Birth Outcomes among Infants Born between 2006 and 2018 after Maternal Exposure during Pregnancy to Ultrafine Particles from Aviation around a Large International Airport in the Netherlands.

Abstract

Background: People who live near airports are exposed to higher concentrations of ultrafine particles (UFPs) from aviation. Pregnant women and their fetuses, in particular, are considered to be highly susceptible to environmental exposures.

Objective: Using existing national databases, we investigated associations between adverse birth outcomes and exposure to UFPs from aviation (UFP-aviation) at the residential address during pregnancy.

Methods: We identified $\sim \mathrm{286,000}$ singleton birth records (from between 2006 and 2018) from mothers who, for at least 6 months during pregnancy, lived in a $50\times 56\mathrm{km}$ area around Schiphol Airport. This information was linked to modeled monthly averaged UFP-aviation concentrations at the residential address during pregnancy. We modeled the association between exposure to UFP-aviation during pregnancy and pregnancy outcomes through logistic regression, adjusting for individual and neighborhood level covariates. We performed a number of sensitivity analyses to investigate the robustness of the results, including adjustment for other air pollutants and noise.

Results: Effect estimates, expressed per 3,500 particles/cm³ (approximately the 5th-9th percentile difference) increase, were generally positive in the main model for preterm birth (PTB) and small for gestational age (SGA) [PTB $\text{OR}=$ 1.02 (95% CI: 0.96, 1.07) and SGA $\text{OR}=$ 1.02 (95% CI: 0.98, 1.07)] and congenital anomalies (CAs) at birth [any CA $\text{OR}=$ 1.05 (95% CI: 0.98, 1.07)]. Associations with UFP-aviation became stronger in some of the sensitivity analyses, such as when the four municipalities with the lowest exposure were excluded (for PTB, SGA, and CA), when the population was restricted to mothers with a Dutch background (PTB), after nonlinear adjustment for nitrogen dioxide (${\mathrm{NO}}_2$) and elemental carbon (EC) (PTB), after including municipality as a random effect (CA), and in some specific strata of the population. No associations were found with infant mortality, low Apgar score, and low birth weight.

Conclusions: We found suggestive evidence for associations between exposure to UFP-aviation during pregnancy and pregnancy outcomes. https://doi.org/10.1289/EHP14398.