title: Traffic emissions are associated with reduced fetal growth in areas of Perth, Western Australia: an application of the AusRoads dispersion model.
abstract: BACKGROUND
  This study, in a region with relatively low industrial activity, used a highly specific marker for traffic emissions, accounted for the inherent fetal growth potential, and used complete record linkage of births, midwife notifications, deaths, hospital morbidity and birth defect records.
  
  
  METHODS
  Clinical records were obtained for pregnancies between 2000 and 2006 in three areas of Perth, Western Australia (n=3,501). We used carbon monoxide as a marker for locally derived traffic emissions, and assessed exposure using the AusRoads dispersion model. Fetal growth was characterised by proportion of optimal birth weight and investigated using multivariate mixed-effects regression.
  
  
  RESULTS
  Exposure in the third trimester was associated with a -0.49% (sd=0.23%) change in proportion of optimal birth weight per 10 μg/m(3) increase in locally derived traffic emissions. However, this result was confined to one of the three study areas due to elevated exposure misclassification among women in the other two areas. Among this group, a neonate who would have otherwise attained an optimal birth weight of 3.5 kg would be expected to be born 58 g lighter for an interquartile increase in third trimester exposure, which was approximately half of the effect observed for maternal smoking during pregnancy.
  
  
  CONCLUSIONS
  We observed an association between maternal exposure to traffic emissions and reduced fetal growth. This effect was supported by sensitivity analyses but only observed in one of the three study areas. Further studies are required to corroborate our results.
authors.affiliation: Centre for the Built Enviironment and Health, School of Population Health, The University of Western Australia, 35 Stirling Highway, Crawley, WA 6009. gavin.pereira@uwa.edu.au
authors.forename: Gavin
authors.initials: G
authors.lastname: Pereira
authors.forename: Natasha
authors.initials: N
authors.lastname: Nassar
authors.forename: Angus
authors.initials: A
authors.lastname: Cook
authors.forename: Carol
authors.initials: C
authors.lastname: Bower
mesh_terms: D000393:Air Pollutants / Q000032:analysis / Q000633:toxicity*; D000397:Air Pollution; D001724:Birth Weight; D002248:Carbon Monoxide; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D047109:Fetal Development; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D016015:Logistic Models; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D011248:Pregnancy Complications; D011256:Pregnancy Outcome; D011263:Pregnancy Trimester, Third; D012111:Residence Characteristics; D012189:Retrospective Studies; D012959:Socioeconomic Factors; D001335:Vehicle Emissions / Q000633:toxicity*; D014904:Western Australia
chemical_list: D000393:Air Pollutants; D001335:Vehicle Emissions; D002248:Carbon Monoxide