TY - JOUR
T1 - Maternal exposure to fine particulate matter and preterm birth and low birth weight in Africa
AU - Bachwenkizi, Jovine
AU - Liu, Cong
AU - Meng, Xia
AU - Zhang, Lina
AU - Wang, Weidong
AU - van Donkelaar, Aaron
AU - Martin, Randall V.
AU - Hammer, Melanie S.
AU - Chen, Renjie
AU - Kan, Haidong
N1 - Publisher Copyright:
© 2021 The Author(s)
PY - 2022/2
Y1 - 2022/2
N2 - Background: Fine particulate matter (PM2.5) exposure has been reported to adversely affect birth outcomes, but the evidence is limited, particularly in low- and middle-income countries (LMICs). We assessed the associations between maternal PM2.5 exposure and low birth weight (LBW) and preterm birth (PTB) in Africa. Methods: We used standard Demographic and Health Surveys (DHS) data (2005–2015) from 15 countries in Africa to conduct a cross-sectional study. The study population was composed of 131,594 births with detailed information on maternal and household variables. LBW was defined as a birth weight of < 2500 g after 37 weeks, and PTB was defined as live birth occurring before 37 weeks of gestation. Average exposure to PM2.5 during pregnancy was estimated using satellite-based models. Multivariable logistic regression models were constructed, and analyses of data by region (Western, Eastern, Central, and Southern Africa) and data stratified by potential effect modifiers were conducted. Results: A total of 13,214 (10%) LBW and 4,377 (3.3%) PTB cases were identified. An interquartile range (IQR) (33.9 μg/m3) increase in PM2.5 during pregnancy was associated with increased odds of LBW and PTB, with odds ratios (ORs) of 1.28 (95% CI: 1.23, 1.34) and 1.08 (95% CI: 1.01, 1.16), respectively. Region-specific analyses revealed significant associations between PM2.5 and LBW in all regions, and significant associations between PM2.5 and PTB in Western and Southern Africa. Subgroup analyses revealed that the association between PM2.5 and LBW was present in all subgroups, and stronger associations were observed in female infants, while the association between PM2.5 and PTB was larger in subgroups of older individuals living in urban areas. Conclusion: This multicountry study in Africa demonstrated significant associations between maternal exposure to PM2.5 and higher odds of LBW and PTB. Our findings may facilitate air quality control strategies that address adverse birth outcomes in LMICs.
AB - Background: Fine particulate matter (PM2.5) exposure has been reported to adversely affect birth outcomes, but the evidence is limited, particularly in low- and middle-income countries (LMICs). We assessed the associations between maternal PM2.5 exposure and low birth weight (LBW) and preterm birth (PTB) in Africa. Methods: We used standard Demographic and Health Surveys (DHS) data (2005–2015) from 15 countries in Africa to conduct a cross-sectional study. The study population was composed of 131,594 births with detailed information on maternal and household variables. LBW was defined as a birth weight of < 2500 g after 37 weeks, and PTB was defined as live birth occurring before 37 weeks of gestation. Average exposure to PM2.5 during pregnancy was estimated using satellite-based models. Multivariable logistic regression models were constructed, and analyses of data by region (Western, Eastern, Central, and Southern Africa) and data stratified by potential effect modifiers were conducted. Results: A total of 13,214 (10%) LBW and 4,377 (3.3%) PTB cases were identified. An interquartile range (IQR) (33.9 μg/m3) increase in PM2.5 during pregnancy was associated with increased odds of LBW and PTB, with odds ratios (ORs) of 1.28 (95% CI: 1.23, 1.34) and 1.08 (95% CI: 1.01, 1.16), respectively. Region-specific analyses revealed significant associations between PM2.5 and LBW in all regions, and significant associations between PM2.5 and PTB in Western and Southern Africa. Subgroup analyses revealed that the association between PM2.5 and LBW was present in all subgroups, and stronger associations were observed in female infants, while the association between PM2.5 and PTB was larger in subgroups of older individuals living in urban areas. Conclusion: This multicountry study in Africa demonstrated significant associations between maternal exposure to PM2.5 and higher odds of LBW and PTB. Our findings may facilitate air quality control strategies that address adverse birth outcomes in LMICs.
KW - Cross-sectional study
KW - Fine particulate matter
KW - Low birth weight
KW - Multicountry
KW - Preterm birth
UR - https://www.scopus.com/pages/publications/85121458632
U2 - 10.1016/j.envint.2021.107053
DO - 10.1016/j.envint.2021.107053
M3 - Article
C2 - 34942408
AN - SCOPUS:85121458632
SN - 0160-4120
VL - 160
JO - Environment International
JF - Environment International
M1 - 107053
ER -