1. Robust relationship between ambient air pollution and infant mortality in India.
- Author
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deSouza PN, Dey S, Mwenda KM, Kim R, Subramanian SV, and Kinney PL
- Subjects
- Child, Environmental Exposure analysis, Environmental Exposure statistics & numerical data, Female, Humans, India epidemiology, Infant, Infant Mortality, Infant, Newborn, Male, Particulate Matter analysis, Particulate Matter toxicity, Pregnancy, Air Pollutants analysis, Air Pollutants toxicity, Air Pollution analysis, Air Pollution statistics & numerical data
- Abstract
Background: Ambient exposure to fine particulate matter (PM
2.5 ) is one of the top global health concerns. We estimate the associations between in-utero and perinatal exposure to PM2.5 and infant, neonatal and postneonatal mortality in India. We evaluate the sensitivity of this association to two widely-used exposure assessments., Method: We linked nationally representative anthropometric data from India's 2015-2016 Demographic and Health Survey (n = 259,627 children under five across 640 districts of India) with satellite-based PM2.5 concentrations during the month of birth of each child. We then estimated the associations between PM2.5 from each dataset and child mortality, after controlling for child, mother and household factors including trends in time and seasonality. We examined if factors: urban/rural, sex, wealth quintile and state modified the associations derived from the two datasets using Wald tests., Results: We found evidence that PM2.5 impacts infant mortality primarily through neonatal mortality. The estimated association between neonatal mortality and PM2.5 in trimester 3 was OR: 1.016 (95% CI: 1.003, 1.030) for every 10 μg/m3 increase in exposure. This association was robust to the exposure assessment used. Child sex was a significant effect modifier, with PM2.5 impacting mortality in infant girls more than boys., Conclusions: Our results revealed a robust association between ambient exposure to PM2.5 in the latter period of pregnancy and early life with infant and neonatal mortality in India. Urgent air pollution management plans are needed to improve infant mortality in India., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)- Published
- 2022
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