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Exposures to Air Pollution and Risk of Acute-onset Placental Abruption: A Case-crossover Study.


ABSTRACT: BACKGROUND:Despite abruption's elusive etiology, knowledge of triggers that precede it by just a few days prior to delivery may help to understand the underpinnings of this acute obstetrical complication. We examine whether air pollution exposures immediately preceding delivery are associated with acute-onset abruptions. METHODS:We applied a bidirectional, time-stratified, case-crossover design to births with an abruption diagnosis in New York City, 2008-2014. We measured ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2). We fit distributed lag nonlinear models based on conditional logistic regression to evaluate individual exposure and cumulative exposures over lags 0-7 days before abruption, adjusted for temperature and relative humidity (similar lags to the main exposures). RESULTS:We identified 1,190 abruption cases. We observed increased odds of abruption for exposure to PM2.5 (per 10 ?g/m) on lag day 3 (odds ratio [OR] 1.19, 95% confidence interval [CI] = 0.98, 1.43), lag day 4 (OR 1.21, 95% CI = 1.01, 1.46), and lag day 5 (OR 1.17, 95% CI = 1.03, 1.33). Similarly, the odds of abruption increased with exposure to NO2 (per 5 ppb) on lag day 3 (OR 1.16, 95% CI = 0.98, 1.37), lag day 4 (OR 1.19, 95% CI = 1.02, 1.39), and lag day 5 (OR 1.16, 95% CI = 1.05, 1.27). Exposures to PM2.5 and NO2 at other lags, or cumulative exposures, were not associated with abruption of acute onset. CONCLUSIONS:This case-crossover study showed evidence of an association between short-term ambient air pollution exposures and increased abruption risk of acute onset.

SUBMITTER: Ananth CV 

PROVIDER: S-EPMC6066409 | biostudies-literature | 2018 Sep

REPOSITORIES: biostudies-literature

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Exposures to Air Pollution and Risk of Acute-onset Placental Abruption: A Case-crossover Study.

Ananth Cande V CV   Kioumourtzoglou Marianthi-Anna MA   Huang Yongmei Y   Ross Zev Z   Friedman Alexander M AM   Williams Michelle A MA   Wang Shuang S   Mittleman Murray A MA   Schwartz Joel J  

Epidemiology (Cambridge, Mass.) 20180901 5


<h4>Background</h4>Despite abruption's elusive etiology, knowledge of triggers that precede it by just a few days prior to delivery may help to understand the underpinnings of this acute obstetrical complication. We examine whether air pollution exposures immediately preceding delivery are associated with acute-onset abruptions.<h4>Methods</h4>We applied a bidirectional, time-stratified, case-crossover design to births with an abruption diagnosis in New York City, 2008-2014. We measured ambient  ...[more]

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