Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy Cohort

2024  Journal Article

Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy Cohort

Pub TLDR

Prenatal exposures to fine particular matter (PM2.5) increased the risk of severe respiratory distress among term newborns and support the development and prioritization of public health and prenatal care strategies to increase awareness and minimize prenatal exposures to air pollution.

DOI: 10.1289/EHP12880    PubMed ID: 38271058
 

College of Health researcher(s)

OSU Profile

Highlights

  • This study examined the impact of prenatal exposure to air pollution on neonatal respiratory distress.
  • Data from a Canadian pregnancy cohort study was used to estimate exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2).
  • Prenatal exposure to air pollution was not associated with physician-diagnosed respiratory distress, oxygen therapy, or neonatal intensive care unit (NICU) admissions.
  • However, it was found that exposure to air pollution was strongly associated with assisted ventilation, multiple clinical interventions, and administration of systemic antibiotics.
  • These associations were consistent across different exposure periods and robust to model specification.
  • This study concluded that prenatal exposure to air pollution increased the risk of severe respiratory distress among term newborns.

Abstract

Background

Respiratory distress is the leading cause of neonatal morbidity and mortality worldwide, and prenatal exposure to air pollution is associated with adverse long-term respiratory outcomes; however, the impact of prenatal air pollution exposure on neonatal respiratory distress has not been well studied.

Objectives

We examined associations between prenatal exposures to fine particular matter (PM2.5) and nitrogen dioxide (NO2) with respiratory distress and related neonatal outcomes.

Methods

We used data from the Maternal-Infant Research on Environmental Chemicals (MIREC) Study, a prospective pregnancy cohort (n=2,001) recruited in the first trimester from 10 Canadian cities. Prenatal exposures to PM2.5(n=1,321) and NO2(n=1,064) were estimated using land-use regression and satellite-derived models coupled with ground-level monitoring and linked to participants based on residential location at birth. We calculated odds ratios (ORs) and 95% confidence intervals (CIs) for associations between air pollution and physician-diagnosed respiratory distress in term neonates in hierarchical logistic regression models adjusting for detailed maternal and infant covariates.

Results

Approximately 7% of newborns experienced respiratory distress. Neonates received clinical interventions including oxygen therapy (6%), assisted ventilation (2%), and systemic antibiotics (3%). Two percent received multiple interventions and 4% were admitted to the neonatal intensive care unit (NICU). Median PM2.5 and NO2 concentrations during pregnancy were 8.81μg/m3 and 18.02ppb, respectively. Prenatal exposures to air pollution were not associated with physician-diagnosed respiratory distress, oxygen therapy, or NICU admissions. However, PM2.5 exposures were strongly associated with assisted ventilation (OR per 1-μg/m3 increase in PM2.5=1.17; 95% CI: 1.02, 1.35), multiple clinical interventions (OR per 1-μg/m3 increase in PM2.5=1.16; 95% CI: 1.07, 1.26), and systemic antibiotics, (OR per 1-μg/m3 increase in PM2.5=1.12; 95% CI: 1.04, 1.21). These associations were consistent across exposure periods-that is, during pre-pregnancy, individual trimesters, and total pregnancy-and robust to model specification. NO2 exposure was associated with administration of systemic antibiotics (OR per 1-ppb increase in NO2=1.03; 95% CI: 1.00, 1.06).

Discussion

Prenatal exposures to PM2.5 increased the risk of severe respiratory distress among term newborns. These findings support the development and prioritization of public health and prenatal care strategies to increase awareness and minimize prenatal exposures to air pollution.

Johnson, M., Mazur, L., Fisher, M., Fraser, W.D., Sun, L., Hystad, P., Gandhi, C.K. (2024) Prenatal Exposure to Air Pollution and Respiratory Distress in Term Newborns: Results from the MIREC Prospective Pregnancy CohortEnvironmental Health Perspectives132(1)