ICUC12-884, updated on 21 May 2025
https://doi.org/10.5194/icuc12-884
12th International Conference on Urban Climate
© Author(s) 2025. This work is distributed under
the Creative Commons Attribution 4.0 License.
The influence of air pollution on preterm birth: A Case-crossover analysis with high spatio-temporal resolution assessment in the Rotterdam-Rijnmond region, The Netherlands
Medha J Pfaff1, Benjamin Y Gravesteijn2, Nienke W Boderie1, Sef van den Elshout3, Lizbeth Burgos Ochoa4, Loes C M Bertens5, Famke J M Mölenberg1, Fabio Porru1, Alex Burdorf1, and Jasper V Been6
Medha J Pfaff et al.
  • 1Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam,Netherlands
  • 2Department of Obstetrics and Gynecology, Amsterdam University Medical Center, Amsterdam, Netherlands
  • 3Department of Air Quality, DCMR Environmental Protection Agency, Schiedam, Netherlands
  • 4Department of Methodology, Tilburg School of Social and Behavioral Sciences, Tilburg, Netherlands
  • 5Department of Obstetrics and Gynecology, Erasmus MC - Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands
  • 6Department of Neonatal and Pediatric Intensive Care, Erasmus MC - Sophia Children’s Hospital, University Medical Center Rotterdam, Rotterdam, Netherlands

Introduction

This study investigated the causal link between transient exposure to three air pollutants (Particulate Matter (PM10), Nitrogen Dioxide (NO2) and Ozone (O3)) and preterm birth (PTB) during the week before delivery. As previous research in the study area mainly investigated long-term exposure to air pollution and is subject to confounding, the current work presents an important contribution to the literature.

Materials and Methods

This included 13’058 singleton preterm deliveries (< 37 weeks) in the Rotterdam-Rijnmond region, between 2003 and 2019. Daily averaged pollutant concentrations were spatiotemporally linked to the residence of birth parents. We conducted conditional logistic regression to derive odds ratios (ORs) and 95% confidence intervals (CIs) for the association between an interquartile range (IQR) increase in pollutants and PTB across individual lag days. Moreover, we performed subset analyses based on season (warm vs. cold), socioeconomic status (SES; lowest vs. highest quintile) and spontaneous PTB cases only.

Results

During the warm season, an IQR increase in O₃ was linked to a 3%, respectively 4%, rise in the odds of PTB on the two days preceding delivery, for the general study population and the spontaneous PTB subgroup. Furthermore, we found odds increased by 9% for low-SES individuals on lag day 6 (95% CI 1.02-1.16). During the cold season, an IQR increase in NO₂ raised PTB odds by 4-10% in the week before birth, peaking on lag day 2 (95% CI 1.06-1.15). The low-SES subgroup saw a 9-10% rise in the three days preceding delivery, while odds for spontaneous PTB were increased by 6% on lag day 6 (95% CI 1.00, 1.11). PM₁₀ was associated with a 3% increase near delivery.

Conclusion

Short-term exposure to ambient air pollutants increases PTB risk, especially for low-SES and spontaneous PTB groups. Future studies should consider labor onset timing and indoor air quality data.

How to cite: Pfaff, M. J., Gravesteijn, B. Y., Boderie, N. W., van den Elshout, S., Burgos Ochoa, L., Bertens, L. C. M., Mölenberg, F. J. M., Porru, F., Burdorf, A., and Been, J. V.: The influence of air pollution on preterm birth: A Case-crossover analysis with high spatio-temporal resolution assessment in the Rotterdam-Rijnmond region, The Netherlands, 12th International Conference on Urban Climate, Rotterdam, The Netherlands, 7–11 Jul 2025, ICUC12-884, https://doi.org/10.5194/icuc12-884, 2025.

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