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Acute air pollution exposure and NICU admission: a case-crossover analysis.

ABSTRACT: PURPOSE:Neonatal intensive care unit (NICU) admission rates have increased over time. Air pollution is associated with adverse pregnancy outcomes, but the relationship between prenatal air pollution exposure and NICU admission has not been investigated. METHODS:In the Consortium on Safe Labor (2002-2008), 27,189 singletons were admitted to the NICU. Modified Community Multiscale Air Quality models estimated exposures for criteria air pollutants and constituents of particles less than or equal to 2.5 microns (PM2.5). Case-crossover analyses calculated odds ratios and 95% confidence intervals for interquartile range increases in pollutant exposure, comparing exposures during the week of delivery to control periods before and after delivery. RESULTS:In models that adjusted for PM2.5, exposure to PM2.5 constituents during the week before delivery was significantly associated with increased odds of NICU admission: elemental carbon (35%), ammonium ions (37%), nitrate compounds (16%), organic compounds (147%), and sulfate compounds (35%). Odds were also significantly increased by day of and day before delivery exposures to carbon monoxide (4%-5%), nitrogen dioxide (13%), nitrogen oxides (4%-8%), particles less than or equal to 10 microns (2%), particles less than or equal to 2.5 microns (2%), and sulfur dioxide (3%-6%). No associations were observed for ozone. CONCLUSIONS:Acute exposures to PM2.5 constituents and several traffic-related pollutants during the week before delivery, the day of delivery, and day before delivery appear to increase the odds of NICU admissions. These novel associations suggest infants exposed in utero to common air pollutants may require additional care during the newborn hospital admission.

SUBMITTER: Seeni I

PROVIDER: S-EPMC6755057 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Acute air pollution exposure and NICU admission: a case-crossover analysis.

Seeni Indulaxmi I Williams Andrew A Nobles Carrie C Chen Zhen Z Sherman Seth S Mendola Pauline P

Annals of epidemiology 20190712

<h4>Purpose</h4>Neonatal intensive care unit (NICU) admission rates have increased over time. Air pollution is associated with adverse pregnancy outcomes, but the relationship between prenatal air pollution exposure and NICU admission has not been investigated.<h4>Methods</h4>In the Consortium on Safe Labor (2002-2008), 27,189 singletons were admitted to the NICU. Modified Community Multiscale Air Quality models estimated exposures for criteria air pollutants and constituents of particles less t ...[more]

PMID: 31445753

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Project description:Background: Previous studies suggested that exposure to air pollution could increase risk of asthma attacks in children. The aim of this study is to investigate the short-term effects of exposure to ambient air pollution on asthma hospital admissions in children in Beijing, a city with serious air pollution and high-quality medical care at the same time. Methods: We collected hospital admission data of asthma patients aged ≤ 18 years old from 56 hospitals from 2013 to 2016 in Beijing, China. Time-stratified case-crossover design and conditional Poisson regression were applied to explore the association between risk of asthma admission in children and the daily concentration of six air pollutants [particulate matter ≤ 2.5 μm (PM2.5), particulate matter ≤ 10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), carbon monoxide (CO), and ozone (O3)], adjusting for meteorological factors and other pollutants. Additionally, stratified analyses were performed by age, gender, and season. Results: In the single-pollutant models, higher levels of PM2.5, SO2, and NO2 were significantly associated with increased risk of hospital admission for asthma in children. The strongest effect was observed in NO2 at lag06 (RR = 1.25, 95%CI: 1.06-1.48), followed by SO2 at lag05 (RR = 1.17, 95%CI: 1.05-1.31). The robustness of effects of SO2 and NO2 were shown in two-pollutant models. Stratified analyses further indicated that pre-school children (aged ≤ 6 years) were more susceptible to SO2. The effects of SO2 were stronger in the cold season, while the effects of NO2 were stronger in the warm season. No significant sex-specific differences were observed. Conclusions: These results suggested that high levels of air pollution had an adverse effect on childhood asthma, even in a region with high-quality healthcare. Therefore, it will be significant to decrease hospital admissions for asthma in children by controlling air pollution emission and avoiding exposure to air pollution.

Dataset Information

Acute air pollution exposure and NICU admission: a case-crossover analysis.

Publications

Acute air pollution exposure and NICU admission: a case-crossover analysis.

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