Ann Med. 2025 Dec;57(1):2534854. doi: 10.1080/07853890.2025.2534854. Epub 2025 Jul 20.
ABSTRACT
BACKGROUND: Accelerated industrialization globally has intensified air pollution, but the susceptibility periods for extreme air pollution in twin pregnancies remain undefined.
METHODS: This study investigated the association between extreme air pollution exposure and preterm birth risk in twin pregnancies. Data on 3623 twin pregnancies in Chongqing from 2017 to 2022 and air pollution readings from 12 monitoring stations were analyzed using distributed lag non-linear quasi-Poisson regression models. Additionally, four extreme air pollution indices were developed to assess the cumulative effects of lagged exposures on preterm birth risk through multivariate logistic regression.
RESULTS: Compared to the lower quartile, the 95th percentile of extreme air pollution exposure showed a positive correlation between concentrations of PM2.5, PM10, NO2, SO2 and CO and preterm birth risk in twin pregnancies, with O3 inversely correlated. Sensitive periods for air pollutants were different. 8-12 and 27-35 gestational weeks were identified for PM2.5; 6-13 and 27-35 gestational weeks were identified for PM10; 5-14 and 21-33 gestational weeks were identified for NO2; 4-15 and 24-36 gestational weeks were identified for SO2; 4-11 and 29-33 gestational weeks were identified for CO. PM2.5, PM10, SO2 and O3 showed cumulative effects across short and long lags, while CO showed a long-term effect. Notably, NO2 exhibited a protective effect during all lag periods.
CONCLUSION: The study highlights gestational windows of 8-11 and 29-33 weeks as highly sensitive to extreme pollution for preterm birth in twin pregnancies, with marked risk increases during 0-3, 0-6 and 0-9-month lag periods.
PMID:40684455 | DOI:10.1080/07853890.2025.2534854
