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Shiliang Liu,¹ Daniel Krewski,¹ Yuanli Shi,¹ Yue Chen,¹ and Richard T. Burnett^1,2

¹McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, and Department of Epidemiology and Community Medicine, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada; ²Environmental Health Science Bureau, Healthy Environments and Consumer Safety Branch, Health Canada, Ottawa, Ontario, Canada

Abstract
The association between ambient air pollution and adverse health effects, such as emergency room visits, hospitalizations, and mortality from respiratory and cardiovascular diseases, has been studied extensively in many countries, including Canada. Recently, studies conducted in China, the Czech Republic, and the United States have related ambient air pollution to adverse pregnancy outcomes. In this study, we examined association between preterm birth, low birth weight, and intrauterine growth retardation (IUGR) among singleton live births and ambient concentrations of sulfur dioxide (SO₂) , nitrogen dioxide (NO₂) , carbon monoxide (CO) , and ozone in Vancouver, Canada, for 1985-1998. Multiple logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs) for such effects. Low birth weight was associated with exposure to SO₂ during the first month of pregnancy (OR = 1.11, 95% CI, 1.01-1.22, for a 5.0 ppb increase) . Preterm birth was associated with exposure to SO₂ (OR = 1.09, 95% CI, 1.01-1.19, for a 5.0 ppb increase) and to CO (OR = 1.08, 95% CI, 1.01-1.15, for a 1.0 ppm increase) during the last month of pregnancy. IUGR was associated with exposure to SO₂ (OR = 1.07, 95% CI, 1.01-1.13, for a 5.0 ppb increase) , to NO₂ (OR = 1.05, 95% CI, 1.01-1.10, for a 10.0 ppb increase) , and to CO (OR = 1.06, 95% CI, 1.01-1.10, for a 1.0 ppm increase) during the first month of pregnancy. In conclusion, relatively low concentrations of gaseous air pollutants are associated with adverse effects on birth outcomes in populations experiencing diverse air pollution profiles. Key words: air pollution, intrauterine growth retardation, low birth weight, preterm birth, risk assessment, sulfur dioxide. Environ Health Perspect 111:1773-1778 (2003) . doi:10.1289/ehp.625 available via http://dx.doi.org/ [Online 4 August 2003]

Address correspondence to S. Liu, McLaughlin Centre for Population Health Risk Assessment, Institute of Population Health, University of Ottawa, 1 Stewart St., Ottawa, Canada K1N 6N5. Telephone: (613) 941-1284. Fax: (613) 941-9927. E-mail: Sliu@uottawa.ca

This study was supported by the Toxic Substance Research Initiative of Health Canada and the Canadian Institutes of Health Research.

We declare that a conflict of interest related to this study and submission of this manuscript for publication was reported.

Received 3 February 2003 ; accepted 4 August 2003.