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Epidemiology. 2019 Jan;30(1):4-10. doi: 10.1097/EDE.0000000000000918.

Traffic-related Air Pollution and Pregnancy Loss.

Author information

1
From the Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY.
2
Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem Jerusalem, Israel.
3
Department of Statistics, Colorado State University Fort Collins, CO.
4
Department of Statistics, The Hebrew University of Jerusalem Jerusalem, Israel.
5
Faculty of Civil and Environmental Engineering, Technion, Israel Institute of Technology, Haifa, Israel.
6
Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School Boston, MA.
7
Department of Epidemiology, Harvard T.H. Chan School of Public Health Boston, MA.
8
Division of Maternal-Fetal Medicine, Brigham & Women's Hospital, Harvard Medical School Boston, MA.
9
Ben-Gurion University of the Negev, Beer Sheva, Israel.
10
Public Health Services, Ministry of Health, Jerusalem, Israel.
11
Department of Environmental Health, Harvard T.H. Chan School of Public Health Boston, MA.

Abstract

BACKGROUND:

Traffic-related air pollution has been linked to multiple adverse pregnancy outcomes. However, few studies have examined pregnancy loss, targeting losses identified by hospital records, a large limitation as it does not capture events not reported to the medical system.

METHODS:

We used a novel variation of the time-series design to determine the association, and identify the critical window of vulnerability, between week-to-week traffic-related air pollution and conceptions resulting in live births, using nitrogen dioxide (NO2) as a traffic emissions tracer. We used information from all live births recorded at Beth Israel Deaconess Medical Center in Boston, MA (2000-2013) and all live births in Tel Aviv District, Israel (2010-2013).

RESULTS:

In Boston (68,969 live births), the strongest association was during the 15th week of gestation; for every 10 ppb of NO2 increase during that week, we observed a lower rate of live births (rate ratio [RR] = 0.87; 95% confidence interval [CI], 0.78, 0.97), using live birth-identified conceptions to infer pregnancy losses. In the Tel Aviv District (95,053 live births), the strongest estimate was during the 16th gestational week gestation (RR = 0.82; 95% CI, 0.76, 0.90 per 10 ppb of NO2).

CONCLUSIONS:

Using weekly conceptions ending in live birth rather than identified pregnancy losses, we comprehensively analyzed the relationship between air pollution and all pregnancy loss throughout gestation. The observed results, with remarkable similarity in two independent locations, suggest that higher traffic-related air pollution levels are associated with pregnancy loss, with strongest estimates between the 10th and 20th gestational weeks.

PMID:
30199416
PMCID:
PMC6269216
[Available on 2020-01-01]
DOI:
10.1097/EDE.0000000000000918
[Indexed for MEDLINE]

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