Estimation of Stillbirths Attributable to Ambient Fine Particles in 137 Countries

Overview

Journal Nat Commun

Specialty Biology

Date 2022 Nov 29

PMID 36446772

Authors

Tao Xue

Mingkun Tong

Jiajianghui Li

Ruohan Wang

Tianjia Guan

Jiwei Li

Pengfei Li

Hengyi Liu

Hong Lu

Yanshun Li

Tong Zhu

Affiliations

Soon will be listed here.

Abstract

Gestational exposure to ambient fine particles (PM) increases the risk of stillbirth, but the related disease burden is unknown, particularly in low- and middle-income countries (LMICs). We combine state-of-the-art estimates on stillbirths, and multiple exposure-response functions obtained from previous meta-analyses or derived by a self-matched case-control study in 54 LMICs. 13,870 stillbirths and 32,449 livebirths are extracted from 113 geocoded surveys from the Demographic and Health Surveys. Each stillbirth is compared to livebirth(s) of the same mother using a conditional logit regression. We find that 10-µg/m increase of PM is associated with an 11.0% (95% confidence interval [CI] 6.4, 15.7) increase in the risk of stillbirth, and the association is significantly enhanced by maternal age. Based on age-specific nonlinear PM-stillbirth curves, we evaluate the PM-related stillbirths in 137 countries. In 2015, of 2.09 (95% CI: 1.98, 2.20) million stillbirths, 0.83 (0.54, 1.08) million or 39.7% (26.1, 50.8) are attributable to PM exposure exceeding the reference level of 10 μg/m. In LMICs, preventing pregnant women from being exposed to PM can improve maternal health.

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