title: The Influence of Meteorological Factors and Atmospheric Pollutants on the Risk of Preterm Birth.
abstract: Atmospheric pollutants and meteorological conditions are suspected to be causes of preterm birth. We aimed to characterize their possible association with the risk of preterm birth (defined as birth occurring before 37 completed gestational weeks). We pooled individual data from 13 birth cohorts in 11 European countries (71,493 births from the period 1994-2011, European Study of Cohorts for Air Pollution Effects (ESCAPE)). City-specific meteorological data from routine monitors were averaged over time windows spanning from 1 week to the whole pregnancy. Atmospheric pollution measurements (nitrogen oxides and particulate matter) were combined with data from permanent monitors and land-use data into seasonally adjusted land-use regression models. Preterm birth risks associated with air pollution and meteorological factors were estimated using adjusted discrete-time Cox models. The frequency of preterm birth was 5.0%. Preterm birth risk tended to increase with first-trimester average atmospheric pressure (odds ratio per 5-mbar increase = 1.06, 95% confidence interval: 1.01, 1.11), which could not be distinguished from altitude. There was also some evidence of an increase in preterm birth risk with first-trimester average temperature in the -5°C to 15°C range, with a plateau afterwards (spline coding, P = 0.08). No evidence of adverse association with atmospheric pollutants was observed. Our study lends support for an increase in preterm birth risk with atmospheric pressure.
authors.affiliation: Inserm and Univ. Grenoble Alpes, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.
authors.forename: Lise
authors.initials: L
authors.lastname: Giorgis-Allemand
authors.affiliation: Department of Cancer and Inflammation Research, Institute of Molecular Medicine, University of Southern Denmark, Odense C, Denmark.
authors.forename: Marie
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authors.lastname: Pedersen
authors.affiliation: Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France.
authors.forename: Claire
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authors.affiliation: Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, P.O. Box 4002, Basel, Switzerland.|University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Aguilera
authors.affiliation: Institute for Risk Assessment Sciences, Utrecht University, P.O. Box 80178, 3508 TD, Utrecht, The Netherlands.|Center for Sustainability, Environment and Health, National Institute for Public Health and the Environment (RIVM), P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
authors.forename: Rob M J
authors.initials: RM
authors.lastname: Beelen
authors.affiliation: Department of Social Medicine, Faculty of Medicine, University of Crete, Heraklion, Greece.
authors.forename: Leda
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authors.lastname: Chatzi
authors.affiliation: Campus MAR, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Marta
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authors.lastname: Cirach
authors.affiliation: Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania.
authors.forename: Asta
authors.initials: A
authors.lastname: Danileviciute
authors.affiliation: Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Audrius
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authors.affiliation: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
authors.forename: Manon
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authors.lastname: van Eijsden
authors.affiliation: CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Marisa
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authors.lastname: Estarlich
authors.affiliation: CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Dept of Medicine, University of Oviedo, Asturias, Spain.
authors.forename: Ana
authors.initials: A
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authors.affiliation: Instituto de Investigación Biosanitaria (ibs.GRANADA), Hospitales Universitarios de Granada, Spain.
authors.forename: Mariana F
authors.initials: MF
authors.lastname: Fernández
authors.affiliation: Universitat Pompeu Fabra (UPF), Barcelona, Spain.
authors.forename: Francesco
authors.initials: F
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authors.affiliation: CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Ulrike
authors.initials: U
authors.lastname: Gehring
authors.affiliation: Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Regina
authors.initials: R
authors.lastname: Grazuleviciene
authors.affiliation: Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Olena
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authors.affiliation: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
authors.forename: Barbara
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authors.affiliation: Institute for Risk Assessment Sciences (IRAS), University of Utrecht, Utrecht, The Netherlands
authors.forename: Gerard
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authors.affiliation: Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania.
authors.forename: Kees
authors.initials: K
authors.lastname: de Hoogh
authors.affiliation: Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.|Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.|Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Edith H
authors.initials: EH
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authors.affiliation: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
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authors.initials: SE
authors.lastname: Håberg
authors.affiliation: University of Malaga, Department of Ecology, Faculty of Sciences, Boulevard Louis Pasteur s/n, 29010 Málaga, Spain.
authors.forename: Carmen
authors.initials: C
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authors.affiliation: The Generation R Study Group, Erasmus University Medical Center, Rotterdam, The Netherlands.|Department of Paediatrics, Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, The Netherlands.|Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.
authors.forename: Vincent W V
authors.initials: VW
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authors.affiliation: Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Michal
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authors.affiliation: Universidad del País Vasco UPV-EUH, Spain; Health Research Institute, Biodonostia, San Sebastián, Spain.
authors.forename: Aitana
authors.initials: A
authors.lastname: Lertxundi
authors.affiliation: Université Grenoble Alpes, CNRS UMR 5309, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.|INSERM U1209, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.|CHU de Grenoble, IAB, Team of Environmental Epidemiology applied to Reproduction and Respiratory Health, Grenoble, France.
authors.forename: Johanna
authors.initials: J
authors.lastname: Lepeule
authors.affiliation: Institute of Health and Society, University of Oslo, P.O. Box 1130 Blindern, Oslo, 0318 Norway.
authors.forename: Per
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authors.lastname: Nafstad
authors.affiliation: National Institute of Public Health, Oslo, Norway.
authors.forename: Wenche
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authors.affiliation: Department of Adult Nursing, Florence Nightingale Faculty of Nursing and Midwifery, King's College London, London, UK.
authors.forename: Evridiki
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authors.affiliation: Department of Epidemiology, Lazio Regional Health System, Rome, Italy.
authors.forename: Daniela
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authors.affiliation: Dept of Pulmonary Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Dirkje
authors.initials: D
authors.lastname: Postma
authors.affiliation: Danish Cancer Society Research Center , Copenhagen , Denmark.|Department of Environmental Science , Aarhus University , Roskilde , Denmark.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.
authors.forename: Ole
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authors.affiliation: National Public Health Center, National Directorate of Environmental Health, 1097 Budapest, Hungary.
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authors.affiliation: Inserm, Institut Albert Bonniot (IAB),Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Grenoble F-38042,France.
authors.forename: Valérie
authors.initials: V
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authors.affiliation: Campus MAR, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain.|Universitat Pompeu Fabra (UPF), Barcelona, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain.
authors.forename: Jordi
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authors.affiliation: Environmental Chemical Processes Laboratory (ECPL), Department of Chemistry, University of Crete, 71003, Heraklion, Greece.
authors.forename: Euripides
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authors.affiliation: Department of Pathology, Odense University Hospital, Odense, Denmark.|Department of Clinical Research, University of Southern Denmark, Odense, Denmark.
authors.forename: Mette
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authors.affiliation: Diet Genes Environment Unit, Danish Cancer Society Research Center, Strandboulevarden 49, DK-2100 Copenhagen, Denmark.
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authors.initials: KT
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authors.affiliation: Bradford Women's and Newborn Unit, Bradford Teaching Hospitals NHS Foundation, Bradford, UK.
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authors.forename: Mihály J
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authors.affiliation: Instituto de Investigación Biosanitaria (ibs.GRANADA), Hospitales Universitarios de Granada, Spain.
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authors.affiliation: Instituto Universitario de Oncología del Principado de Asturias (IUOPA), Dept of Medicine, University of Oviedo, Asturias, Spain.
authors.forename: John
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authors.affiliation: Joint Research Unit for Epidemiology and Environmental Health, FISABIO-Universitat de València-Universitat Jaume I, Valencia, Spain.|Joint Research Unit for Epidemiology and Environmental Health, FISABIO-Universitat de València-Universitat Jaume I, Valencia, Spain.
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Nieuwenhuijsen
authors.affiliation: Institute for Risk Assessment Sciences (IRAS), University of Utrecht, Utrecht, The Netherlands
authors.forename: Göran
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authors.affiliation: Department of Epidemiology and Health Promotion, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands.
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authors.affiliation: CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.|Department of Environmental Science, Vytauto Didziojo Universitetas, K. Donelaicio 58, Kaunas 44248, Lithuania.|Department of Environmental Sciences , Vytautas Magnus University , Kaunas , Lithuania.
authors.forename: Manolis
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authors.affiliation: Universitat Pompeu Fabra (UPF), Barcelona, Spain.
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mesh_terms: D000393:Air Pollutants / Q000009:adverse effects*; D001274:Atmospheric Pressure; D005060:Europe; D006801:Humans; D008685:Meteorological Concepts; D047928:Premature Birth / Q000139:chemically induced / Q000209:etiology*; D016016:Proportional Hazards Models; D014504:Urban Health
chemical_list: D000393:Air Pollutants
keywords: atmospheric pollution; atmospheric pressure; cohort studies; humidity; meteorological conditions; pooled analysis; preterm birth; temperature