title: Air pollution and preterm premature rupture of membranes: a spatiotemporal analysis.
abstract: Preterm premature rupture of membranes (PROM) is the leading identifiable predisposing factor for preterm birth. Although maternal exposure to air pollution can potentially have an impact on preterm PROM, there is no available evidence on such an impact. In this study, based on 5,555 singleton births occurring in Barcelona, Spain (2002-2005), we investigated the associations of maternal exposure to nitrogen dioxide, nitrogen oxides, and particulate matter with aerodynamic diameters of ≤2.5 µm (PM2.5), 2.5 µm-10 µm, and ≤10 µm and PM2.5 light absorption with preterm PROM and gestational age at the rupture of membranes (ROM). We utilized temporally adjusted land-use regression models to predict pollutant levels at each subject's home address during each week of her pregnancy. We conducted matched (according to the length of exposure) case-control analyses to estimate the preterm PROM risk associated with 1 interquartile-range increase in exposure levels during the entire pregnancy and during the last 3 months prior to ROM. We found an increase in preterm PROM risk of up to 50% (95% confidence interval: 4, 116) and a 1.3-day (95% confidence interval: -1.9, -0.6) reduction in gestational age at ROM associated with PM2.5 absorbance, nitrogen dioxide exposure, and nitrogen oxide exposure during the entire pregnancy and the last 3 months prior to ROM.
authors.forename: Payam
authors.initials: P
authors.lastname: Dadvand
authors.forename: Xavier
authors.initials: X
authors.lastname: Basagaña
authors.forename: Francesc
authors.initials: F
authors.lastname: Figueras
authors.forename: David
authors.initials: D
authors.lastname: Martinez
authors.forename: Rob
authors.initials: R
authors.lastname: Beelen
authors.forename: Marta
authors.initials: M
authors.lastname: Cirach
authors.forename: Audrey
authors.initials: A
authors.lastname: de Nazelle
authors.forename: Gerard
authors.initials: G
authors.lastname: Hoek
authors.forename: Bart
authors.initials: B
authors.lastname: Ostro
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000139:chemically induced* / Q000453:epidemiology; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects*; D011247:Pregnancy; D015995:Prevalence; D012923:Social Class; D013030:Spain / Q000453:epidemiology; D062211:Spatio-Temporal Analysis
keywords: air pollution; land-use regression; maternal exposure; nitrogen oxides; particulate matter; pregnancy; premature rupture of membranes; preterm birth