2024

Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: A Generalized Additive ModelAbstractBackground: There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. Methods: Data on adverse pregnancy outcomes and air pollutants including Ozone (O₃), Nitric oxide (NO), Nitrogen Dioxide (NO₂), Sulfur Dioxide (SO₂), Carbon Monoxide (CO), Particles with a diameter of less than 10 micrometers (PM₁₀) and Particles with a diameter less than 2.5 micrometers (PM_2.5) were collected over the years 2008-2018. A time-series analysis using the generalized additive model (GAM) with up to 6-day lags was used. Results: The results showed that the SO₂ pollutant on 0, 1, 3, 4, and 6-day lags and PM₁₀ on lag 0 had direct and significant associations with spontaneous abortion. NO, NO₂ and CO on 0-6-day lags; and O₃ on 6-day lags showed direct and significant associations with preeclampsia. NO and NO₂ pollutants showed significant and direct associations with gestational diabetes, during 0 and 6- day lags. NO on 0, 3 and 4-day lags, CO in all 0-6 day lags and PM_2.5 on 1, 3, 5, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. Conclusions: Air pollution is apparently causing adverse human reproductive outcomes in Ahvaz. This study further emphasizes the need to control ambient air pollution in Ahvaz.