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The aim of this study is to estimate the health impact and economic value on birth outcomes, such as low birthweight (LBW), preterm birth (PTB), small for gestational age (SGA), attributable to a reduction of PM10 levels in Spain. Reduction based on four scenarios was implemented: fulfillment of WHO guidelines and EU limits, and an attributable reduction of 15% and 50% in annual PM10 levels. Retrospective study on 288,229 live-born singleton children born between 2009\u20132010, using data from Spain Birth Registry Statistics database, as well as mean PM10 mass concentrations. Our finding showed that a decrease in annual exposure to PM10 appears to be associated with a decrease in the annual cases of LBW, SGA and PTB, as well as a reduction in hospital cost attributed to been born with LBW. Improving pregnancy outcomes by reducing the number of LBW up to 5% per year, will result in an estimate associated monetary saving of 50,000 to 7,000,000 euros annually. This study agrees with previous literature and highlights the need to implement, and ensure compliance with, stricter policies that regulate the maximum exposure to outdoor PM permitted in Spain, contributing to decreased environmental health risk, especially negative birth outcomes.<\/jats:p>","DOI":"10.3390\/ijerph20032290","type":"journal-article","created":{"date-parts":[[2023,1,30]],"date-time":"2023-01-30T03:31:11Z","timestamp":1675049471000},"page":"2290","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Air Pollution and Birth Outcomes: Health Impact and Economic Value Assessment in Spain"],"prefix":"10.3390","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9375-0147","authenticated-orcid":false,"given":"Marcelle Virginia","family":"Canto","sequence":"first","affiliation":[{"name":"Department of Preventive Medicine, Hospital Central de la Cruz Roja, 28003 Madrid, Spain"},{"name":"Doctoral Program in Biomedical Sciences and Public Health, International Doctorate Program, National University of Distance Education (UNED), 28015 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8624-0333","authenticated-orcid":false,"given":"M\u00f2nica","family":"Guxens","sequence":"additional","affiliation":[{"name":"Barcelona Institute of Global Health (ISGlobal), 08003 Barcelona, Spain"},{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Department of Medicine and Live Sciences, Universitat Pompeu Fabra, 08002 Barcelona, Spain"},{"name":"Department of Child and Adolescent Psychiatry\/Psychology, Erasmus MC, University Medical Centre, 3015 GE Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Garc\u00eda-Alt\u00e9s","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Departament de Salut, Direcci\u00f3 General de Planificaci\u00f3 i Recerca en Salut, 08028 Barcelona, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 Biom\u00e8dica (IIB Sant Pau), 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4402-2239","authenticated-orcid":false,"given":"Maria Jos\u00e9","family":"L\u00f3pez","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 Biom\u00e8dica (IIB Sant Pau), 08003 Barcelona, Spain"},{"name":"Public Health Agency of Barcelona, 08023 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4345-4988","authenticated-orcid":false,"given":"Marc","family":"Mar\u00ed-Dell\u2019Olmo","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Institut d\u2019Investigaci\u00f3 Biom\u00e8dica (IIB Sant Pau), 08003 Barcelona, Spain"},{"name":"Public Health Agency of Barcelona, 08023 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0300-1810","authenticated-orcid":false,"given":"Javier","family":"Garc\u00eda-P\u00e9rez","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Cancer and Environmental Epidemiology Unit, Chronic Diseases Department, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6154-9142","authenticated-orcid":false,"given":"Rebeca","family":"Ramis","sequence":"additional","affiliation":[{"name":"Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), 28029 Madrid, Spain"},{"name":"Cancer and Environmental Epidemiology Unit, Chronic Diseases Department, National Centre for Epidemiology, Carlos III Institute of Health, 28029 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,1,27]]},"reference":[{"key":"ref_1","unstructured":"(2022, May 09). 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