scholarly journals Measuring Burden of Disease Attributable to Air Pollution Due to Preterm Birth Complications and Infant Death in Paris Using Disability-Adjusted Life Years (DALYs)

2020 ◽  
Vol 17 (21) ◽  
pp. 7841
Author(s):  
Séverine Deguen ◽  
Guadalupe Perez Marchetta ◽  
Wahida Kihal-Talantikite
Keyword(s):  
Air Pollution ◽  
Preterm Birth ◽  
Infant Death ◽  
Burden Of Disease ◽  
Preterm Births ◽  
Census Block ◽  
Infant Deaths ◽  
Birth Complications ◽  
Block Level ◽  
Pm10 Exposure

Several studies have found maternal exposure to particulate matter pollution was associated with adverse birth outcomes, including infant mortality and preterm birth. In this context, our study aims to quantify the air pollution burden of disease due to preterm birth complications and infant death in Paris, with particular attention to people living in the most deprived census blocks. Data on infant death and preterm birth was available from the birth and death certificates. The postal address of mother’s newborn was converted in census block number. A socioeconomic deprivation index was built at the census block level. Average annual ambient concentrations of PM10 were modelled at census block level using the ESMERALDA atmospheric modelling system. The number of infant deaths attributed to PM10 exposure is expressed in years of life lost. We used a three-step compartmental model to appraise neurodevelopmental impairment among survivors of preterm birth. We estimated that 12.8 infant deaths per 100,000 live births may be attributable to PM10 exposure, and about one third of these infants lived in deprived census blocks. In addition, we found that approximately 4.8% of preterm births could be attributable to PM10 exposure, and approximately 1.9% of these infants died (corresponding to about 5.75 deaths per 100,000 live birth). Quantification of environmental hazard-related health impacts for children at local level is essential to prioritizing interventions. Our study suggests that additional effort is needed to reduce the risk of complications and deaths related to air pollution exposure, especially among preterm births. Because of widespread exposure to air pollution, significant health benefits could be achieved through regulatory interventions aimed at reducing exposure of the population as a whole, and particularly of the most vulnerable, such as children and pregnant women.

scholarly journals Are the effects of air pollution on birth weight modified by infant sex and neighborhood socioeconomic deprivation? A multilevel analysis in Paris (France)

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0247699
Author(s):  
Séverine Deguen ◽  
Wahida Kihal-Talantikite ◽  
Morgane Gilles ◽  
Arlette Danzon ◽  
Marion Carayol ◽  
...  
Keyword(s):  
Air Pollution ◽  
Birth Weight ◽  
Statistical Tests ◽  
Scientific Evidence ◽  
Deprivation Level ◽  
Socioeconomic Deprivation ◽  
Census Block ◽  
Socioeconomic Index ◽  
Block Level ◽  
Infant Sex

Adverse birth outcomes related to air pollution are well documented; however, few studies have accounted for infant sex. There is also scientific evidence that the neighborhood socioeconomic profile may modify this association even after adjusting for individual socioeconomic characteristics. The objective is to analyze the association between air pollution and birth weight by infant sex and neighborhood socioeconomic index. All birth weights (2008–2011) were geocoded at census block level. Each census block was assigned a socioeconomic deprivation level, as well as daily NO2 and PM10 concentrations. We performed a multilevel model with a multiple statistical test and sensible analysis using the spline function. Our findings suggest the existence of a differential association between air pollution and BW according to both neighborhood socioeconomic level and infant sex. However, due to multiple statistical tests and controlling the false discovery rate (FDR), all significant associations became either not statistically significant or borderline. Our findings reinforce the need for additional studies to investigate the role of the neighborhood socioeconomic which could differentially modify the air pollution effect.

scholarly journals Using a Clustering Approach to Investigate Socio-Environmental Inequality in Preterm Birth—A Study Conducted at Fine Spatial Scale in Paris (France)

2018 ◽  
Vol 15 (9) ◽  
pp. 1895 ◽  
Author(s):  
Severine Deguen ◽  
Nina Ahlers ◽  
Morgane Gilles ◽  
Arlette Danzon ◽  
Marion Carayol ◽  
...  
Keyword(s):  
Air Pollution ◽  
Spatial Distribution ◽  
Preterm Birth ◽  
Spatial Clustering ◽  
Birth Certificate ◽  
Deprivation Level ◽  
Health Interventions ◽  
Census Block ◽  
Economic Deprivation ◽  
Clustering Approach

Background & Objectives: Today, to support public policies aiming to tackle environmental and health inequality, identification and monitoring of the spatial pattern of adverse birth outcomes are crucial. Spatial identification of the more vulnerable population to air pollution may orient health interventions. In this context, the objective of this study is to investigate the geographical distribution of the risk of preterm birth (PTB, gestational age ≤36 weeks) at the census block level in in city of Paris, France. We also aimed to assess the implication of neighborhood characteristics including air pollution and socio-economic deprivation. Material & Methods: Newborn health data are available from the first birth certificate registered by the Maternal and Child Care department of Paris. All PTB from January 2008 to December 2011 were geocoded at the mother residential census block. Each census block was assigned a socioeconomic deprivation level and annual average ambient concentrations of NO2. A spatial clustering approach was used to investigate the spatial distribution of PTB. Results: Our results highlight that PTB is non-randomly spatially distributed, with a cluster of high risk in the northeastern area of Paris (RR = 1.15; p = 0.06). After adjustment for socio-economic deprivation and NO2 concentrations, this cluster becomes not statistically significant or shifts suggesting that these characteristics explain the spatial distribution of PTB; further, their combination shows an interaction in comparison with SES or NO2 levels alone. Conclusions: Our results may inform the decision makers about the areas where public health efforts should be strengthened to tackle the risk of PTB and to choose the most appropriate and specific community-oriented health interventions.

scholarly journals Postmortem investigations and identification of multiple causes of child deaths: An analysis of findings from the Child Health and Mortality Prevention Surveillance (CHAMPS) network

PLoS Medicine ◽  
2021 ◽  
Vol 18 (9) ◽  
pp. e1003814
Author(s):  
Robert F. Breiman ◽  
Dianna M. Blau ◽  
Portia Mutevedzi ◽  
Victor Akelo ◽  
Inacio Mandomando ◽  
...  
Keyword(s):  
Preterm Birth ◽  
Child Health ◽  
Causes Of Death ◽  
Causal Chain ◽  
Underlying Condition ◽  
Infant Deaths ◽  
Birth Complications ◽  
Child Deaths ◽  
Causal Chains ◽  
Health And Mortality

Background The current burden of >5 million deaths yearly is the focus of the Sustainable Development Goal (SDG) to end preventable deaths of newborns and children under 5 years old by 2030. To accelerate progression toward this goal, data are needed that accurately quantify the leading causes of death, so that interventions can target the common causes. By adding postmortem pathology and microbiology studies to other available data, the Child Health and Mortality Prevention Surveillance (CHAMPS) network provides comprehensive evaluations of conditions leading to death, in contrast to standard methods that rely on data from medical records and verbal autopsy and report only a single underlying condition. We analyzed CHAMPS data to characterize the value of considering multiple causes of death. Methods and findings We examined deaths identified from December 2016 through November 2020 from 7 CHAMPS sites (in Bangladesh, Ethiopia, Kenya, Mali, Mozambique, Sierra Leone, and South Africa), including 741 neonatal, 278 infant, and 241 child <5 years deaths for which results from Determination of Cause of Death (DeCoDe) panels were complete. DeCoDe panelists included all conditions in the causal chain according to the ICD-10 guidelines and assessed if prevention or effective management of the condition would have prevented the death. We analyzed the distribution of all conditions listed as causal, including underlying, antecedent, and immediate causes of death. Among 1,232 deaths with an underlying condition determined, we found a range of 0 to 6 (mean 1.5, IQR 0 to 2) additional conditions in the causal chain leading to death. While pathology provides very helpful clues, we cannot always be certain that conditions identified led to death or occurred in an agonal stage of death. For neonates, preterm birth complications (most commonly respiratory distress syndrome) were the most common underlying condition (n = 282, 38%); among those with preterm birth complications, 256 (91%) had additional conditions in causal chains, including 184 (65%) with a different preterm birth complication, 128 (45%) with neonatal sepsis, 69 (24%) with lower respiratory infection (LRI), 60 (21%) with meningitis, and 25 (9%) with perinatal asphyxia/hypoxia. Of the 278 infant deaths, 212 (79%) had ≥1 additional cause of death (CoD) beyond the underlying cause. The 2 most common underlying conditions in infants were malnutrition and congenital birth defects; LRI and sepsis were the most common additional conditions in causal chains, each accounting for approximately half of deaths with either underlying condition. Of the 241 child deaths, 178 (75%) had ≥1 additional condition. Among 46 child deaths with malnutrition as the underlying condition, all had ≥1 other condition in the causal chain, most commonly sepsis, followed by LRI, malaria, and diarrheal disease. Including all positions in the causal chain for neonatal deaths resulted in 19-fold and 11-fold increases in attributable roles for meningitis and LRI, respectively. For infant deaths, the proportion caused by meningitis and sepsis increased by 16-fold and 11-fold, respectively; for child deaths, sepsis and LRI are increased 12-fold and 10-fold, respectively. While comprehensive CoD determinations were done for a substantial number of deaths, there is potential for bias regarding which deaths in surveillance areas underwent minimally invasive tissue sampling (MITS), potentially reducing representativeness of findings. Conclusions Including conditions that appear anywhere in the causal chain, rather than considering underlying condition alone, markedly changed the proportion of deaths attributed to various diagnoses, especially LRI, sepsis, and meningitis. While CHAMPS methods cannot determine when 2 conditions cause death independently or may be synergistic, our findings suggest that considering the chain of events leading to death can better guide research and prevention priorities aimed at reducing child deaths.

scholarly journals Premature Adult Death and Equity Impact of a Reduction of NO2, PM10, and PM2.5 Levels in Paris—A Health Impact Assessment Study Conducted at the Census Block Level

2018 ◽  
Vol 16 (1) ◽  
pp. 38 ◽  
Author(s):  
Wahida Kihal-Talantikite ◽  
Pierre Legendre ◽  
Pauline Le Nouveau ◽  
Séverine Deguen
Keyword(s):  
Air Pollution ◽  
Small Area ◽  
Adult Population ◽  
Health Impact ◽  
Census Block ◽  
Premature Deaths ◽  
Pm10 And Pm2.5 ◽  
Block Level ◽  
Pm2.5 Exposure ◽  
Dose Response Function

Background: To support environmental policies aiming to tackle air pollution, quantitative health impact assessments (HIAs) stand out as one of the best decision-making tools. However, no risk assessment studies have quantified or mapped the health and equity impact of air pollution reduction at a small spatial scale. Objectives: We developed a small-area analysis of the impact of air pollution on “premature” death among an adult population over 30 years of age to quantify and map the health and equity impact related to a reduction of air pollution. Methods: All-cause mortality data of an adult population (>30 years) from January 2004 to December 2009 were geocoded at the residential census block level in Paris. Each census block was assigned socioeconomic deprivation levels and annual average ambient concentrations of NO2, PM10, and PM2.5. HIAs were used to estimate, at a small-area level, the number of “premature” deaths associated with a hypothetical reduction of NO2, PM10, and PM2.5 exposure. In total, considering global dose response function for the three pollutants and socioeconomic deprivation specific dose response function, nine HIAs were performed for NO2 and six and four HIAs for PM10 and PM2.5, respectively. Finally, a clustering approach was used to quantify how the number of “premature” deaths could vary according to deprivation level. Results: The number of deaths attributable to NO2, PM10, and PM2.5 exposure were equal to 4301, 3209, and 2662 deaths, respectively. The most deprived census blocks always appeared as one of the groups most impacted by air pollution. Our findings showed that “premature” deaths attributable to NO2 were not randomly distributed over the study area, with a cluster of excess “premature” deaths located in the northeastern area of Paris. Discussion: This study showed the importance of stratifying an environmental burden of disease study on the socioeconomic level, in order to take into consideration the modifier effect of socioeconomic status on the air pollution-mortality relationship. In addition, we demonstrated the value of spatial analysis to guide decision-making. This shows the need for tools to support priority-setting and to guide policymakers in their choice of environmental initiatives that would maximize health gains and reduce social inequalities in health.

scholarly journals Measuring the Burden of Disease Due to Preterm Birth Complications in Korea Using Disability-Adjusted Life Years (DALY)

2019 ◽  
Vol 16 (3) ◽  
pp. 519 ◽  
Author(s):  
Hyun Kim ◽  
Min-Woo Jo ◽  
Seok-Hwan Bae ◽  
Seok-Jun Yoon ◽  
Jin Lee
Keyword(s):  
Preterm Birth ◽  
Burden Of Disease ◽  
Premature Birth ◽  
Disability Weight ◽  
Mortality Data ◽  
Years Of Life Lost ◽  
Disability Adjusted Life Years ◽  
Birth Complications ◽  
Disability Adjusted Life ◽  
Life Years

The premature birth rate in Korea has increased from 13.5% in 2008 to 15.7% in 2013. The complications of premature birth are a major determinant of neonatal mortality and morbidities. The purpose of this study was to estimate the burden of premature birth in Korea using disability-adjusted life years (DALY). DALY consists of years of life lost (YLL) and years lost due to disability (YLD). In this study, preterm birth complications refer to nine diseases: P07, P22, P25, P26, P27, P28, P52, P77, P612, and H351 (International Classification of Diseases—10th Revision). YLL was calculated using mortality data from the 2012 National Health Insurance Data. YLD is a function of the prevalence, disability weight (DW), and duration of each complication. DW was determined by the Korean Disability Weight Study for National Burden of Disease in Korea 2013/2015. The burden of premature birth in Korea is 79,574 DALY (YLL: 43,725; YLD: 35,849). The burden for men (DALY: 43,603; YLL: 24,004; YLD: 19,599) is higher than that of women (DALY: 35,970; YLL: 19,720; YLD: 16,250). This study could provide essential data for evaluating the effects of policies intended to reduce preterm birth.

scholarly journals Built Environment and Preterm Birth

2014 ◽  
Vol 7 (3) ◽  
pp. 77-87
Author(s):  
Nikki Keene Woods ◽  
Linda Watson ◽  
An-Diep T Nguyen
Keyword(s):  
United States ◽  
Preterm Birth ◽  
Systems Approach ◽  
Health Resources ◽  
Preterm Births ◽  
The United States ◽  
Neighborhood Environment ◽  
Neighborhood Deprivation ◽  
Infant Deaths ◽  
Group Density

Background. Preterm birth affects approximately 500,000 babies a year in the United States. One out of nine babies born in the United States deliver before 37 weeks gestation. Preterm birth can cause lifelong neurological problems, cerebral palsy, vision and hearing impairments, and developmental delay. The estimated $26 billion a year in preterm birth related costs are staggering to the health care system. Preterm-related causes of death in 2008 together accounted for 35% of all infant deaths. Methods. This paper is a review of the literature published (2006-2012) on the relationship between neighborhood environment and preterm birth. Results. Neighborhood deprivation and the neighborhood environment were associated with low-birth weight and preterm birth. Examples of neighborhood deprivation include economic deprivation, social disorder, and lack of health resources. Neighborhood environment can be described as neighborhood physical deterioration, violent crime, and group density. Conclusions. A significant association exists between the neighborhood environment and birth outcomes. More research is needed to explore interventions with a systems approach to promote healthy maternal behavior, reduce stress, and improve care for expecting mothers living in stressful neighborhood environments in order to reduce preterm births.

scholarly journals A birth population-based survey of preterm morbidity and mortality by gestational age

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Xiaojing Guo ◽  
Xiaoqiong Li ◽  
Tingting Qi ◽  
Zhaojun Pan ◽  
Xiaoqin Zhu ◽  
...  
Keyword(s):  
Birth Weight ◽  
Preterm Birth ◽  
Preterm Infants ◽  
Birth Defects ◽  
Gestational Age ◽  
Death Rate ◽  
Preterm Births ◽  
Mortality Rates ◽  
Morbidity And Mortality ◽  
Hospital Death

Abstract Background Despite 15–17 millions of annual births in China, there is a paucity of information on prevalence and outcome of preterm birth. We characterized the outcome of preterm births and hospitalized preterm infants by gestational age (GA) in Huai’an in 2015, an emerging prefectural region of China. Methods Of 59,245 regional total births, clinical data on 2651 preterm births and 1941 hospitalized preterm neonates were extracted from Huai’an Women and Children’s Hospital (HWCH) and non-HWCH hospitals in 2018–2020. Preterm prevalence, morbidity and mortality rates were characterized and compared by hospital categories and GA spectra. Death risks of preterm births and hospitalized preterm infants in the whole region were analyzed with multivariable Poisson regression. Results The prevalence of extreme, very, moderate, late and total preterm of the regional total births were 0.14, 0.53, 0.72, 3.08 and 4.47%, with GA-specific neonatal mortality rates being 44.4, 15.8, 3.7, 1.5 and 4.3%, respectively. There were 1025 (52.8% of whole region) preterm admissions in HWCH, with significantly lower in-hospital death rate of inborn (33 of 802, 4.1%) than out-born (23 of 223, 10.3%) infants. Compared to non-HWCH, three-fold more neonates in HWCH were under critical care with higher death rate, including most extremely preterm infants. Significantly all-death risks were found for the total preterm births in birth weight <  1000 g, GA < 32 weeks, amniotic fluid contamination, Apgar-5 min < 7, and birth defects. For the hospitalized preterm infants, significantly in-hospital death risks were found in out-born of HWCH, GA < 32 weeks, birth weight <  1000 g, Apgar-5 min < 7, birth defects, respiratory distress syndrome, necrotizing enterocolitis and ventilation, whereas born in HWCH, antenatal glucocorticoids, cesarean delivery and surfactant use decreased the death risks. Conclusions The integrated data revealed the prevalence, GA-specific morbidity and mortality rate of total preterm births and their hospitalization, demonstrating the efficiency of leading referral center and whole regional perinatal-neonatal network in China. The concept and protocol should be validated in further studies for prevention of preterm birth.

P.261 Air pollution and bipolar disorder: is there an association between manic episodes and PM10 exposure?

2020 ◽  
Vol 40 ◽  
pp. S147-S148
Author(s):  
A. Ceresa ◽  
M. Carugno ◽  
D. Palpella ◽  
A.C. Pesatori ◽  
M. Buoli
Keyword(s):  
Bipolar Disorder ◽  
Air Pollution ◽  
Pm10 Exposure

scholarly journals Spontaneous Preterm Birth: Is Prevention with Aspirin Possible?

2021 ◽  
Author(s):  
Richard Berger ◽  
Ioannis Kyvernitakis ◽  
Holger Maul
Keyword(s):  
Preterm Birth ◽  
Low Dose ◽  
Randomized Study ◽  
Preterm Births ◽  
Spontaneous Preterm Birth ◽  
Dose Aspirin ◽  
Nulliparous Women ◽  
Low Dose Aspirin ◽  
Secondary Analyses ◽  
Double Blinded

Abstract Background The rate of preterm births in Germany is 8.6%, which is very high compared to other European countries. As preterm birth contributes significantly to perinatal morbidity and mortality rates, the existing prevention strategies need to be optimized and expanded further. About ⅔ of all women with preterm birth have preterm labor or premature rupture of membranes. They are bracketed together under the term “spontaneous preterm birth” as opposed to iatrogenic preterm birth, for example as a consequence of preeclampsia or fetal growth retardation. Recent studies suggest that low-dose aspirin does not just reduce the rate of iatrogenic preterm births but can also further reduce the rate of spontaneous preterm births. This review article presents the current state of knowledge. Method A selective literature search up until April 2020 was done in PubMed, using the terms “randomized trial”, “randomized study”, “spontaneous preterm birth”, and “aspirin”. Results Secondary analyses of prospective randomized studies on the prevention of preeclampsia with low-dose aspirin show that this intervention also significantly reduced the rate of spontaneous preterm births in both high-risk and low-risk patient populations. The results of the ASPIRIN trial, a prospective, randomized, double-blinded multicenter study carried out in six developing countries, also point in this direction, with the figures showing that the daily administration of 81 mg aspirin starting before 14 weeks of gestation lowered the preterm birth rate of nulliparous women without prior medical conditions by around 11% (11.6 vs. 13.1%; RR 0.89; 95% CI: 0.81 – 0.98, p = 0.012). Conclusion Further studies on this issue are urgently needed. If these confirm the currently available results, then it would be worth discussing whether general aspirin prophylaxis for all pregnant women starting at the latest in 12 weeks of gestation is indicated.

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