title: Exposure to Ambient Air Pollution and Premature Rupture of Membranes.
abstract: Premature rupture of membranes (PROM) is a major factor that predisposes women to preterm delivery. Results from previous studies have suggested that there are associations between exposure to air pollution and preterm birth, but evidence of a relationship with PROM is sparse. Modified Community Multiscale Air Quality models were used to estimate mean exposures to particulate matter less than 10 µm or less than 2.5 µm in aerodynamic diameter, nitrogen oxides, carbon monoxide, sulfur dioxide, and ozone among 223,375 singleton deliveries in the Air Quality and Reproductive Health Study (2002-2008). We used log-linear models with generalized estimating equations to estimate adjusted relative risks and 95% confidence intervals for PROM per each interquartile-range increase in pollutants across the whole pregnancy, on the day of delivery, and 5 hours before delivery. Whole-pregnancy exposures to carbon monoxide and sulfur dioxide were associated with an increased risk of PROM (for carbon monoxide, relative risk (RR) = 1.09, 95% confidence interval (CI): 1.04, 1.14; for sulfur dioxide, RR = 1.15, 95% CI: 1.06, 1.25) but not preterm PROM. Ozone exposure increased the risk of PROM on the day of delivery (RR = 1.06, 95% CI: 1.02, 1.09) and 1 day prior (RR = 1.04, 95% CI: 1.01, 1.07). In the 5 hours preceding delivery, there were 3%-7% increases in risk associated with exposure to ozone and particulate matter less than 2.5 µm in aerodynamic diameter and inverse associations with exposure to carbon monoxide and nitrogen oxides. Acute and long-term air pollutant exposures merit further study in relation to PROM.
authors.forename: Maeve E
authors.initials: ME
authors.lastname: Wallace
authors.forename: Katherine L
authors.initials: KL
authors.lastname: Grantz
authors.forename: Danping
authors.initials: D
authors.lastname: Liu
authors.forename: Yeyi
authors.initials: Y
authors.lastname: Zhu
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.forename: Pauline
authors.initials: P
authors.lastname: Mendola
mesh_terms: D000328:Adult; D000367:Age Factors; D000393:Air Pollutants / Q000009:adverse effects*; D000397:Air Pollution / Q000009:adverse effects*; D000428:Alcohol Drinking / Q000453:epidemiology; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000139:chemically induced*; D006801:Humans; D018811:Maternal Exposure / Q000009:adverse effects*; D010298:Parity; D047928:Premature Birth / Q000139:chemically induced; D044469:Racial Groups / Q000706:statistics & numerical data; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000393:Air Pollutants
keywords: ambient air pollution; premature rupture of membranes; preterm birth