Environmental Analysis Health and Toxicology

  • Volume 30
  • /
  • Pages.11.1-11.19
  • /
  • 2015
  • /
  • 2671-9525(eISSN)
The Korean Society of Environmental Health and Toxicology (환경독성보건학회)
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A meta-analysis of exposure to particulate matter and adverse birth outcomes

  • Lamichhane, Dirga Kumar (Department of Social and Preventive Medicine, Inha University School of Medicine) ;
  • Leem, Jong-Han (Department of Occupational and Environmental Medicine, Inha University School of Medicine) ;
  • Lee, Ji-Young (Department of Social and Preventive Medicine, Inha University School of Medicine) ;
  • Kim, Hwan-Cheol (Department of Occupational and Environmental Medicine, Inha University School of Medicine)
  • Received : 2015.06.15
  • Accepted : 2015.11.02
  • Published : 2015.01.01
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Abstract

Objectives The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. Methods We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to $2.5{\mu}m$ and $10.0{\mu}m$ in diameter, $PM_{2.5}$ and $PM_{10}$, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results In random effects meta-analyses, BW as a continuous outcome was negatively associated with $10{\mu}g/m^3$ increase in $PM_{10}$ (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947) and $PM_{2.5}$ (-22.17 g; 95% CI, -37.93 to -6.41 g; Isquared=92.3%, p<0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per $10{\mu}g/m^3$ increase in $PM_{10}$ (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p=0.977) and $PM_{2.5}$ (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p<0.001) exposure during entire pregnancy was observed. Effect size of change in BW per $10{\mu}g/m^3$ increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.

Keywords

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