Associations Between Ambient Air Pollutant Concentrations and Birth Weight: A Quantile Regression Analysis

Epidemiology. 2019 Sep;30(5):624-632. doi: 10.1097/EDE.0000000000001038.


Introduction: We investigated the extent to which associations of ambient air pollutant concentrations and birth weight varied across birth weight quantiles.

Methods: We analyzed singleton births ≥27 weeks of gestation from 20-county metropolitan Atlanta with conception dates between January 1, 2002 and February 28, 2006 (N = 273,711). Trimester-specific and total pregnancy average concentrations for 10 pollutants, obtained from ground observations that were interpolated using 12-km Community Multiscale Air Quality model outputs, were assigned using maternal residence at delivery. We estimated associations between interquartile range width (IQRw) increases in pollutant concentrations and changes in birth weight using quantile regression.

Results: Gestational age-adjusted associations were of greater magnitude at higher percentiles of the birth weight distribution. Pollutants with large vehicle source contributions (carbon monoxide, nitrogen dioxide, PM2.5 elemental carbon, and total PM2.5 mass), as well as PM2.5 sulfate and PM2.5 ammonium, were associated with birth weight decreases for the higher birth weight percentiles. For example, whereas the decrease in mean birthweight per IQRw increase in PM2.5 averaged over pregnancy was -7.8 g (95% confidence interval = -13.6, -2.0 g), the quantile-specific associations were: 10th percentile -2.4 g (-11.5, 6.7 g); 50th percentile -8.9 g (-15.7, -2.0g); and 90th percentile -19.3 g (-30.6, -7.9 g). Associations for the intermediate and high birth weight quantiles were not sensitive to gestational age adjustment. For some pollutants, we saw associations at the lowest quantile (10th percentile) when not adjusting for gestational age.

Conclusions: Associations between air pollution and reduced birth weight were of greater magnitude for newborns at relatively heavy birth weights.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Air Pollutants / adverse effects*
  • Air Pollutants / analysis
  • Air Pollution / adverse effects*
  • Air Pollution / analysis
  • Air Pollution / statistics & numerical data
  • Birth Weight*
  • Female
  • Georgia
  • Humans
  • Infant, Low Birth Weight*
  • Infant, Newborn
  • Male
  • Maternal Exposure / adverse effects*
  • Maternal Exposure / statistics & numerical data
  • Particulate Matter / adverse effects
  • Particulate Matter / analysis
  • Pregnancy
  • Regression Analysis
  • Urban Health / statistics & numerical data


  • Air Pollutants
  • Particulate Matter