Impact of air pollution and temperature on adverse birth outcomes: Madrid, 2001–2009

Background/objectives: Low birth weight (<2500 g) (LBW), premature birth (<37 weeks of gestation) (PB), and late foetal death (<24 h of life) (LFD) are causes of perinatal morbi-mortality, with short- and long-term social and economic health impacts. This study sought to identify gestational windows of susceptibility during pregnancy and to analyse and quantify the impact of different air pollutants, noise and temperature on the adverse birth outcomes. Methods: Time-series study to assess the impact of mean daily PM_2.5, NO₂ and O₃ (μg/m³), mean daily diurnal (Leqd) and nocturnal (Leqn) noise levels (dB(A)), maximum and minimum daily temperatures (°C) on the number of births with LBW, PB or LFD in Madrid across the period 2001–2009. We controlled for linear trend, seasonality and autoregression. Poisson regression models were fitted for quantification of the results. The final models were expressed as relative risk (RR) and population attributable risk (PAR). Results: Leqd was observed to have the following impacts in LBW: at onset of gestation, in the second trimester and in the week of birth itself. NO₂ had an impact in the second trimester. In the case of PB, the following: Leqd in the second trimester, Leqn in the week before birth and PM_2.5 in the second trimester. In the case of LFD, impacts were observed for both PM_2.5 in the third trimester, and minimum temperature. O₃ proved significant in the first trimester for LBW and PB, and in the second trimester for LFD. Conclusions: Pollutants concentrations, noise and temperature influenced the weekly average of new-borns with LBW, PB and LFD in Madrid. Special note should be taken of the effect of diurnal noise on LBW across the entire pregnancy. The exposure of pregnant population to the environmental factors analysed should therefore be controlled with a view to reducing perinatal morbi-mortality. - Highlights: • Exposure to pollutants during pregnancy has been related to adverse birth outcomes. • This study therefore sought to analyse the influence of air pollution and noise levels on adverse births. • This study sought to identify gestational windows of susceptibility during pregnancy. • Special note should be taken of the effect of diurnal noise on LBW across the entire pregnancy. - This study analyse the influence of air pollution, noise and temperature on adverse birth outcomes identifying and quantifying the susceptible periods of exposure during pregnancy.