Estimation of disease burdens on preterm births and low birth weights attributable to maternal fine particulate matter exposure in Shanghai, China

- This is one of few studies evaluating the burdens of PM2.5 on PTB and LBW in China.
- 32.61% of PTB and 23.36% of LBW may be attributable to PM2.5 in Shanghai, China.
- Considerable benefits could be achieved by reducing PM2.5 exposure in pregnancy.

BackgroundStudies have shown that maternal exposure to particulate matter ≤ 2.5 μm in aerodynamic diameter (PM2.5) was associated with adverse birth outcomes such as preterm birth (PTB) and low birth weight (LBW). However, the burdens of PTB and LBW attributable to PM2.5 were rarely evaluated, especially in developing countries.ObjectivesTo estimate the burdens of PTBs and LBWs attributable to outdoor PM2.5 in Shanghai, China.MethodsWe collected annual-average PM2.5 concentrations, concentration-response relationships between PM2.5 exposure during pregnancy and PTBs and LBWs, rates of PTB and LBW, number of live births, and population sizes in grids of 10 km × 10 km in Shanghai in 2013. Then, they were combined to estimate the odds ratios (ORs), relative risks (RRs), attributable fractions (AFs), and numbers of PTBs and LBWs associated with PM2.5 exposure.ResultsThe population-weighted annual-average concentration of PM2.5 in Shanghai was 56.19 μg/m3 in 2013. According to the first-class limit of PM2.5 (15 μg/m3) in the Ambient Air Quality Standards of China, the weighted RRs of PTBs or LBWs associated with PM2.5 in Shanghai were 1.49 [95% confidence interval (CI): 1.16-1.80] and 1.31 (95% CI: 1.04-1.67), respectively. There might be 32.61% (95% CI: 13.93%-44.42%) or 4160 (95% CI: 1778-5667) PTBs and 23.36% (95% CI: 3.86%-40.02%) or 1882 (95% CI: 311-3224) LBWs attributable to PM2.5 exposure. The estimates varied appreciably among different districts of Shanghai.ConclusionsOur analysis suggested that outdoor PM2.5 air pollution might have led to considerable burdens of PTBs and LBWs in Shanghai, China.

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