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Prenatal PM2.5 linked to preterm birth in Puerto Rico

In the PROTECT birth cohort, an IQR rise in pregnancy-average PM2.5 was associated with higher preterm-birth risk among relatively healthy Puerto Rican women.

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How many PROTECT births entered the PM2.5 analysis?

1092 live singleton births from 21 municipalities (2011–2018).

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

What share of births was preterm?

About 9.1%.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

What was mean pregnancy-average PM2.5?

6.8 μg/m³ (IQR 5.4–7.4); range 3.1–19.8.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

What was the municipal-adjusted RR per IQR PM2.5?

1.012 (95% CI 1.004–1.021).

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

How was PM2.5 assigned to mothers?

From the nearest EPA community monitor to municipality of residence at birth (mean 10.6 km).

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

How was preterm birth defined?

Birth before completion of 37 weeks of gestation.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

Which regression estimated the risk ratio?

Modified Poisson with a sandwich variance estimator, scaled per IQR PM2.5.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

Did DBP or DiBP phthalates modify the PM2.5–PTB association?

No; interaction p-values were 0.55 and 0.86.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

Why might the Puerto Rico effect look smaller than some US cohorts?

Average PM2.5 here was lower than many mainland studies (~9.0–15.6 μg/m³), and exposure used central EPA monitors.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

What exposure-error problem did the authors flag?

Area-wide monitor averages and no accounting for residential moves, likely biasing toward the null.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified

Who is excluded from generalizing these results?

Women with major medical or obstetric comorbidities; PROTECT enrolled relatively healthy 18–40-year-olds.

Source: Preterm birth and PM2.5 in Puerto Rico: evidence from the PROTECT birth cohort · DOI · quote verified