Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study
Open accessAbstract
Objective To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss.Design Case-crossover study from 2007 to 2015.Setting An academic emergency department in the Wasatch Front area of Utah.Patient(s) A total of 1,398 women who experienced spontaneous pregnancy loss events.Intervention(s) None.Main outcome measure(s) Odds of spontaneous pregnancy loss.Result(s) We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01-1.33; P=.04). A 10-μg/m 3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR 3-day average = 1.09; 95% CI 0.99-1.20; P=.05) (OR 7-day average = 1.11; 95% CI 0.99-1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone.Conclusions We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.
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An important determinant of risk of miscarriage is the gestational age of a pregnancy.
“An important determinant of risk of miscarriage is the gestational age of a pregnancy.”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [80]
The Discussion (page unavailable) says the study could not determine exact gestational age or test whether the effect of air pollution differed by gestational age. It names maternal age as a risk factor, but does not say whether gestational age itself determines miscarriage risk (searched: gestational age, miscarriage risk, gestational week). (LLM, conf=0.77)
Experimental — accuracy not yet measuredThe risk of pregnancy loss decreases with advancing gestational age.
“The risk of pregnancy loss decreases with advancing gestational age. 79-82”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [80]
The Discussion (page unavailable) says the authors could not determine exact gestational age or test whether effects differed by gestational age. The Results report associations between air pollutants and pregnancy loss, but not whether loss risk decreases as pregnancy advances. Searches for gestational age, gestational week, and declining risk found no passage making that claim. (LLM, conf=0.76)
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- Authors
- Leiser, C. L., Hanson, H. A., Sawyer, K., Steenblik, J., Al-Dulaimi, R., Madsen, T., Gibbins, K., Hotaling, J. M., Ibrahim, Y. O., VanDerslice, J. A., & Fuller, M.
- Affiliations
- Huntsman Cancer Institute (US)
- University of Utah (US)
- Hurley Medical Center (US)
- Oregon Health & Science University (US)
- Corresponding author
- Leiser, Claire L.
- ORCID
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 2019-02
- Volume
- 111
- Issue
- 2
- Pages
- 341-347
- ISSN
- 0015-0282 (ISSN-L)
- PMC
- PMC6351170
- OpenAlex
- W2902054112
- Cited by
- 74
- References
- 31
- Citations by year
- 2026: 5 · 2025: 12 · 2024: 9 · 2023: 8 · 2022: 13 · 2021: 10 · 2020: 12 · 2019: 5
- FWCI
- 3.34
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (1K12HD085852-01)
- University of Utah
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Pregnancy and Medication Impact
- Keywords
- spontaneous pregnancy loss, air pollution, nitrogen dioxide, PM2.5, ozone, short-term exposure, maternal health, environmental exposure
- MeSH terms
- Abortion, Spontaneous, Adolescent, Adult, Air Pollutants, Child, Emergency Service, Hospital, Female, Humans, Middle Aged, Nitrogen Dioxide, Particle Size, Pregnancy, Risk Factors, Time Factors, Utah, Case-Control Studies, Risk Assessment, Cross-Over Studies, Inhalation Exposure, Particulate Matter, Young Adult
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