ArticleEnvironmental epidemiology (Philadelphia, Pa.)2019
Should we adjust for delivery hospital in studies of air pollution and pregnancy outcomes?
Article in Environmental epidemiology (Philadelphia, Pa.), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers, 1 of them a synthesis that pooled it.
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2 citing papers in PubMed, 1 synthesis or guideline pooled it, 7 citations in OpenAlex.
- The impact of particulate matter 2.5 on the risk of preeclampsia: an updated systematic review and meta-analysis.Environmental science and pollution research international · 2020Pooled it
- Disentangling impacts of multiple pollutants on acute cardiovascular events in New York city: A case-crossover analysis.Environmental research · 2024Article
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7 authors at 2 institutions in 2 countries.
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Abstract
In conducting a study of ambient air pollution and pregnancy outcome in New York City, we identified delivery hospital as a potential confounder, given its association with both maternal residence and therefore air pollution exposure, and with clinical practices and as a potential marker of outcome misclassification in the coding of pregnancy complications. Motivated by evidence that adjustment for delivery hospital affected associations between air pollution and pregnancy outcome, we undertook a detailed empirical examination of the role of delivery hospital that warrants consideration by others addressing this topic.
methodsIn a study of air pollution and pregnancy outcome, we identified births from 2008 to 2010 to residents of New York City and, after restrictions, included 238,960 in the analysis. Air pollution exposure estimates for ambient fine particles (PM
resultsStatistical adjustment for delivery hospital markedly attenuated the relationship of air pollution with birth weight and gestational hypertension, with smaller effects on preterm birth and preeclampsia. Delivery hospital was associated with estimated maternal air pollution levels after adjusting for individual-level patient characteristics, more strongly for PM
conclusionsBased on these results, delivery hospital warrants closer consideration in studies of air pollution and other spatial factors in relation to pregnancy outcomes. The possibility of confounding by delivery hospital needs to be balanced with the risk of adjusting for a mediator of the air pollution-pregnancy outcome association in studies of this type.
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