title: Environmental contaminant exposures and preterm birth: a comprehensive review.
abstract: Preterm birth is a significant public health concern, as it is associated with high risk of infant mortality, various morbidities in both the neonatal period and later in life, and a significant societal economic burden. As many cases are of unknown etiology, identification of the contribution of environmental contaminant exposures is a priority in the study of preterm birth. This is a comprehensive review of all known studies published from 1992 through August 2012 linking maternal exposure to environmental chemicals during pregnancy with preterm birth. Using PubMed searches, studies were identified that examined associations between preterm birth and exposure to five categories of environmental toxicants, including persistent organic pollutants, drinking-water contaminants, atmospheric pollutants, metals and metalloids, and other environmental contaminants. Individual studies were summarized and specific suggestions were made for future work in regard to exposure and outcome assessment methods as well as study design, with the recommendation of focusing on potential mediating toxicological mechanisms. In conclusion, no consistent evidence was found for positive associations between individual chemical exposures and preterm birth. By identifying limitations and addressing the gaps that may have impeded the ability to identify true associations thus far, this review can guide future epidemiologic studies of environmental exposures and preterm birth.
authors.affiliation: Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan 48109-2029, USA. kellferg@umich.edu
authors.forename: Kelly K
authors.initials: KK
authors.lastname: Ferguson
authors.forename: Marie S
authors.initials: MS
authors.lastname: O'Neill
authors.forename: John D
authors.initials: JD
authors.lastname: Meeker
mesh_terms: D000393:Air Pollutants / Q000009:adverse effects; D004147:Dioxins / Q000009:adverse effects; D060766:Drinking Water / Q000009:adverse effects; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D006843:Hydrocarbons, Chlorinated / Q000009:adverse effects; D008670:Metals / Q000009:adverse effects; D010575:Pesticides / Q000009:adverse effects; D011078:Polychlorinated Biphenyls / Q000009:adverse effects; D011247:Pregnancy / Q000187:drug effects; D047928:Premature Birth / Q000139:chemically induced*; D014874:Water Pollutants, Chemical / Q000009:adverse effects
chemical_list: D000393:Air Pollutants; D004147:Dioxins; D060766:Drinking Water; D006843:Hydrocarbons, Chlorinated; D008670:Metals; D010575:Pesticides; D014874:Water Pollutants, Chemical; D011078:Polychlorinated Biphenyls