Prenatal exposure to particulate matter air pollution and biothermal stress could contribute to neonatal resuscitation — The Association Specialists
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  2. Oral Presentations - Climate, environment and human health 1
  3. Prenatal exposure to particulate matter air pollution and biothermal stress could contribute to neonatal resuscitation

Prenatal exposure to particulate matter air pollution and biothermal stress could contribute to neonatal resuscitation (24221)

Sylvester Dodzi Nyadanu 1 , Gavin Pereira 1 , Gizachew Tessema 1
  1. Curtin University, Perth, Bentley, WESTERN AUSTRALIA, Australia

Background: About 10% of newborns globally require resuscitation at birth to establish effective respiration and fetal circulation. Ambient air pollution and temperature have been associated with adverse pregnancy outcomes and cardiorespiratory diseases, but their relationship with neonatal resuscitation has not been studied. This study investigates the association between maternal exposure to fine particulate matter (PM2.5) and novel composite biothermal metric (Universal Thermal Climate Index, UTCI) with neonatal resuscitation while identifying potential susceptible windows.

Method: A total of 412,687 singleton live births, of which 30% received resuscitation from 01/01/2000–3/12/2015 across Western Australia, were linked to monthly PM2.5 and UTCI from conception to birth. Novel distributed lag non-linear Cox regressions that accounted for spatial clustering and both the intensity and timing of past exposures estimated the cumulative and monthly covariate-adjusted hazard ratios (aHR) and 95% confidence intervals (95% CI) of climate-related exposures and neonatal resuscitation.

Results: Relative to 5 µg/m3 PM2.5 and median UTCI (14.2 ℃), cumulative exposures at various exposure thresholds independently and synergistically were associated with higher hazards of neonatal resuscitation.  The elevated aHRs for PM2.5 exposure were 1.30 (95% CI 1.13, 1.50) and 1.20 (95% CI 1.09, 1.31) at the 10th (6.9 µg/m3) and 50th (8.0 µg/m3) centiles, respectively. Elevated aHR for UTCI were 1.22 (95% CI 1.18, 1.29) and 1.28 (95% CI 1.24, 1.33) at the 1st (9.7 ℃) and the 95th (18.2 ℃) centiles, respectively. Monthly exposure showed a slight J-shape with critical windows in gestational months 7-10 for PM2.5 and inverted U-shape associations for UTCI with critical windows in gestational months 1-9 (peaked in 4-6 months).

Conclusion: This first epidemiologic evidence suggests that both extreme biothermal exposures and ambient air pollution were associated with increased hazards of neonatal resuscitation with identified critical periods. Climate-related health interventions and further studies from other geodemographic settings are particularly required.