The association of in-utero exposure to ambient fine particulate air pollution with low birth weight in India
2021
Nihit Goyal | David Canning
A growing body of research indicates that in-utero exposure to ambient fine particulate matter (PM _2.5 ) is a risk factor for low birth weight (LBW). However, research on India, where the high and rising level of ambient air pollution is a significant health concern, is limited. In this study, we analyze the association between ambient PM _2.5 and LBW in India. We match data on birth weight from the National Family and Health Survey (NFHS) conducted in India in 2015–16 with high-resolution spatial data on annual ambient PM _2.5 concentration to calculate in-utero exposure based on the residential location of each child. We estimate the association of in-utero exposure to ambient PM _2.5 with birth weight and LBW, after adjusting for child level, maternal, and household level characteristics that predict birth weight. In our sample ( n = 149 416), in comparison to the reference category of in-utero PM _2.5 level less than 26.7 µ g m ^−3 , the adjusted OR of LBW increases non-linearly from 1.098 (95% CI: 0.954, 1.263) for children in the exposure band 39.3–44.7 µ g m ^−3 (i.e., the fourth octile) to 1.241 (95% CI: 1.065, 1.447) for those in the exposure band 44.7–51.6 µ g m ^−3 (i.e., the fifth octile) and 1.405 (95% CI: 1.126,1.753) for those with in-utero PM _2.5 level greater than 77.3 µ g m ^−3 (i.e., the last octile). Our findings show that exposure to ambient PM _2.5 is strongly associated with LBW in India and suggest that policies that improve air quality may be necessary for achieving the World Health Assembly target of 30% reduction in LBW by 2025.
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