Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study

Claire L. Leiser, Heidi A. Hanson, Kara Sawyer, Jacob Steenblik, Ragheed Al-Dulaimi, Troy Madsen, Karen Gibbins, James M. Hotaling, Yetunde Oluseye Ibrahim, James A. VanDerslice, Matthew Fuller

Research output: Contribution to journalArticle

5 Scopus citations


Objective: To investigate the relationship between acute exposure to air pollutants and spontaneous pregnancy loss. Design: Case-crossover study from 2007 to 2015. Setting: An academic emergency department in the Wasatch Front area of Utah. Patient(s): A total of 1,398 women who experienced spontaneous pregnancy loss events. Intervention(s): None. Main Outcome Measure(s): Odds of spontaneous pregnancy loss. Result(s): We found that a 10-ppb increase in 7-day average levels of nitrogen dioxide was associated with a 16% increase in the odds of spontaneous pregnancy loss (odds ratio [OR] = 1.16; 95% confidence interval [CI] 1.01–1.33; P=.04). A 10-μg/m 3 increase in 3-day and 7-day averages of fine particulate matter were associated with increased risk of spontaneous pregnancy loss, but the associations did not reach statistical significance (OR 3-day average = 1.09; 95% CI 0.99–1.20; P=.05) (OR 7-day average = 1.11; 95% CI 0.99–1.24; P=.06). We found no evidence of increased risk for any other metrics of nitrogen dioxide or fine particulate matter or any metric for ozone. Conclusions: We found that short-term exposure to elevated levels of air pollutants was associated with higher risk for spontaneous pregnancy loss.

Original languageEnglish (US)
Pages (from-to)341-347
Number of pages7
JournalFertility and sterility
Issue number2
Publication statusPublished - Feb 1 2019



  • adverse pregnancy outcomes
  • Air pollution
  • female reproductive effects
  • NO
  • PM -PM -ultrafine

ASJC Scopus subject areas

  • Reproductive Medicine
  • Obstetrics and Gynecology

Cite this

Leiser, C. L., Hanson, H. A., Sawyer, K., Steenblik, J., Al-Dulaimi, R., Madsen, T., ... Fuller, M. (2019). Acute effects of air pollutants on spontaneous pregnancy loss: a case-crossover study. Fertility and sterility, 111(2), 341-347.