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CLC number: R173

On-line Access: 2019-03-01

Received: 2018-03-07

Revision Accepted: 2018-08-10

Crosschecked: 2019-01-10

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Le-qian Guo


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Journal of Zhejiang University SCIENCE B 2019 Vol.20 No.3 P.238-252


Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis

Author(s):  Le-qian Guo, Yu Chen, Bai-bing Mi, Shao-nong Dang, Dou-dou Zhao, Rong Liu, Hong-li Wang, Hong Yan

Affiliation(s):  Department of Epidemiology and Biostatistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an 710061, China; more

Corresponding email(s):   yanhong1234@aliyun.com

Key Words:  Air pollution, Low birth weight, Preterm birth, Meta-analysis, Adverse birth outcome

Le-qian Guo, Yu Chen, Bai-bing Mi, Shao-nong Dang, Dou-dou Zhao, Rong Liu, Hong-li Wang, Hong Yan. Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis[J]. Journal of Zhejiang University Science B, 2019, 20(3): 238-252.

@article{title="Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis",
author="Le-qian Guo, Yu Chen, Bai-bing Mi, Shao-nong Dang, Dou-dou Zhao, Rong Liu, Hong-li Wang, Hong Yan",
journal="Journal of Zhejiang University Science B",
publisher="Zhejiang University Press & Springer",

%0 Journal Article
%T Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis
%A Le-qian Guo
%A Yu Chen
%A Bai-bing Mi
%A Shao-nong Dang
%A Dou-dou Zhao
%A Rong Liu
%A Hong-li Wang
%A Hong Yan
%J Journal of Zhejiang University SCIENCE B
%V 20
%N 3
%P 238-252
%@ 1673-1581
%D 2019
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1800122

T1 - Ambient air pollution and adverse birth outcomes: a systematic review and meta-analysis
A1 - Le-qian Guo
A1 - Yu Chen
A1 - Bai-bing Mi
A1 - Shao-nong Dang
A1 - Dou-dou Zhao
A1 - Rong Liu
A1 - Hong-li Wang
A1 - Hong Yan
J0 - Journal of Zhejiang University Science B
VL - 20
IS - 3
SP - 238
EP - 252
%@ 1673-1581
Y1 - 2019
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1800122

Several reviews have assessed the relationship between exposure to ambient air pollution and adverse birth outcomes during pregnancy, but the results remain controversial. The objective of this study was to assess this correlation quantitatively and to explore sources of heterogeneity. We included all published case-control or cohort studies that evaluated the correlation between ambient air pollution and low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Analytical methods and inclusion criteria were provided on the PROSPERO website (CRD42018085816). We evaluated pooled effects and heterogeneity. Subgroup analyses (grouped by exposure period, study settings, study design, exposure types, data source, Newcastle-Ottawa quality score (NOS), and adjustment for smoking or meteorological factors) were also conducted and publication bias was examined. The risk of bias in systematic reviews (ROBIS) tool was used to evaluate the overall risk of bias in this review. Forty studies met the inclusion criteria. We observed pooled odds ratios (ORs) of 1.03–1.21 for LBW and 0.97–1.06 for PTB when mothers were exposed to CO, NO2, NOx, O3, PM2.5, PM10, or SO2 throughout their pregnancy. For SGA, the pooled estimate was 1.02 in relation to NO2 concentrations. Subgroup analysis and sensitivity analysis decreased the heterogeneity to some extent, such as the subgroups of continuous measures (OR=0.98 (0.97–0.99), I2=0.0%) and NOS>7 (OR=0.98 (0.97–0.99), I2=0.0%) in evaluating the association between PTB and NO2. This review was completed with a low risk of bias. High concentrations of air pollution were significantly related to the higher risk of adverse birth outcomes. However, the sources of heterogeneity among studies should be further explored.




Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article


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[65]List of electronic supplementary materials

[66]Table S1 PRISMA 2009 checklist

[67]Table S2 Characteristics of primary studies

[68]Table S3 Questions in ROBIS

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