Air Pollution

Ambient and Indoor Air Pollution in Pregnancy on the risk of Low birth weight and Ensuing Effects in infants (APPLE); A cohort study in South India

Investigators

Dr. Giridhara R Babu, Professor & Head, Life Course Epidemiology, Indian Institute of Public Health, Bengaluru.

Prof. Gudlavalleti Venkata Satyanarayana Murthy, Public Health Foundation of India, Indian Institute of Public Health-Hyderabad,  Madhapur, Hyderabad- 500033. Contact No:  +91 -40- 49006001

C.P. Van Schayck, Professor of Preventive Medicine, Scientific Director CaRe, Care and Public Health, Research Institute, Maastricht University Medical Centre.

Collaborating Institution:

Maastricht University, the Netherlands

C. P. Van Schayck,

CO-Investigator

Professor of Preventive Medicine, Scientific Director CaRe

Care and Public Health Research Institute (CAPHRI), Maastricht University Medical Centre

Email: Onno.vanSchayck@maastrichtuniversity.nl

Introduction:

Exposure to air pollution (IAP) is a significant cause of morbidity and mortality in developing countries. Pregnant women exposed to higher pollutant levels are at higher risk of delivering a low-birth-weight (LBW) baby. There is a lack of standardized data for most risk factors, including the levels and types of specific pollutants and how they impact LBW. We aim to prospectively assess the association between ambient and indoor air pollution levels in pregnancy and low birth weight and understand the subsequent risk of adiposity in these infants. 

Objectives of the Project:

1.         To explore the association between exposure to the total level of air pollutants in pregnancy and low birth weight.

2.         To evaluate the association between exposure to the total level of air pollutants in pregnancy and adiposity in infants, mediated through low birth weight.

Study findings: The study has recruited 519 study participants and among 297 underwent pollution assessment during pregnancy. We completed 450 at birth follow ups, 310 6th month and 250 one year follow ups. A majority (41.7%) of the pregnant women had completed high school education and 45% of the study sample belonged to the lower socioeconomic status.  Nearly 22% of them reported tobacco smoking among their spouse. The primary fuel in most households was liquid petroleum gas (96%) and 17% of the participants reported having traditional biomass fuel as a secondary fuel outside the residence. More than 70% of the study participants reported not having any type of ventilation at their residence, nearly 44% of them reported burning incense sticks, 34% burning frankincense sticks as part of the prayer and 15% of them used mosquito coils at home.

Air pollution Assessment: The mean and standard deviation were reported for the pollution parameters. The mean level of PM2.5 reported was 30.32ug/m3, PM10 was 54.18ug/m3 and CO was 2.52 ppm. The observed ambient PM10 was 55.37ug/m3 and ambient CO was 1.07ug/m3. We investigated the association between indoor PM, CO and ambient PM and CO with birth weight for gestational age Z-score. We did not find any significant association between the pollution parameters and birth weight for age Z-scores, but we observed significant results for PM2.5 and PM10 with weight for age z-scores of the infants assessed at six months.

Research papers published:

Shriyan P, Babu GR, Ravi D, Ana Y, van Schayck OC, Thankachan P, Murthy GV. Ambient and Indoor Air Pollution in Pregnancy and the risk of Low birth weight and Ensuing Effects in Infants (APPLE): A cohort study in Bangalore, South India. Wellcome Open Research. 2019

Papers under review:

  1. Effect of prenatal exposure to particulate matter (2.5 and 10) and carbon monoxide on infant birth outcome; A prospective study.
  2. Effect of prenatal exposure to particulate matter (2.5 and 10) and carbon monoxide on infant adiposity

Funder: Strategic Programmes, Large Initiatives and Coordinated Action Enabler (SPLICE) / Dept of Science and Technology

Field pictures:

Figure 1. Recruitment

Figure 2. Pollution assessment device used for personal assessment

Figure 3. Infant at birth follow up