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Air Pollution and Stillbirth Risk: Exposure to Airborne Particulate Matter during Pregnancy Is Associated with Fetal Death
Open accessAbstract
OBJECTIVE: To test the hypothesis that exposure to fine particulate air pollution (PM2.5) is associated with stillbirth. STUDY DESIGN: Geo-spatial population-based cohort study using Ohio birth records (2006-2010) and local measures of PM2.5, recorded by the EPA (2005-2010) via 57 monitoring stations across Ohio. Geographic coordinates of the mother's residence for each birth were linked to the nearest PM2.5 monitoring station and monthly exposure averages calculated. The association between stillbirth and increased PM2.5 levels was estimated, with adjustment for maternal age, race, education level, quantity of prenatal care, smoking, and season of conception. RESULTS: There were 349,188 live births and 1,848 stillbirths of non-anomalous singletons (20-42 weeks) with residence ≤10 km of a monitor station in Ohio during the study period. The mean PM2.5 level in Ohio was 13.3 μg/m3 [±1.8 SD, IQR(Q1: 12.1, Q3: 14.4, IQR: 2.3)], higher than the current EPA standard of 12 μg/m3. High average PM2.5 exposure through pregnancy was not associated with a significant increase in stillbirth risk, adjOR 1.21(95% CI 0.96,1.53), nor was it increased with high exposure in the 1st or 2nd trimester. However, exposure to high levels of PM2.5 in the third trimester of pregnancy was associated with 42% increased stillbirth risk, adjOR 1.42(1.06,1.91). CONCLUSIONS: Exposure to high levels of fine particulate air pollution in the third trimester of pregnancy is associated with increased stillbirth risk. Although the risk increase associated with high PM2.5 levels is modest, the potential impact on overall stillbirth rates could be robust as all pregnant women are potentially at risk.
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“Similarly, in an Ohio cohort, “high” PM2.5 exposure, defined as greater than or equal to the mean PM2.5 level during the study period (13.3 μg/m3) plus the IQR for the specific time period measured for each birth) was not associated with increase in stillbirth risk through pregnancy, first or second trimester; however, high PM2.5 exposure during the third trimester was associated with 42% increase”
From Air pollution and children’s health—a review of adverse effects associated with prenatal exposure from fine to ultrafine particulate matter (2021) · cites this paper as [18]
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“Our review of the evidence also found that high stress is associated with miscarriage risk (aOR 1·46; 95% CI 1·161·77; Table 6) 66,71,73-77”
From Miscarriage matters: the epidemiological, physical, psychological, and economic costs of early pregnancy loss (2021) · cites this paper as [77]
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Self-citation
Metadata
- Authors
- DeFranco, E., Hall, E., Hossain, M., Chen, A., Haynes, E. N., Jones, D., Ren, S., Lu, L., & Muglia, L.
- Affiliations
- Cincinnati Children's Hospital Medical Center (US)
- University of Cincinnati (US)
- Corresponding author
- DeFranco, Emily
- Venue
- PLOS ONE
- Publisher
- Public Library of Science (PLoS)
- Published
- 2015-03-20
- Volume
- 10
- Issue
- 3
- Pages
- e0120594
- ISSN
- 1932-6203 (ISSN-L)
- PMC
- PMC4368103
- OpenAlex
- W2042390942
- Cited by
- 120
- References
- 26
- Citations by year
- 2026: 8 · 2025: 13 · 2024: 8 · 2023: 11 · 2022: 10 · 2021: 17 · 2020: 7 · 2019: 13 · 2018: 12 · 2017: 11 · 2016: 8
- FWCI
- 6.47
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- PLoS ONE (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Funders
- March of Dimes Foundation (22-FY13-543)
- Cincinnati Children's Hospital Medical Center
- Topics
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Social Sciences › Sociology and Political Science › Environmental Justice and Health Disparities
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Indoor Air Quality and Microbial Exposure
- Keywords
- air pollution, PM2.5, stillbirth, fetal death, pregnancy, trimester-specific exposure, maternal exposure, birth outcomes, Ohio
- MeSH terms
- Adult, Air Pollutants, Air Pollution, Female, Humans, Infant, Newborn, Middle Aged, Ohio, Pregnancy, Risk Factors, Stillbirth, Particulate Matter
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