Evidence map›Paper›PMID 21447454›Full record

ArticleEnvironmental health perspectives2011

Air pollution and stillbirth: a population-based case-control study in Taiwan.

Bing-Fang Hwang, Yungling Leo Lee, Jouni J K Jaakkola

Open access · diamondAbstract read
In one paragraph

Article in Environmental health perspectives, 2011. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
30citing papers in PubMed, 3 pooled it
3.1field-weighted citation impact, top 11% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 62 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA.Environmental epidemiology (Philadelphia, Pa.) · 2026
    Article
  5. Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA.medRxiv : the preprint server for health sciences · 2026
    Article
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  11. Residential proximity to roadways and placental-associated stillbirth: a case-control study.International journal of environmental health research · 2021
    Article
  12. Article
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  15. Traffic-related Air Pollution and Pregnancy Loss.Epidemiology (Cambridge, Mass.) · 2019
    Article
  16. Article
  17. Review
  18. Road Traffic Noise, Air Pollutants, and the Prevalence of Cardiovascular Disease in Taichung, Taiwan.International journal of environmental research and public health · 2018
    Article
  19. Chronic and Acute Ozone Exposure in the Week Prior to Delivery Is Associated with the Risk of Stillbirth.International journal of environmental research and public health · 2017
    Article
  20. Residential Proximity to Roadways and Ischemic Placental Disease in a Cape Cod Family Health Study.International journal of environmental research and public health · 2017
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

3 authors at 3 institutions in 4 countries.

Bing-Fang HwangDepartment of Occupational Safety and Health, College of Public Health, China Medical University, Taichung, Taiwan. bfhwang@mail.cmu.edu.tw
Yungling Leo Lee
Jouni J K Jaakkola
China Medical University · TWNational Taiwan University · TWUniversity of Birmingham · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThere is limited evidence suggesting that prenatal exposure to ambient air pollutants may increase the risk of stillbirth, but previous epidemiological studies have not elaborated the most susceptible gestational period for the effects of air pollution exposure on stillbirth.

objectivesWe estimated associations between exposure to ambient air pollutants and stillbirth, with special reference to the assessment of gestational periods when the fetus is most susceptible.

methodsWe conducted a population-based case-control study in Taiwan. The case group consisted of 9,325 stillbirths, and the control group included 93,250 births randomly selected from 1,510,064 Taiwanese singleton newborns in 2001-2007. Adjusted logistic regression models were used to estimate odds ratios (ORs) per 10-ppb change for ozone and nitrogen dioxide, 1-ppb change for sulfur dioxide (SO2), 10-μg/m3 change for particulate matter with aerodynamic diameter ≤ 10 μm (PM10), and 100-ppb change for carbon monoxide during different gestational periods and according to term or preterm (< 37 weeks) birth status.

resultsStillbirth increased in association with a 1-ppb increase in first-trimester SO2 [adjusted OR = 1.02; 95% confidence interval (CI), 1.00-1.04], particularly among preterm births (adjusted OR = 1.04; 95% CI, 1.01-1.07). Stillbirth was also associated with a 10-μg/m3 increase in PM10 during the first (adjusted OR = 1.02; 95% CI, 1.00-1.05) and second (adjusted OR = 1.02; 95% CI, 1.00-1.04) month of gestation, and, as with SO2, associations appeared to be restricted to preterm births (first-trimester adjusted OR = 1.03; 95% CI, 1.00-1.07).

conclusionThe study provides evidence that exposure to outdoor air SO2 and PM10 may increase the risk of stillbirth, especially among preterm births, and that the most susceptible time periods for exposure are during the first trimester of gestation.

Indexed as

AdultAir PollutantsCase-Control StudiesCohort StudiesFemaleHumansMaternal ExposurePregnancyPregnancy Trimester, FirstPremature BirthRisk AssessmentStillbirthTaiwanYoung AdultAir Pollutants

Identifiers

PMID21447454
PMCPMC3230395
OpenAlexW2029453973

What OpenQuestion holds

Textmetadata
LicenceCC0
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.