Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study

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Authors:

Claire L. Leiser, M.S.P.H., Heidi A. Hanson, Ph.D., M.S., Kara Sawyer, M.D., Jacob Steenblik, M.P.H., M.H.A., Ragheed Al-Dulaimi, M.D., M.P.H., M.Sc., Troy Madsen, M.D., Karen Gibbins, M.D., James M. Hotaling, M.D., Yetunde Oluseye Ibrahim, M.D., James A. VanDerslice, Ph.D., Matthew Fuller, M.D.

Abstract:

Objective

To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss.

Design

Case-crossover study from 2007 to 2015.

Setting

An academic emergency department in the Wasatch Front area of Utah.

Patient(s)

A total of 1,398 women who experienced spontaneous pregnancy loss events.

Intervention(s)

None.

Main Outcome Measure(s)

Odds of spontaneous pregnancy loss.

Result(s)

We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01–1.33; P=.04). A 10-μg/m3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR3-day average = 1.09; 95% CI 0.99–1.20; P=.05) (OR7-day average = 1.11; 95% CI 0.99–1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone.

Conclusions

We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.


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Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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