While increasing evidence suggests that ozone (O3) exposure is associated with adverse birth outcomes, only one study has focused on its impact on the premature rupture of membranes (PROM). Therefore, we thus examined the effect of O3 on PROM in Xinxiang, China, using an over-dispersed Poisson generalized additive model. Several confounding factors, including meteorological factors, temporal trends, the day of the week, and public holidays, were considered in the model. We identified a total of 3255 instances of PROM from January 1, 2015 to December 31, 2017, and there was a significant association between the daily maximum 8-h mean concentrations (O3-8h) and PROM. Each 10 μg/m3 increase in the 3-day average concentration (lag02) of O3-8h corresponded to an increment in PROM of 5.42% (95% CI: 1.45-9.39%). Although the results of the stratified analyses were insignificant, a few trending results were observed: stronger associations between O3 and PROM would occur in women with advanced age (≥35) or during the warm season than those in younger women (<35) or during the cool season. Our study indicates that O3 exposure is an important risk factor of PROM and should be considered in its prevention and control in the study area.
Keywords: Acute effect; Air pollution; Ozone; Premature rupture of membranes.
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