Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study
Background: Maternal ambient fine particulate matter (PM2.5) has been linked with fetal low birthweight (LBW), while national causal evidence is limited, particularly in low- and middle-income countries. Methods: We used nationwide registry-based birth records of 3839531 singleton livebirths, with m...
Saved in:
| Main Authors: | , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2024-12-01
|
| Series: | Ecotoxicology and Environmental Safety |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0147651324014908 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846138622406819840 |
|---|---|
| author | Ziqing Tang Xuan Long Kai Wang Klaus Berger Yunquan Zhang Fatemeh Mayvaneh |
| author_facet | Ziqing Tang Xuan Long Kai Wang Klaus Berger Yunquan Zhang Fatemeh Mayvaneh |
| author_sort | Ziqing Tang |
| collection | DOAJ |
| description | Background: Maternal ambient fine particulate matter (PM2.5) has been linked with fetal low birthweight (LBW), while national causal evidence is limited, particularly in low- and middle-income countries. Methods: We used nationwide registry-based birth records of 3839531 singleton livebirths, with maternal age (MA) between 15 and 49 years, across 31 provinces in Iran from 2013 through 2018. Monthly gridded concentrations of ambient PM2.5 during entire pregnancy were estimated through validated spatiotemporal models. We adopted traditional logistic/linear regression and double robust model (DRM) based on generalized propensity scores (GPS) to evaluate associations of maternal PM2.5 exposure with LBW risk and birthweight change. MA-specific exposure-response functions were investigated using restricted cubic splines in both traditional and casual inference models. PM2.5-attributable LBW burden were parallelly estimated, under the scenarios of achieving counterfactual exposure levels of multiple WHO interim targets. Results: A total of 228655 LBW births were identified, and mean birthweight of was 3187 g. Both traditional and causal modelling approaches yielded consistently positive associations of maternal PM2.5 exposure with increased LBW risk and reduced birthweight, but marginally larger effect estimates were seen under GPS-based DRM analyses. Specifically, a 10-μg/m3 increase in ambient PM2.5 during the entire pregnancy was associated with the odds of 1.071 (95% confidence interval: 1.066, 1.076) for LBW and reduced birthweight of 8.9 (8.4, 9.4) g in GPS-based DRM analysis. MA-stratified analyses suggested non-linear exposure-response relationships of PM2.5 exposure with both LBW (Pnonlinear <0.001) risk and birthweight change (Pnonlinear <0.001) over the exposure range of 17–104 μg/m3, with notably steeper slopes at low concentrations (<37.3 μg/m3). According to GPS-based DRM analysis, achieving the interim target level 1–3 of annual PM2.5 (i.e., 35, 25, and 15 μg/m3) could avoid 5.5%–32.6% of overall LBW infants and birthweight loss of 7.0–57.6 g per livebirth during 2013–2018 in Iran. Conclusions: Our findings provided nationwide evidence of causality for elevated LBW risk and birthweight loss associated with maternal PM2.5 exposure in Iran. Improving air quality through multisectoral efforts may avoid dramatic LBW burden to promote neonatal health later in life. |
| format | Article |
| id | doaj-art-a979fcca1b964fc68859e743332bc58f |
| institution | Kabale University |
| issn | 0147-6513 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Ecotoxicology and Environmental Safety |
| spelling | doaj-art-a979fcca1b964fc68859e743332bc58f2024-12-07T08:24:43ZengElsevierEcotoxicology and Environmental Safety0147-65132024-12-01288117414Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference studyZiqing Tang0Xuan Long1Kai Wang2Klaus Berger3Yunquan Zhang4Fatemeh Mayvaneh5School of Public Health, Wuhan University of Science and Technology, Wuhan 430065, ChinaWuhan Third Hospital (Tongren Hospital of Wuhan University), Wuhan 430060, ChinaThe Seventh Affiliated Hospital, Sun Yat-sen University, Shenzhen 518107, ChinaInstitute of Epidemiology and Social Medicine, University of Münster, Münster 48149, GermanySchool of Public Health, Wuhan University of Science and Technology, Wuhan 430065, China; Corresponding authors.Institute of Epidemiology and Social Medicine, University of Münster, Münster 48149, Germany; Corresponding authors.Background: Maternal ambient fine particulate matter (PM2.5) has been linked with fetal low birthweight (LBW), while national causal evidence is limited, particularly in low- and middle-income countries. Methods: We used nationwide registry-based birth records of 3839531 singleton livebirths, with maternal age (MA) between 15 and 49 years, across 31 provinces in Iran from 2013 through 2018. Monthly gridded concentrations of ambient PM2.5 during entire pregnancy were estimated through validated spatiotemporal models. We adopted traditional logistic/linear regression and double robust model (DRM) based on generalized propensity scores (GPS) to evaluate associations of maternal PM2.5 exposure with LBW risk and birthweight change. MA-specific exposure-response functions were investigated using restricted cubic splines in both traditional and casual inference models. PM2.5-attributable LBW burden were parallelly estimated, under the scenarios of achieving counterfactual exposure levels of multiple WHO interim targets. Results: A total of 228655 LBW births were identified, and mean birthweight of was 3187 g. Both traditional and causal modelling approaches yielded consistently positive associations of maternal PM2.5 exposure with increased LBW risk and reduced birthweight, but marginally larger effect estimates were seen under GPS-based DRM analyses. Specifically, a 10-μg/m3 increase in ambient PM2.5 during the entire pregnancy was associated with the odds of 1.071 (95% confidence interval: 1.066, 1.076) for LBW and reduced birthweight of 8.9 (8.4, 9.4) g in GPS-based DRM analysis. MA-stratified analyses suggested non-linear exposure-response relationships of PM2.5 exposure with both LBW (Pnonlinear <0.001) risk and birthweight change (Pnonlinear <0.001) over the exposure range of 17–104 μg/m3, with notably steeper slopes at low concentrations (<37.3 μg/m3). According to GPS-based DRM analysis, achieving the interim target level 1–3 of annual PM2.5 (i.e., 35, 25, and 15 μg/m3) could avoid 5.5%–32.6% of overall LBW infants and birthweight loss of 7.0–57.6 g per livebirth during 2013–2018 in Iran. Conclusions: Our findings provided nationwide evidence of causality for elevated LBW risk and birthweight loss associated with maternal PM2.5 exposure in Iran. Improving air quality through multisectoral efforts may avoid dramatic LBW burden to promote neonatal health later in life.http://www.sciencedirect.com/science/article/pii/S0147651324014908Fine particulate matterLow birthweightCausal inferenceDisease burdenIran |
| spellingShingle | Ziqing Tang Xuan Long Kai Wang Klaus Berger Yunquan Zhang Fatemeh Mayvaneh Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study Ecotoxicology and Environmental Safety Fine particulate matter Low birthweight Causal inference Disease burden Iran |
| title | Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study |
| title_full | Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study |
| title_fullStr | Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study |
| title_full_unstemmed | Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study |
| title_short | Risk and burden of low birthweight related to maternal PM2.5 exposure in Iran: A national causal inference study |
| title_sort | risk and burden of low birthweight related to maternal pm2 5 exposure in iran a national causal inference study |
| topic | Fine particulate matter Low birthweight Causal inference Disease burden Iran |
| url | http://www.sciencedirect.com/science/article/pii/S0147651324014908 |
| work_keys_str_mv | AT ziqingtang riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy AT xuanlong riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy AT kaiwang riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy AT klausberger riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy AT yunquanzhang riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy AT fatemehmayvaneh riskandburdenoflowbirthweightrelatedtomaternalpm25exposureinirananationalcausalinferencestudy |