title: Impact of noise and air pollution on pregnancy outcomes.
abstract: BACKGROUND
  Motorized traffic is an important source of both air pollution and community noise. While there is growing evidence for an adverse effect of ambient air pollution on reproductive health, little is known about the association between traffic noise and pregnancy outcomes.
  
  
  METHODS
  We evaluated the impact of residential noise exposure on small size for gestational age, preterm birth, term birth weight, and low birth weight at term in a population-based cohort study, for which we previously reported associations between air pollution and pregnancy outcomes. We also evaluated potential confounding of air pollution effects by noise and vice versa. Linked administrative health data sets were used to identify 68,238 singleton births (1999-2002) in Vancouver, British Columbia, Canada, with complete covariate data (sex, ethnicity, parity, birth month and year, income, and education) and maternal residential history. We estimated exposure to noise with a deterministic model (CadnaA) and exposure to air pollution using temporally adjusted land-use regression models and inverse distance weighting of stationary monitors for the entire pregnancy.
  
  
  RESULTS
  Noise exposure was negatively associated with term birth weight (mean difference = -19 [95% confidence interval = -23 to -15] g per 6 dB(A)). In joint air pollution-noise models, associations between noise and term birth weight remained largely unchanged, whereas associations decreased for all air pollutants.
  
  
  CONCLUSIONS
  Traffic may affect birth weight through exposure to both air pollution and noise.
authors.affiliation: From the aInstitute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands; and bSchool of Population and Public Health, University of British Columbia, Vancouver, Canada.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
authors.forename: Lillian
authors.initials: L
authors.lastname: Tamburic
authors.forename: Hind
authors.initials: H
authors.lastname: Sbihi
authors.forename: Hugh W
authors.initials: HW
authors.lastname: Davies
authors.forename: Michael
authors.initials: M
authors.lastname: Brauer
mesh_terms: D000397:Air Pollution / Q000009:adverse effects*; D001955:British Columbia; D015331:Cohort Studies; D016001:Confidence Intervals; D004784:Environmental Monitoring / Q000379:methods; D005260:Female; D005865:Gestational Age; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects*; D009622:Noise / Q000009:adverse effects*; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth; D018570:Risk Assessment; D047929:Term Birth