Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study

Fertil Steril. 2019 Feb;111(2):341-347. doi: 10.1016/j.fertnstert.2018.10.028. Epub 2018 Dec 5.

Abstract

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/m3 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 (OR3-day average = 1.09; 95% CI 0.99-1.20; P=.05) (OR7-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.

Keywords: Air pollution; NO(2); PM(10)-PM(2.5)-ultrafine; adverse pregnancy outcomes; female reproductive effects.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Spontaneous / diagnosis
  • Abortion, Spontaneous / etiology*
  • Adolescent
  • Adult
  • Air Pollutants / adverse effects*
  • Case-Control Studies
  • Child
  • Cross-Over Studies
  • Emergency Service, Hospital
  • Female
  • Humans
  • Inhalation Exposure / adverse effects*
  • Middle Aged
  • Nitrogen Dioxide / adverse effects*
  • Particle Size
  • Particulate Matter / adverse effects*
  • Pregnancy
  • Risk Assessment
  • Risk Factors
  • Time Factors
  • Utah
  • Young Adult

Substances

  • Air Pollutants
  • Particulate Matter
  • Nitrogen Dioxide