Satellite-derived air pollution exposure during pregnancy and preterm birth in South-West Oltenia
Abstract
Background: Air pollution monitoring remains limited in many regions due to the uneven distribution of ground-based stations. Satellite data from the Copernicus Sentinel-5P mission provide continuous measurements of atmospheric pollutants and allow improved population-level exposure assessment. This study aimed to evaluate the association between satellite-derived air pollution exposure during pregnancy and preterm birth in South-West Oltenia.
Methods: We built a regional dataset of atmospheric pollutants (2019–2023) at administrative unit level. Daily satellite data were processed and summary statistics (minimum, maximum, mean) for each pollutant were computed. For this analysis, NO₂ and O₃ were used. Exposure was defined as the number of months within the 9 months preceding birth in which concentrations exceeded the area-specific mean (>2 to > 6 months), for both mean and maximum values. Birth data from a regional tertiary hospital included 11,945 live births, of which 995 were preterm. Proportions were compared across exposure categories and odds ratios (OR) were estimated.
Results: Preterm births consistently showed higher exposure to months with pollutant levels above local baseline values. For mean NO₂ values above the local average for >2 months, 51% of preterm births were exposed versus 46% of all births (OR = 1.19). For maximum values, the association was stronger (59% vs. 54%; OR = 1.25). Stronger associations were observed for O₃, where 75% of preterm births were exposed compared to 66% of all births (OR≈1.55).
Conclusions: Satellite-derived data provide a practical way to assess cumulative exposure to air pollution during pregnancy. Higher exposure was consistently associated with preterm birth, with stronger signals for O₃, suggesting the value of multi-pollutant approaches in future studies. This findings support the integration of satellite-based monitoring into environmental health surveillance in regions with limited ground infrastructure.
Key messages: • Satellite data can support exposure assessment during pregnancy in regions with limited monitoring.
• Higher air pollution exposure, particularly NO2 and O₃, was associated with preterm birth.
Related
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BibTeX
@article{cara2026satellitederived,
title = {{Satellite-derived air pollution exposure during pregnancy and preterm birth in South-West Oltenia}},
author = {ML Cara and A Becheru and AL Golli and IM Prejbeanu and DG Iliescu and C Cara},
journal = {The European Journal of Public Health},
year = {2026},
month = oct,
doi = {10.1093/eurpub/ckag169.1296},
url = {https://doi.org/10.1093/eurpub/ckag169.1296},
note = {CC BY-NC 4.0},
}
RIS
TY - JOUR
TI - Satellite-derived air pollution exposure during pregnancy and preterm birth in South-West Oltenia
AU - ML Cara
AU - A Becheru
AU - AL Golli
AU - IM Prejbeanu
AU - DG Iliescu
AU - C Cara
PY - 2026
DA - 2026/10/01
JO - The European Journal of Public Health
DO - 10.1093/eurpub/ckag169.1296
UR - https://doi.org/10.1093/eurpub/ckag169.1296
AB - Background: Air pollution monitoring remains limited in many regions due to the uneven distribution of ground-based stations. Satellite data from the Copernicus Sentinel-5P mission provide continuous measurements of atmospheric pollutants and allow improved population-level exposure assessment. This study aimed to evaluate the association between satellite-derived air pollution exposure during pregnancy and preterm birth in South-West Oltenia. Methods: We built a regional dataset of atmospheric pollutants (2019–2023) at administrative unit level. Daily satellite data were processed and summary statistics (minimum, maximum, mean) for each pollutant were computed. For this analysis, NO₂ and O₃ were used. Exposure was defined as the number of months within the 9 months preceding birth in which concentrations exceeded the area-specific mean (>2 to > 6 months), for both mean and maximum values. Birth data from a regional tertiary hospital included 11,945 live births, of which 995 were preterm. Proportions were compared across exposure categories and odds ratios (OR) were estimated. Results: Preterm births consistently showed higher exposure to months with pollutant levels above local baseline values. For mean NO₂ values above the local average for >2 months, 51% of preterm births were exposed versus 46% of all births (OR = 1.19). For maximum values, the association was stronger (59% vs. 54%; OR = 1.25). Stronger associations were observed for O₃, where 75% of preterm births were exposed compared to 66% of all births (OR≈1.55). Conclusions: Satellite-derived data provide a practical way to assess cumulative exposure to air pollution during pregnancy. Higher exposure was consistently associated with preterm birth, with stronger signals for O₃, suggesting the value of multi-pollutant approaches in future studies. This findings support the integration of satellite-based monitoring into environmental health surveillance in regions with limited ground infrastructure. Key messages: • Satellite data can support exposure assessment during pregnancy in regions with limited monitoring. • Higher air pollution exposure, particularly NO2 and O₃, was associated with preterm birth.
SN - 1101-1262
SN - 1464-360X
ER -