/01/2023] [Accepted: 12/17/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Air pollutants, such as fine particulate matter (PM2.5), nitrogen dioxide (NO2), and ozone (O3), have been associated with adverse birth outcomes, including low birth weight, often exhibiting sex-specific effects. However, the modifying effect of placental telomere length (TL), reflecting cumulative lifetime oxidative stress in mothers, remains unexplored. METHOD Using data from a Northeastern U.S. birth cohort (n = 306), we employed linear regression and weighted quantile sum models to assess trimester-average air pollution exposures and birth weight for gestational age (BWGA) z-scores. Placental TL, categorized by median split, was considered as an effect modifier. Interactions among air pollutants, placental TL, infant sex, and BWGA z-score were evaluated. RESULTS Without placental TL as a modifier, only 1st trimester O3 was significantly associated with BWGA z-scores (coefficient: 0.33, 95% CI: 0.03, 0.63). In models considering TL interactions, a significant modifying effect was observed between 3rd trimester NO2 and BWGA z-scores (interaction p-value = 0.02). Specifically, a one interquartile range (1-IQR) increase in 3rd trimester NO2 was linked to a 0.28 (95% CI: 0.06, 0.52) change in BWGA z-score among shorter placental TL group, with no significant association among longer TL group. Among male infants, there were significant associations between 3rd trimester PM2.5 exposure and BWGA z-scores in the longer TL group (coefficient: -0.34, 95% CI: -0.61, -0.02), and between 1st trimester O3 exposure and BWGA z-scores among males in the shorter TL group (coefficient: 0.59, 95% CI: 0.06, 1.08). For females, only a negative association in 2nd trimester mixture model was observed within the longer TL group (coefficient: -0.10, 95% CI: -0.21, -0.01). CONCLUSION These findings highlight the need to consider the complex interactions among prenatal air pollutant exposures, placental TL, and fetal sex to better elucidate those at greatest risk for adverse birth outcomes.
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Affiliation(s)
- Xueying Zhang
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Elena Colicino
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Whitney Cowell
- Department of Pediatrics, Grossman School of Medicine, New York University, New York, NY, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry and Behavioral Sciences, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Itai Kloog
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Brent A Coull
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Joel D Schwartz
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; The Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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8
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Hammer L, Heazell AEP, Povey A, Myers JE, Thompson JMD, Johnstone ED. Assessment of the association between ambient air pollution and stillbirth in the UK: Results from a secondary analysis of the MiNESS case-control study. BJOG 2024; 131:598-609. [PMID: 37880925 DOI: 10.1111/1471-0528.17696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 09/27/2023] [Accepted: 10/12/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE We examined whether the risk of stillbirth was related to ambient air pollution in a UK population. DESIGN Prospective case-control study. SETTING Forty-one maternity units in the UK. POPULATION Women who had a stillbirth ≥28 weeks' gestation (n = 238) and women with an ongoing pregnancy at the time of interview (n = 597). METHODS Secondary analysis of data from the Midlands and North of England Stillbirth case-control study only including participants domiciled within 20 km of fixed air pollution monitoring stations. Pollution exposure was calculated using pollution climate modelling data for NO2 , NOx and PM2.5 . The association between air pollution exposure and stillbirth risk was assessed using multivariable logistic regression adjusting for household income, maternal body mass index (BMI), maternal smoking, Index of Multiple Deprivation quintile and household smoking and parity. MAIN OUTCOME MEASURE Stillbirth. RESULTS There was no association with whole pregnancy ambient air pollution exposure and stillbirth risk, but there was an association with preconceptual NO2 exposure (adjusted odds ratio [aOR] 1.06, 95% CI 1.01-1.08 per microg/m3 ). Risk of stillbirth was associated with maternal smoking (aOR 2.54, 95% CI 1.38-4.71), nulliparity (aOR 2.16, 95% CI 1.55-3.00), maternal BMI (aOR 1.05, 95% CI 1.01-1.08) and placental abnormalities (aOR 4.07, 95% CI 2.57-6.43). CONCLUSIONS Levels of ambient air pollution exposure during pregnancy in the UK, all of were beneath recommended thresholds, are not associated with an increased risk of stillbirth. Periconceptual exposure to NO2 may be associated with increased risk but further work is required to investigate this association.
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Affiliation(s)
- Lucy Hammer
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, Manchester, UK
| | - Alexander E P Heazell
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, Manchester, UK
- Saint Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
| | - Andrew Povey
- Centre for Occupational and Environmental Health, Division of Population Health, Health Services Research and Primary Care, University of Manchester, Manchester, UK
| | - Jenny E Myers
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, Manchester, UK
- Saint Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
| | - John M D Thompson
- Department of Obstetrics and Gynaecology, University of Auckland, Auckland, New Zealand
- Department of Paediatrics: Child Health and Youth Health, University of Auckland, Auckland, New Zealand
| | - Edward D Johnstone
- Maternal and Fetal Health Research Centre, Division of Developmental Biology and Medicine, University of Manchester, Manchester, UK
- Saint Mary's Hospital, Manchester University Hospitals NHS Foundation Trust, Manchester Academic Science Centre, Manchester, UK
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9
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Zhang C, Yang J, Wei J, Liu Y, Zhu H, Li X, Wang J, Chen R. Individual ambient ozone exposure during pregnancy and adverse birth outcomes: Exploration of the potentially vulnerable windows. JOURNAL OF HAZARDOUS MATERIALS 2024; 464:132945. [PMID: 37980828 DOI: 10.1016/j.jhazmat.2023.132945] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/13/2023] [Accepted: 11/04/2023] [Indexed: 11/21/2023]
Abstract
BACKGROUND Ambient ozone (O3) exposure during pregnancy might be associated with preterm birth (PTB) and low birth weight (LBW); however, existing evidence remains inconclusive. It is necessary to explore the relationships and potential susceptible periods further. METHODS To explore the relationship between O3 exposure and adverse birth outcomes, a study using records of 34,122 singleton live births in Beijing between 2016 and 2019 was conducted. The O3 exposure in each gestational week of pregnant women was estimated, and Cox proportional hazard models were used to estimate the hazard ratios (HRs) and corresponding 95% confidence intervals (CIs). Distributed lag nonlinear model (DLNM) incorporated in Cox proportional hazard models were used to explore potential critical windows. RESULTS An increase of 10 μg/m3 in O3 exposure was associated with a 3.9% (95%CI: 0.6-7.3%) higher risk of PTB. Additionally, this increase in O3 exposure was positively linked to PTB during the 2nd - 7th, 22nd - 29th, and 37th gestational weeks, and LBW during the 2nd - 7th, 24th - 29th, and 37th gestational weeks. CONCLUSIONS This study demonstrates a positive correlation between O3 exposure and PTB, and identified specific sensitive periods during pregnancy when the risk was higher.
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Affiliation(s)
- Chenqing Zhang
- School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Jie Yang
- Maternal and Child Health Care Hospital of Tongzhou District, Beijing 101101, PR China
| | - Jing Wei
- Department of Atmospheric and Oceanic Science, Earth System Science Interdisciplinary Center, University of Maryland, College Park, USA
| | - Yuansheng Liu
- School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Huiping Zhu
- School of Public Health, Capital Medical University, Beijing 100069, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, PR China
| | - Xiaobo Li
- School of Public Health, Capital Medical University, Beijing 100069, PR China
| | - Jiajia Wang
- School of Public Health, Capital Medical University, Beijing 100069, PR China; Laboratory for Gene-Environment and Reproductive Health, Laboratory for Clinical Medicine, Capital Medical University, PR China.
| | - Rui Chen
- School of Public Health, Capital Medical University, Beijing 100069, PR China; Beijing Laboratory of Allergic Diseases, Capital Medical University, Beijing 100069, PR China.
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10
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Bravo MA, Zephyr D, Fiffer MR, Miranda ML. Weekly prenatal PM 2.5 and NO 2 exposures in preterm, early term, and full term infants: Decrements in birth weight and critical windows of susceptibility. ENVIRONMENTAL RESEARCH 2024; 240:117509. [PMID: 37890819 PMCID: PMC10842146 DOI: 10.1016/j.envres.2023.117509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 10/13/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023]
Abstract
BACKGROUND Previous studies have observed associations between birth weight and prenatal air pollution exposure, but there is not consensus on timing of critical windows of susceptibility. OBJECTIVE We estimated the difference in birth weight among preterm, early term and full term births associated with weekly exposure to PM2.5 and NO2 throughout gestation. METHODS We included all singleton live births in the Lower Peninsula of Michigan (United States) between 2007 and 2012 occurring at or after 32 weeks gestational age (n = 497,897). Weekly ambient PM2.5 and NO2 concentrations were estimated at maternal residences using 1-km gridded data from ensemble-based models. We utilized a distributed lag nonlinear model to estimate the difference in birth weight associated with weekly exposures from the last menstrual period (week 0) through 31 weeks gestation for preterm births; through 36 weeks gestation for early term births; and through 38 weeks gestation for full term births. RESULTS In single-pollutant models, a 5 μg/m3 increase in PM2.5 exposure was associated with a reduction in birth weight among preterm births (-37.1 g [95% confidence interval [CI]: 60.8 g, -13.5 g]); early term births (-13.5 g [95% CI: 26.2 g, -0.67 g]); and full term births (-8.23 g [95% CI: 15.8 g, -0.68 g])]. In single-pollutant models, a 10 ppb increase in NO2 exposure was associated with a -11.7 g (95% CI: 14.46 g, -8.92 g) decrement in birth weight among full term births only. In models co-adjusted for PM2.5 and NO2, PM2.5 exposure was associated with reduced birth weight among preterm births (-36.9 g [95% CI: 61.9 g, -11.8 g]) and NO2 exposure was associated with reduced birth weight among full term births (-11.8 g [95% CI: 14.7 g, -8.94 g]). The largest decrements in birth weight were associated with PM2.5 exposure between approximately 10 and 26 weeks of pregnancy; for NO2 exposure, the largest decrements in birth weight in full term births were associated with exposure between weeks 6-18. CONCLUSION We observed the largest and most persistent adverse associations between PM2.5 exposure and birth weight in preterm infants, and between NO2 exposure and birth weight in full term infants. Exposure during the first half of pregnancy had a greater impact on birthweight.
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Affiliation(s)
- Mercedes A Bravo
- Global Health Institute, School of Medicine, Duke University, Durham, NC, USA; Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA.
| | - Dominique Zephyr
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Melissa R Fiffer
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA
| | - Marie Lynn Miranda
- Children's Environmental Health Initiative, University of Illinois Chicago, Chicago, IL, USA; Department of Pediatrics, University of Illinois Chicago, Chicago, IL, USA
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11
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Wei Q, Lin W, Zhang H, Lai Y, Zhuang S, Han Z, Wang Q, Wang L, Li W, Wen L, Hou H, Hu Q. Role of antenatal anxiety in the relationship between maternal exposure to nitrogen dioxide and small for gestational age: A birth cohort study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 900:165812. [PMID: 37499810 DOI: 10.1016/j.scitotenv.2023.165812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/04/2023] [Accepted: 07/24/2023] [Indexed: 07/29/2023]
Abstract
BACKGROUND Both Nitrogen dioxide (NO2) exposure and antenatal anxiety have individually been associated with small for gestational age (SGA). Little is known, however, about whether there is effect modification of antenatal anxiety on NO2-related SGA. METHODS The prospective birth cohort study included 1823 mother-newborn pairs in Guangzhou, China, from January 2017 to April 2020. Exposure to NO2 during the pre-conceptional and prenatal periods was estimated using an inverse distance weighted method. Antenatal anxiety was assessed by Trait Anxiety Inventory. SGA was determined by the Chinese gestational age- and sex-specific birthweight standards. Cox proportional hazards regression models was used to estimate hazard ratios (HRs) and 95 % confidence intervals (CIs) for SGA as per 10 μg/m3 increase in NO2. Modifying effects of trait anxiety on NO2-related SGA were identified by stratified analyses, and three-dimensional response surface plots and two-dimensional heat maps. RESULTS Each 10 μg/m3 increase in NO2 exposure during the third trimester was significantly associated with SGA risk among overall participants (HR = 1.221, 95 % CI: 1.014-1.471) and primipara (HR = 1.271, 95 % CI: 1.023-1.579). We found significant effect modification of anxiety level for NO2-related SGA in the third trimester (Pinteraction < 0.05). Pregnant women with higher levels of trait anxiety were more likely to deliver SGA newborns, particularly for those with high trait anxiety (HR = 1.781, 95 % CI: 1.007-2.945). Primiparous women were more susceptible. CONCLUSIONS This study provides evidence that antenatal trait anxiety may modify the effects of maternal NO2 exposure on SGA risk. The third trimester could be a critical window of susceptibility.
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Affiliation(s)
- Qiannan Wei
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China.
| | - Hedi Zhang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Yuming Lai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Shuling Zhuang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Zhenyan Han
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Qingqing Wang
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Lijie Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Wenzhuo Li
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Li Wen
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Hongying Hou
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
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12
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Liao J, Zhang Y, Yang Z, Qiu C, Chen W, Zhang JJ, Berhane K, Bai Z, Han B, Xu J, Jiang YH, Gilliland F, Yan W, Huang G, Chen Z. Identifying critical windows of air pollution exposure during preconception and gestational period on birthweight: a prospective cohort study. Environ Health 2023; 22:71. [PMID: 37858139 PMCID: PMC10585741 DOI: 10.1186/s12940-023-01022-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 09/26/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Few studies have assessed air pollution exposure association with birthweight during both preconception and gestational periods. METHODS Leveraging a preconception cohort consisting of 14220 pregnant women and newborn children in Shanghai, China during 2016-2018, we aim to assess associations of NO2 and PM2.5 exposure, derived from high-resolution spatial-temporal models, during preconception and gestational periods with outcomes including term birthweight, birthweight Z-score, small-for-gestational age (SGA) and large-for-gestational age (LGA). Linear and logistic regressions were used to estimate 3-month preconception and trimester-averaged air pollution exposure associations; and distributed lag models (DLM) were used to identify critical exposure windows at the weekly resolution from preconception to delivery. Two-pollutant models and children's sex-specific associations were explored. RESULTS After controlling for covariates, one standard deviation (SD) (11.5 μg/m3, equivalent to 6.1 ppb) increase in NO2 exposure during the second and the third trimester was associated with 13% (95% confidence interval: 2 - 26%) and 14% (95% CI: 1 - 29%) increase in SGA, respectively; and one SD (9.6 μg/m3) increase in PM2.5 exposure during the third trimester was associated with 15% (95% CI: 1 - 31%) increase in SGA. No association have been found for outcomes of birthweight, birthweight Z-score and LGA. DLM found that gestational weeks 22-32 were a critical window, when NO2 exposure had strongest associations with SGA. The associations of air pollution exposure tended to be stronger in female newborns than in male newborns. However, no significant associations of air pollution exposure during preconception period on birthweight outcomes were found. CONCLUSION Consistent with previous studies, we found that air pollution exposure during mid-to-late pregnancy was associated with adverse birthweight outcomes.
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Affiliation(s)
- Jiawen Liao
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Yi Zhang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China
| | - Zhenchun Yang
- Duke Global Health Institute, Durham, NC, United States of America
| | - Chenyu Qiu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Wu Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Junfeng Jim Zhang
- Duke Global Health Institute, Durham, NC, United States of America
- Division of Environmental Science and Policy, Nicholas School of the Environment, Duke University, Durham, NC, United States of America
| | - Kiros Berhane
- Department of Biostatistics, Mailman School of Public Health, Columbia University, New York, NY, United States of America
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yong-Hui Jiang
- Department of Genetics, Neuroscience, and Pediatrics, Yale University School of Medicine, New Haven, CT, United States of America
| | - Frank Gilliland
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America
| | - Weili Yan
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China
| | - Guoying Huang
- Department of Clinical Epidemiology & Clinical Trial Unit, Children's Hospital of Fudan University, National Children's Medical Center & Shanghai Key Laboratory of Birth Defects, Shanghai, China.
| | - Zhanghua Chen
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.
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13
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Wang W, Mu S, Yan W, Ke N, Cheng H, Ding R. Prenatal PM2.5 exposure increases the risk of adverse pregnancy outcomes: evidence from meta-analysis of cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:106145-106197. [PMID: 37723397 DOI: 10.1007/s11356-023-29700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 08/31/2023] [Indexed: 09/20/2023]
Abstract
Adverse pregnancy outcomes (APOs) are a significant cause of fetal death. A wide range of maternal psychological, social, and environmental factors may contribute to these outcomes. Mounting epidemiological studies have indicated that PM2.5 may result in these unfavorable consequences. Previously published meta-analyses have been updated and extended. Cohort studies were searched from three databases (up to July 24, 2023), and their quality was assessed by Newcastle-Ottawa Scale (NOS). Publication bias was examined by Egger's test and funnel plot. Despite a large number of studies showing similar results, the inconsistencies between these findings require careful generalization before concluding. This meta-analysis included 67 cohort studies from 20 countries, and the findings revealed that maternal PM2.5 exposure and five APOs were correlated significantly throughout pregnancy: preterm birth (PTB) (RR = 1.05; 95% CI: 1.03, 1.07); low birth weight (LBW) (RR = 1.02; 95% CI: 1.01, 1.04); small for gestational age (SGA) (RR = 1.03; 95% CI: 1.01, 1.04); stillbirth (RR = 1.24; 95% CI: 1.06, 1.45); and change in birthweight (weight change = -6.82 g; 95% CI: -11.39, -2.25). A positive association was found between APOs and PM2.5 exposure in this meta-analysis, and the degree of increased risk of APOs varied due to different gestation periods. Therefore, it is necessary to protect pregnant women at specific times.
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Affiliation(s)
- Wanrong Wang
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
- Department of Respiratory and Critical Care Medicine, First Affiliated Hospital of Anhui Medical University, Hefei, 230022, Anhui Province, People's Republic of China
| | - Siqi Mu
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Weizhen Yan
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Naiyu Ke
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Han Cheng
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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14
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Niu Z, Habre R, Yang T, Grubbs BH, Eckel SP, Toledo-Corral CM, Johnston J, Dunton GF, Lurvey N, Al-Marayati L, Lurmann F, Pavlovic N, Bastain TM, Breton CV, Farzan SF. Preconceptional and prenatal exposure to air pollutants and risk of gestational diabetes in the MADRES prospective pregnancy cohort study. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100575. [PMID: 37727593 PMCID: PMC10505827 DOI: 10.1016/j.lana.2023.100575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 07/28/2023] [Accepted: 07/31/2023] [Indexed: 09/21/2023]
Abstract
Background Air pollution has been associated with gestational diabetes mellitus (GDM). We aim to investigate susceptible windows of air pollution exposure and factors determining population vulnerability. Methods We ascertained GDM status in the prospective Maternal and Developmental Risks from Environmental and Social Stressors (MADRES) pregnancy cohort from Los Angeles, California, USA. We calculated the relative risk of GDM by exposure to ambient particulate matter (PM10; PM2.5), nitrogen dioxide (NO2), and ozone (O3) in each week from 12 weeks before to 24 weeks after conception, adjusting for potential confounders, with distributed lag models to identify susceptible exposure windows. We examined effect modification by prenatal depression, median-split pre-pregnancy BMI (ppBMI) and age. Findings Sixty (9.7%) participants were diagnosed with GDM among 617 participants (mean age: 28.2 years, SD: 5.9; 78.6% Hispanic, 11.8% non-Hispanic Black). GDM risk increased with exposure to PM2.5, PM10, and NO2 in a periconceptional window ranging from 5 weeks before to 5 weeks after conception: interquartile-range increases in PM2.5, PM10, and NO2 during this window were associated with increased GDM risk by 5.7% (95% CI: 4.6-6.8), 8.9% (8.1-9.6), and 15.0% (13.9-16.2), respectively. These sensitive windows generally widened, with greater effects, among those with prenatal depression, with age ≥28 years, or with ppBMI ≥27.5 kg/m2, than their counterparts. Interpretation Preconception and early-pregnancy are susceptible windows of air pollutants exposure that increased GDM risk. Prenatal depression, higher age, or higher ppBMI may increase one's vulnerability to air pollution-associated GDM risk. Funding National Institutes of Health, Environmental Protection Agency.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Sandrah P. Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Claudia M. Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Department of Health Sciences, California State University, Northridge, Northridge, CA, USA
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Genevieve F. Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Laila Al-Marayati
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | | | - Theresa M. Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Shohreh F. Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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15
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Howarth MV, Eiser AR. Environmentally Mediated Health Disparities. Am J Med 2023; 136:518-522. [PMID: 36828212 PMCID: PMC10213113 DOI: 10.1016/j.amjmed.2023.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 02/24/2023]
Abstract
We describe important settings where environmental exposure leads to disease disparities. Lead exposure in urban settings disproportionately impacts the urban Black poor. Native Americans have been forcibly relocated to areas of the West that have arsenic-contaminated groundwater or exposure to radionuclides near mines and nuclear development. Latino farm workers are disproportionately exposed to pesticides and herbicides. These chemicals are associated with cancer, neuropsychiatric disorders, renal failure, and respiratory disorders. The rural poor, both white and of color, are disproportionately impacted by hydraulic fracturing, exposing residents to volatile organic compounds such as toluene and benzene and heavy metals such as lead and arsenic. The urban and rural poor are both exposed to air pollution that significantly impact health. Short- and long-term ambient air pollution exposure has been associated with all-cause cardiovascular disease, stroke, blood pressure, and ischemic heart disease. Cancer due to air pollution has disproportionately impacted poor communities like "Cancer Alley" where numerous industrial sources are geographically clustered. Understanding local environmental hazards and available resources to address them can enhance the quality of medical care.
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Affiliation(s)
- Marilyn V Howarth
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Arnold R Eiser
- Center of Excellence in Environmental Toxicology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.
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16
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Wellenius GA. Assessing exposure to air pollution during pregnancy:The role of personal exposure monitoring. Paediatr Perinat Epidemiol 2023. [PMID: 37245867 DOI: 10.1111/ppe.12988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023]
Affiliation(s)
- Gregory A Wellenius
- Center for Climate and Health, Boston University School of Public Health, Boston, Massachusetts, USA
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17
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Chiarello DI, Ustáriz J, Marín R, Carrasco-Wong I, Farías M, Giordano A, Gallardo FS, Illanes SE, Gutiérrez J. Cellular mechanisms linking to outdoor and indoor air pollution damage during pregnancy. Front Endocrinol (Lausanne) 2023; 14:1084986. [PMID: 36875486 PMCID: PMC9974835 DOI: 10.3389/fendo.2023.1084986] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 01/30/2023] [Indexed: 02/17/2023] Open
Abstract
Pregnancies are a critical window period for environmental influences over the mother and the offspring. There is a growing body of evidence associating indoor and outdoor air pollution exposure to adverse pregnancy outcomes such as preterm birth and hypertensive disorders of pregnancy. Particulate matter (PM) could trigger oxi-inflammation and could also reach the placenta leading to placental damage with fetal consequences. The combination of strategies such as risk assessment, advise about risks of environmental exposures to pregnant women, together with nutritional strategies and digital solutions to monitor air quality can be effective in mitigating the effects of air pollution during pregnancy.
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Affiliation(s)
- Delia I. Chiarello
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
| | - Javier Ustáriz
- Department of Chemical and Bioprocess Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Reinaldo Marín
- Center for Biophysics and Biochemistry (CBB), Venezuelan Institute for Scientific Research (IVIC), Caracas, Venezuela
| | - Ivo Carrasco-Wong
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
| | - Marcelo Farías
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Ady Giordano
- Inorganic Chemistry Department, Faculty of Chemistry and of Pharmacy, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Felipe S. Gallardo
- Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Sebastián E. Illanes
- Reproductive Biology Program, Center for Biomedical Research and Innovation (CiiB), Universidad de los Andes, Santiago, Chile
- IMPACT, Center of Interventional Medicine for Precision and Advanced Cellular Therapy, Santiago, Chile
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universidad de los Andes, Santiago, Chile
| | - Jaime Gutiérrez
- Cellular Signaling and Differentiation Laboratory (CSDL), School of Medical Technology, Faculty of Medicine and Science, Universidad San Sebastián, Santiago, Chile
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18
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Zhou W, Ming X, Yang Y, Hu Y, He Z, Chen H, Li Y, Cheng J, Zhou X. Associations between maternal exposure to ambient air pollution and very low birth weight: A birth cohort study in Chongqing, China. Front Public Health 2023; 11:1123594. [PMID: 36960371 PMCID: PMC10028238 DOI: 10.3389/fpubh.2023.1123594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023] Open
Abstract
Introduction There have been many researches done on the association between maternal exposure to ambient air pollution and adverse pregnancy outcomes, but few studies related to very low birth weight (VLBW). This study thus explores the association between maternal exposure to ambient air pollutants and the risk of VLBW, and estimates the sensitive exposure time window. Methods A retrospective cohort study analyzed in Chongqing, China, during 2015-2020. The Generalized Additive Model were applied to estimate exposures for each participant during each trimester and the entire pregnancy period. Results For each 10 μg/m3 increase in PM2.5 during pregnancy, the relative risk of VLBW increased on the first trimester, with RR = 1.100 (95% CI: 1.012, 1.195) in the single-pollutant model. Similarly, for each 10 μg/m3 increase in PM10, there was a 12.9% (RR = 1.129, 95% CI: 1.055, 1.209) increase for VLBW on the first trimester in the single-pollutant model, and an 11.5% (RR = 1.115, 95% CI: 1.024, 1.213) increase in the multi-pollutant model, respectively. The first and second trimester exposures of NO2 were found to have statistically significant RR values for VLBW. The RR values on the first trimester were 1.131 (95% CI: 1.037, 1.233) and 1.112 (95% CI: 1.015, 1.218) in the single-pollutant model and multi-pollutant model, respectively; The RR values on the second trimester were 1.129 (95% CI: 1.027, 1.241) and 1.146 (95% CI: 1.038, 1.265) in the single-pollutant model and multi-pollutant model, respectively. The RR of O3 exposure for VLBW on the entire trimester was 1.076 (95% CI: 1.010-1.146), and on the second trimester was 1.078 (95% CI: 1:016, 1.144) in the single-pollutant model. Conclusion This study indicates that maternal exposure to high levels of PM2.5, PM10, NO2, and O3 during pregnancy may increase the risk of very low birth weight, especially for exposure on the first and second trimester. Reducing the risk of early maternal exposure to ambient air pollution is thus necessary for pregnant women.
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Affiliation(s)
- Wenzheng Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Xin Ming
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yunping Yang
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yaqiong Hu
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Ziyi He
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Hongyan Chen
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Yannan Li
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
| | - Jin Cheng
- Institute of Toxicology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, China
- Jin Cheng
| | - Xiaojun Zhou
- Department of Quality Management Section, Women and Children's Hospital of Chongqing Medical University, Chongqing, China
- Department of Quality Management Section, Chongqing Health Center for Women and Children, Chongqing, China
- *Correspondence: Xiaojun Zhou
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19
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Numeric Error in Abstract and Omission in Results. JAMA Netw Open 2022; 5:e2245389. [PMID: 36378316 PMCID: PMC9667329 DOI: 10.1001/jamanetworkopen.2022.45389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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