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Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis.

ABSTRACT: Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytical methods and inclusion criteria were provided on the PROSPERO website (CRD42018085816). We evaluated pooled effects and heterogeneity. Subgroup analyses (grouped by exposure period, study settings, study design, exposure types, data source, Newcastle-Ottawa quality score (NOS), and adjustment for smoking or meteorological factors) were also conducted and publication bias was examined. The risk of bias in systematic reviews (ROBIS) tool was used to evaluate the overall risk of bias in this review. Forty studies met the inclusion criteria. We observed pooled odds ratios (ORs) of 1.03-1.21 for LBW and 0.97-1.06 for PTB when mothers were exposed to CO, NO2, NOx, O3, PM2.5, PM10, or SO2 throughout their pregnancy. For SGA, the pooled estimate was 1.02 in relation to NO2 concentrations. Subgroup analysis and sensitivity analysis decreased the heterogeneity to some extent, such as the subgroups of continuous measures (OR=0.98 (0.97-0.99), I2=0.0%) and NOS>7 (OR=0.98 (0.97-0.99), I2=0.0%) in evaluating the association between PTB and NO2. This review was completed with a low risk of bias. High concentrations of air pollution were significantly related to the higher risk of adverse birth outcomes. However, the sources of heterogeneity among studies should be further explored.

SUBMITTER: Guo LQ

PROVIDER: S-EPMC6421124 | biostudies-literature | 2019 Mar.

REPOSITORIES: biostudies-literature

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Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis.

Guo Le-Qian LQ Chen Yu Y Mi Bai-Bing BB Dang Shao-Nong SN Zhao Dou-Dou DD Liu Rong R Wang Hong-Li HL Yan Hong H

Journal of Zhejiang University. Science. B 20190301 3

Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytica ...[more]

PMID: 30829011

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Project description:There is inconclusive evidence on the association between ambient air pollution and pulmonary tuberculosis (PTB) incidence, tuberculosis-related hospital admission and mortality. This review aimed to assess the extent to which selected air pollutants are associated to PTB incidence, hospital admissions and mortality. This was a systematic review of studies published in English from January 1st, 1946, through May 31st, 2022, that quantitatively assessed the association between PM2.5, PM10, NO2, SO2, CO, O3 and the incidence of, hospital admission or death from PTB. Medline, Embase, Scopus and The Cochrane Library were searched. Extracted data from eligible studies were analysed using STATA software. Random-effect meta-analysis was used to derive pooled adjusted risk and odds ratios. A total of 24 studies (10 time-series, 5 ecologic, 5 cohort, 2 case-control, 1 case cross-over, 1 cross-sectional) mainly from Asian countries were eligible and involved a total of 437,255 tuberculosis cases. For every 10 μg/m3 increment in air pollutant concentration, there was a significant association between exposure to PM2.5 (pooled aRR = 1.12, 95% CI: 1.06-1.19, p < 0.001, N = 6); PM10 (pooled aRR = 1.06, 95% CI: 1.01-1.12, p = 0.022, N = 8); SO2 (pooled aRR = 1.08, 95% CI: 1.04-1.12, p < 0.001, N = 9); and the incidence of PTB. There was no association between exposure to CO (pooled aRR = 1.04, 95% CI: 0.98-1.11, p = 0.211, N = 4); NO2 (pooled aRR = 1.08, 95% CI: 0.99-1.17, p = 0.057, N = 7); O3 (pooled aRR = 1.00, 95% CI: 0.99-1.02, p = 0.910, N = 6) and the incidence of PTB. There was no association between the investigated air pollutants and mortality or hospital admissions due to PTB. Overall quality of evidence was graded as low (GRADE approach). Exposure to PM2.5, PM10 and SO2 air pollutants was found to be associated with an increased incidence of PTB, while exposure to CO, NO2 and O3 was not. There was no observed association between exposure to these air pollutants and hospital admission or mortality due to PTB. The quality of the evidence generated, however, remains low. Addressing the tuberculosis epidemic by 2030 as per the 4th Sustainable Development Goal may require a more rigorous exploration of this association.

Project description:IntroductionChronic kidney disease is a serious and a frequent disease associated with a high risk of morbi-mortality. Although several risk factors have already been well addressed, mostly diabetes and hypertension, many remain underappreciated, such as chronic exposure to air pollution.Methods and analysisWe will search EMBASE, PubMed, Web of Science, Cochrane Library and CINAHL database, from inception to 31 March 2020, for relevant records using a combination of keywords related to the type of exposure (ozone, carbon monoxide, nitrogen oxides and dioxide, sulfur dioxide, PM2.5, PMcoarse and PM10) and to the type of outcome (chronic kidney disease, end-stage renal/kidney disease, kidney failure, proteinuria/albuminuria, renal function, renal transplant, kidney graft, kidney transplant failure, nephrotic syndrome and kidney cancer). The review will be reported according to the guidelines of the Meta-analysis Of Observational Studies in Epidemiology. Two independent reviewers will select studies without design or language restrictions, using original data and investigating the association between exposure to one or more of the prespecified air pollutants and subsequent risk of renal outcomes. Using random-effects meta-analyses, we will present pooled summary statistics (HR, OR or beta-coefficients with their respective 95% CI) associated with a standardised increase in each pollutant level. The results will be presented by air pollutant and outcome. Heterogeneity will be assessed using the χ2 test on Cochran's Q statistic and quantified by calculating I2. The Egger's test and visual inspection of funnel plots will be used to assess publication bias.Ethics and disseminationSince primary data are not collected in this study, ethical approval is not required. This review is expected to provide relevant data on the associations between various air pollutants' exposure and renal outcomes. The final report will be published in an international peer-reviewed journal.Prospero registration numberCRD42020187956.

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Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis.

Publications

Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis.

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