Prenatal exposure to particulate matter and infant birth outcomes: Evidence from a population‐wide database

• Published in: Health economics 2024-09, Vol.33 (9), p.2182-2200
• Main Authors: Jahanshahi, Babak, Johnston, Brian, McGovern, Mark E., McVicar, Duncan, O’Reilly, Dermot, Rowland, Neil, Vlachos, Stavros
• Format: Article
• Language: English
• Subjects: Adult; Air Pollutants - adverse effects; Air Pollutants - analysis; Air pollution; Air Pollution - adverse effects; Babies; Birth weight; Births; Childbirth & labor; Databases, Factual; Female; Geographic information systems; Health status; Humans; infant outcomes; Infant, Newborn; Infants; Low income groups; Maternal & child health; Maternal and infant welfare; Maternal characteristics; Maternal Exposure - adverse effects; mother fixed‐effects; Mothers; Northern Ireland - epidemiology; Observational studies; Outdoor air quality; particulate matter; Particulate Matter - adverse effects; Particulate Matter - analysis; Placenta; Pollution; Population-based studies; Pregnancy; Pregnancy Outcome - epidemiology; Prenatal care; Prenatal exposure; Prenatal Exposure Delayed Effects; Public health
• ISSN: 1057-9230; 1099-1050; 1099-1050
• DOI: 10.1002/hec.4862

There are growing concerns about the impact of pollution on maternal and infant health. Despite an extensive correlational literature, observational studies which adopt methods that seek to address potential biases due to unmeasured confounders draw mixed conclusions. Using a population database of births in Northern Ireland (NI) linked to localized geographic information on pollution in mothers' postcodes (zipcodes) of residence during pregnancy, we examine whether prenatal exposure to PM2.5 is associated with a comprehensive range of birth outcomes, including placental health. Overall, we find little evidence that particulate matter is related to infant outcomes at the pollution levels experienced in NI, once we implement a mother fixed effects approach that accounts for time‐invariant factors. This contrasts with strong associations in models that adjust for observed confounders but without fixed effects. While reducing ambient air pollution remains an urgent public health priority globally, our results imply that further improvements in short‐run levels of prenatal PM2.5 exposure in a relatively low‐pollution, higher‐income country context, are unlikely to impact on birth outcomes at the population level.