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Sex differences in preterm birth and the impact of particulate matter pollution: A retrospective cross-sectional study of the Global Burden of Disease 2021.
Article in Science progress. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- The influence of fetal sex on preterm birth risk in gestational diabetes mellitus: A retrospective cohort study.Experimental and therapeutic medicine · 2026Article
- Global, regional, and national burden of preterm birth 1990 to 2023, with projections of prevalence to 2050.Frontiers in public health · 2026Article
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Authors and funding
9 authors.
Funding
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Abstract
ObjectivePreterm birth is a major global public health issue. However, sex difference in incidence and the potential association with air pollution in these disparities have not been fully explored globally.MethodsThis study is a retrospective, cross-sectional secondary analysis based on the Global Burden of Disease (GBD) 2021 database. Indicators included incidence, disability-adjusted life years (DALYs), years of life lost (YLLs), age-standardized rates, age-standardized YLL rate, age-standardized DALY rate, age-standardized YLL percent (ASYP), and age-standardized DALY percent (ASDP). Analyses were stratified by sex, socio-demographic index (SDI), and 21 GBD regions.ResultsFrom 1990 to 2021, male infants consistently experienced higher rates of preterm birth and greater disease burden than females, though the male-to-female ratio gradually narrowed. Particulate matter pollution significantly contributed to the burden of preterm birth, with males experiencing a higher burden than females. In 2021, particulate matter pollution accounted for roughly 1.3 times the burden observed in females and contributed to 31.1% of male ASYP and 26.7% of ASDP. Household air pollution was a major contributor, and its impact on males and females was similar in proportional terms. Regional variation was marked, with low-SDI regions, particularly sub-Saharan Africa and South Asia, experiencing the highest burden. Sex-stratified analyses revealed that air pollution, particularly household air pollution, had a more pronounced impact on males in some regions.ConclusionsMale infants consistently face a higher risk and burden of preterm birth worldwide. Particulate matter pollution, particularly household air pollution, appears to be linked to these disparities, especially in low-SDI regions. These findings underscore the need for targeted interventions to reduce indoor air pollution and mitigate sex-based inequalities in preterm birth burden.
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