Combined exposure to PM and PM in reductions of physiological development among preterm birth: a retrospective study from 2014 to 2017 in China.

BACKGROUND

Preterm birth (PTB) has been linked with ambient particulate matter (PM) exposure. However, data are limited between physiological development of PTB and PM exposure.

METHODS

Trimester and season-specific PM exposure including PM and PM was collected from Jiaxing between January 2014 and December 2017. Information about parents and 3,054 PTB (gestational age < 37 weeks) outcomes such as weight (g), head circumference (cm), chest circumference (cm), height (cm) and Apgar 5 score were obtained from birth records. We used generalized linear models to assess the relationship between PTB physiological developmental indices and PM, PM and their combined exposures. A binary logistic regression model was performed to assess the association between exposures and low birth weight (LBW, < 2,500 g).

RESULTS

Results showed that there were 75.5% of low birth weight (LBW) infants in PTB. Decreased PM and PM levels were found in Jiaxing from 2014 to 2017, with a higher PM level than PM each year. During the entire pregnancy, the highest median concentration of PM and PM was in winter (61.65 ± 0.24 vs. 91.65 ± 0.29 μg/m) followed by autumn, spring and summer, with statistical differences in trimester-specific stages. After adjusting for several potential factors, we found a 10 μg/m increase in joint exposure of PM and PM during the entire pregnancy associated with reduced 0.02 week (95%CI: -0.05, -0.01) in gestational age, 7.9 g (95%CI: -13.71, -2.28) in birth weight, 0.8 cm in height (95%CI: -0.16, -0.02), 0.05 cm (95%CI: -0.08, - 0.01) in head circumference, and 0.3 (95%CI: -0.04, -0.02) in Apgar 5 score, except for the chest circumference. Trimester-specific exposure of PM and PM sometimes showed an opposite effect on Additionally, PM (OR = 1.37, 95%CI: 1.11, 1.68) was correlated with LBW.

CONCLUSION

Findings in this study suggest a combined impact of fine particulate matter exposure on neonatal development, which adds to the current understanding of PTB risk and health.