Abstract:
Background. Recently, an association between adverse pregnancy outcome and air pollution was hypothesized
in several papers. The aim of the present study is to evaluate the impact of particles with aerodynamic diameter
< 10 mm (PM10) on the intrauterine growth retardation (IUGR) in two regions with the different level s of air pollution.
Methods and Results. The study group includes all singleton full term births of European origin over a two-year
period in the district of Teplice (n=1,943) and Prachatice (n=883). Information on reproductive and health history
and lifestyle was obtained from maternal questionnaires and medical records. IUGR was chosen as the indicator of
reproductive effects. The mean concentration of PM10 for each women in particular gestational month was calculated.
Three concentration intervals were constructed (low <40 mg/m
3
; medium 40-50 mg/m
3
; high >50 mg/m
3
). Relative
risk of IUGR was estimated for particular month and pollutant level. Influence of the potential confounders (maternal
age, height and pre-pregnancy weight, smoking, season and the year of study) was controlled using logistic regression
models; adjusted odd’s ratio (AOR) was estimated. Relative risk of IUGR in Teplice District was increased for
medium PM10 levels (AOR=1.62 CI: 1.07-2.46) (P<0.02) as well as for high levels in the first gestational month
(2.64 CI: 1.48-4.71) (P<0.001). The same association was observed also in Prachatice District, though the PM10 did
not achieve the „high“ levels (>50 mg/m
3
). AOR for IUGR for mothers exposed in the 1st gestational month to
medium PM10 levels was three times the risk of those exposed to low levels (3.50 CI: 1.82-6.81) (P<0.0003). No
similar relationship was observed in any other gestational stage.
Conclusions. Influence of particles or other associated air pollutants on fetal growth in early ge station is one of
several possible explanations of these results. Timing of this effect in both different regions is compatible with
a current hypothesis of IUGR etio-pathogenesis. Seasonal factors, one of the other possible explanations, is less
probable. More investigation is required to evaluate a possible causal nature of the relationship observed.
Key words:
air pollution, PM10, reproductive effects, intrauterine growth retardation, fetal growth retardation,
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