Acute and chronic maternal exposure to fine particulate matter and prelabor rupture of the fetal membranes: A nation-wide survey in China

Cuiping Wang; Guoqi Yu; Ramkumar Menon; Nanbert Zhong; Chong Qiao; Jing Cai; Weidong Wang; Huijuan Zhang; Ming Liu; Kang Sun; Haidong Kan; Jun Zhang

Environment International (Dec 2022)

Acute and chronic maternal exposure to fine particulate matter and prelabor rupture of the fetal membranes: A nation-wide survey in China

Cuiping Wang,
Guoqi Yu,
Ramkumar Menon,
Nanbert Zhong,
Chong Qiao,
Jing Cai,
Weidong Wang,
Huijuan Zhang,
Ming Liu,
Kang Sun,
Haidong Kan,
Jun Zhang

Affiliations

Cuiping Wang: Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Guoqi Yu: Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Ramkumar Menon: Department of Obstetrics and Gynecology/Cell Biology at the University Texas Medical Branch at Galveston, TX, U.S.A
Nanbert Zhong: The New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY, U.S.A
Chong Qiao: Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
Jing Cai: School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
Weidong Wang: School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
Huijuan Zhang: Department of Pathology, International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Ming Liu: Department of Obstetrics, Shanghai Oriental Hospital, Tongji University, Shanghai, China
Kang Sun: Center for Reproductive Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
Haidong Kan: School of Public Health, Shanghai Institute of Infectious Disease and Biosecurity, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China; Children’s Hospital of Fudan University, National Center for Children’s Health, Shanghai, China; Corresponding authors at: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China (J. Zhang) Department of Environmental Health, School of Public Health, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China (H. Kan).
Jun Zhang: Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China; Corresponding authors at: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, 1665 Kongjiang Road, Shanghai 200092, China (J. Zhang) Department of Environmental Health, School of Public Health, Fudan University, P.O. Box 249,130 Dong-An Road, Shanghai 200032, China (H. Kan).

Journal volume & issue: Vol. 170
p. 107561

Abstract

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Background: Prelabor rupture of the fetal membranes (PROM) is a major contributor to adverse perinatal outcomes. Some epidemiologic studies explored the association between maternal PM2.5 exposure and PROM but failed to treat the labor induction and prelabor cesarean section as censored observations. Objective: We aimed to evaluated whether acute and chronic maternal ambient PM2.5 exposure may increase the risk of PROM in China. Methods: This study was based on the China Labor and Delivery Survey, a nationwide multicenter investigation. Included in the current analysis were 45,879 singleton spontaneous births in 96 hospitals in mainland China from 2015 to 2017. Outcomes were PROM, preterm PROM (<37 weeks’ gestation) and term PROM (≥37 weeks’ gestation). Daily concentration of PM2.5 at 1 km spatial resolution was estimated by gap-filling model. Generalized linear mixed model and mixed effects Cox model were applied to assess the associations of acute (from 0 to 4 days before delivery) and chronic (average gestational and trimester-specific) ambient PM2.5 exposure with outcomes, respectively. Results: Significant associations were found between acute PM2.5 exposures (per interquartile range increase) and the risk of preterm PROM (OR = 1.11; 95 % CI: 1.03, 1.19 for PM2.5 on delivery day; OR = 1.10; 95 % CI: 1.02, 1.18 for PM2.5 1 day before delivery) but not for term PROM. An interquartile range increase in PM2.5 during the second trimester was associated with elevated risks of PROM (HR = 1.14; 95 % CI: 1.07, 1.22), preterm PROM (HR = 1.22; 95 % CI: 1.02, 1.45) and term PROM (HR = 1.13; 95 % CI: 1.06, 1.22), respectively. Women who were less educated, obese, or gave birth in a cold season appeared to be more sensitive to ambient PM2.5 exposure. Conclusion: Our findings suggest that both acute and chronic maternal exposures to ambient PM2.5 during pregnancy are risk factors for PROM.

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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