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Acute and recent air pollution exposure and cardiovascular events at labour and delivery
  1. Tuija Männistö1,2,3,4,5,
  2. Pauline Mendola1,
  3. Katherine Laughon Grantz1,
  4. Kira Leishear6,7,
  5. Rajeshwari Sundaram8,
  6. Seth Sherman9,
  7. Qi Ying10,
  8. Danping Liu8
  1. 1Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
  2. 2Northern Finland Laboratory Centre NordLab, Oulu, Finland
  3. 3Department of Clinical Chemistry, University of Oulu, Oulu, Finland
  4. 4Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
  5. 5Department of Chronic Disease Prevention, National Institute for Health and Welfare, Oulu, Finland
  6. 6Glotech Inc., Rockville, Maryland, USA
  7. 7US Food and Drug Administration, Silver Spring, Maryland, USA
  8. 8Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Rockville, Maryland, USA
  9. 9The EMMES Corporation, Rockville, Maryland, USA
  10. 10Zachry Department of Civil Engineering, Texas A&M University, College Station, Texas, USA
  1. Correspondence to Dr Pauline Mendola, Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, 6100 Executive Boulevard, 7B05, Rockville, MD 20852, USA; Pauline.Mendola{at}nih.gov

Abstract

Objective To study the relationship between acute air pollution exposure and cardiovascular events during labour/delivery.

Methods The Consortium on Safe Labor (2002–2008), an observational US cohort with 223 502 singleton deliveries provided electronic medical records. Air pollution exposure was estimated by modified Community Multiscale Air Quality models. Cardiovascular events (cardiac failure/arrest, stroke, myocardial infarcts and other events) were recorded in the hospital discharge records for 687 pregnancies (0.3%). Logistic regression with generalised estimating equations estimated the relationship between cardiovascular events and daily air pollutant levels for delivery day and the 7 days preceding delivery.

Results Increased odds of cardiovascular events were observed for each IQR increase in exposure to nitric oxides at 5 and 6 days prior to delivery (OR=1.17, 99% CI 1.04 to 1.30 and OR=1.15, 1.03 to 1.28, respectively). High exposure to toxic air pollution species such as ethylbenzene (OR=1.50, 1.08 to 2.09), m-xylene (OR=1.54, 1.11 to 2.13), o-xylene (OR=1.51, 1.09 to 2.09), p-xylene (OR=1.43, 1.03 to 1.99) and toluene (OR=1.42, 1.02 to 1.97) at 5 days prior to delivery were also associated with cardiovascular events. Decreased odds of events were observed with exposure to ozone.

Conclusions Air pollution in the days prior to delivery, especially nitrogen oxides and some toxic air pollution species, was associated with increased risk of cardiovascular events during the labour/delivery admission.

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