| This investigation is a population-based case-control study that examined the relationship between maternal exposure to ambient sulfur dioxide (SO{dollar}sb2){dollar} and the birth of very low birthweight (VLBW) infants. This study brings together contributions from geography, meteorology, atmospheric transport modeling techniques, and epidemiology in describing the relationship between maternal exposures to ambient concentrations of SO{dollar}sb2{dollar} and the resultant outcome of VLBW newborns.; Exposure estimates {dollar}(mu{dollar}g/m{dollar}sp3){dollar} were obtained through environmental transport modeling that allowed assignment of an environmental SO{dollar}sb2{dollar} exposure estimate to each study subject for case-control analysis. Crude (2.21 95% CI = 1.51,3.23) and adjusted (1.76, 95% CI = 1.09,2.83) odds ratios suggest an association between VLBW and exposures to SO{dollar}sb2{dollar} in this study of 145 cases and 202 controls living in Georgia Health Care District 9.; This study adds support to a previous ecologic study that showed a relationship between exposure to environmental SO{dollar}sb2{dollar} and shortened gestational ages. However, additional studies are required to answer many of the questions that are raised by this investigation, in particular, the role other environmental pollutants may play in combination with SO{dollar}sb2,{dollar} in the outcome of VLBW. SO{dollar}sb2{dollar} may be serving as an environmentally measured surrogate for some unidentified unmeasured causative agent that may directly impact maternal reproductive physiology resulting in preterm delivery and the resultant VLBW. |
