title: Association of stillbirth with ambient air pollution in a California cohort study.
abstract: Recent studies have suggested an association between air pollution and stillbirth. In this California study, we examined the records of 13,999 stillbirths and 3,012,270 livebirths occurring between 1999 and 2009. Using a retrospective cohort design and logistic regression models, we calculated the odds of stillbirth associated with each pollutant exposure by trimester and throughout the entire pregnancy. Covariates considered in the model included infant sex, maternal demographic characteristics, season of last menstrual period, apparent temperature, air basin of mother's residence, and year of conception. In single-pollutant models, we found that a 10-µg/m(3) increase in particulate matter with an aerodynamic diameter less than or equal to 2.5 µm (odds ratio (OR) = 1.06, 95% confidence interval (CI): 0.99, 1.13) and a 10-ppb increase in nitrogen dioxide (OR = 1.08, 95% CI: 1.03, 1.13) during the entire pregnancy were associated with stillbirth. A 10-ppb increase in ozone exposure during the third trimester was also associated with a slightly elevated risk (OR = 1.03, 95% CI: 1.01, 1.05). These ozone and nitrogen dioxide findings were fairly stable after adjustment in 2-pollutant models. However, adjustment for nitrogen dioxide attenuated the full-pregnancy-particulate matter relationship. No significant associations were found for sulfur dioxide or carbon monoxide. These findings support growing evidence of an association between air pollution and adverse birth outcomes.
authors: Rochelle
authors: R
authors: Green
authors: Varada
authors: V
authors: Sarovar
authors: Brian
authors: B
authors: Malig
authors: Rupa
authors: R
authors: Basu
mesh_terms: D000393:Air Pollutants / Q000032:analysis*; D000397:Air Pollution / Q000032:analysis*; D002140:California / Q000453:epidemiology; D002248:Carbon Monoxide / Q000032:analysis; D005260:Female; D005865:Gestational Age; D006801:Humans; D018811:Maternal Exposure; D009585:Nitrogen Dioxide / Q000032:analysis; D010126:Ozone / Q000032:analysis; D052638:Particulate Matter / Q000032:analysis; D011247:Pregnancy; D011264:Pregnancy Trimesters; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D050497:Stillbirth / Q000453:epidemiology*; D013458:Sulfur Dioxide / Q000032:analysis; D013696:Temperature
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter; D013458:Sulfur Dioxide; D010126:Ozone; D002248:Carbon Monoxide; D009585:Nitrogen Dioxide
keywords: California; air pollutants; fetal death; nitrogen dioxide; ozone; particulate matter; stillbirth