{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T07:34:56Z","timestamp":1777534496364,"version":"3.51.4"},"reference-count":38,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T00:00:00Z","timestamp":1564531200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n            <jats:title>Background:<\/jats:title>\n            <jats:p>Low birth weight (LBW) has been associated with adverse health outcomes across the lifespan. Among ethnic\/racial minority populations, few studies have examined the association between LBW (&lt;2,500 or \u22652,500\u2009g) and prenatal exposure to air pollution, a key modifiable environmental risk factor.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>We examined the association between LBW and prenatal exposure to PM<jats:sub>2.5<\/jats:sub> in a Hispanic and black population in Puerto Rico between 1999 and 2013, adjusting for individual and municipality-level confounders. We used modified Poisson regression to estimate the association and performed sensitivity analyses treating birth weight as continuous or polychotomous. In secondary analyses, we applied a 2-stage mixed effects model suitable for longitudinally measured exposures and binary outcomes.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>Among 332,129 total and 275,814 term births, 12.2% and 6.3% of infants had LBW, respectively. Eighty-eight percent of mothers were Hispanic. Mean (SD) PM<jats:sub>2.5<\/jats:sub> concentrations declined from 9.9 (1.7) \u00b5g\/m<jats:sup>3<\/jats:sup> in 1999 to 6.1 (1.1) \u00b5g\/m<jats:sup>3<\/jats:sup> in 2013. Mean birth weights dropped to 3,044\u2009g in 2010 and rose steadily afterward. Among term births, a SD increase in PM<jats:sub>2.5<\/jats:sub> was associated with a 3.2% (95% CI = \u22121.0%, 6.3%) higher risk of LBW. First (risk ratio, 1.02; 95% CI = 1.00, 1.04) and second (1.02; 95% CI = 1.01, 1.05) trimester exposures were associated with increased LBW risk. In a 2-stage approach that longitudinally modeled monthly prenatal exposure levels, a standard deviation increase in average PM<jats:sub>2.5<\/jats:sub> was associated with higher risk of LBW (odds ratio, 1.04; 95% CI = 1.01, 1.08).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>In Puerto Rico, LBW is associated with prenatal PM<jats:sub>2.5<\/jats:sub> exposure.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/ee9.0000000000000058","type":"journal-article","created":{"date-parts":[[2019,7,31]],"date-time":"2019-07-31T13:50:16Z","timestamp":1564581016000},"page":"e058","source":"Crossref","is-referenced-by-count":13,"title":["Low birth weight and PM2.5 in Puerto Rico"],"prefix":"10.1097","volume":"3","author":[{"given":"Kipruto","family":"Kirwa","sequence":"first","affiliation":[{"name":"Department of Civil and Environmental Engineering, Tufts University, Medford, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rafael","family":"McConnell-Rios","sequence":"additional","affiliation":[{"name":"University of Puerto Rico, San Juan, PR"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Justin","family":"Manjourides","sequence":"additional","affiliation":[{"name":"Department of Health Sciences, Northeastern University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"Cordero","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Georgia, Athens, GA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A.","family":"Alshawabekeh","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Northeastern University, Boston, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen H.","family":"Suh","sequence":"additional","affiliation":[{"name":"Department of Civil and Environmental Engineering, Tufts University, Medford, MA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","published-online":{"date-parts":[[2019,8]]},"reference":[{"key":"R1-20230908","doi-asserted-by":"crossref","first-page":"S107","DOI":"10.1111\/j.1523-1755.2005.09718.x","article-title":"Long-term consequences of low birth weight.","volume":"68","author":"Reyes","year":"2005","journal-title":"Kidney Int Suppl"},{"key":"R2-20230908","doi-asserted-by":"crossref","first-page":"574","DOI":"10.2471\/BLT.16.180273","article-title":"A cohort study of low birth weight and health outcomes in the first year of life, Ghana.","volume":"95","author":"O\u2019Leary","year":"2017","journal-title":"Bull World Health Organ"},{"key":"R3-20230908","doi-asserted-by":"crossref","first-page":"e95","DOI":"10.1016\/S2214-109X(14)70360-2","article-title":"Incidence and severity of childhood pneumonia in the first year of life in a South African birth cohort: the Drakenstein Child 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