[{"data":1,"prerenderedAt":-1},["ShallowReactive",2],{"detail-sidebar-cat-0-en-105":3,"doc-seo-270534-105":59,"doc-detail-270534-en":130},{"code":4,"msg":5,"data":6},0,"success",[7,13,18,23,28,33,38,43,48,51,55],{"id":8,"doc_module":4,"doc_module_name":9,"category_name":10,"show_sort_weight":11,"slug":12},1,"Document","Story & Novel",90,"story-novel",{"id":14,"doc_module":4,"doc_module_name":9,"category_name":15,"show_sort_weight":16,"slug":17},2,"Literature",80,"literature",{"id":19,"doc_module":4,"doc_module_name":9,"category_name":20,"show_sort_weight":21,"slug":22},4,"Exam",70,"exam",{"id":24,"doc_module":4,"doc_module_name":9,"category_name":25,"show_sort_weight":26,"slug":27},5,"Comic",60,"comic",{"id":29,"doc_module":4,"doc_module_name":9,"category_name":30,"show_sort_weight":31,"slug":32},6,"Technology",50,"technology",{"id":34,"doc_module":4,"doc_module_name":9,"category_name":35,"show_sort_weight":36,"slug":37},7,"Healthcare",40,"healthcare",{"id":39,"doc_module":4,"doc_module_name":9,"category_name":40,"show_sort_weight":41,"slug":42},8,"Research & Report",30,"research-report",{"id":44,"doc_module":4,"doc_module_name":9,"category_name":45,"show_sort_weight":46,"slug":47},9,"Religion & Spirituality",20,"religion-spirituality",{"id":46,"doc_module":4,"doc_module_name":9,"category_name":49,"show_sort_weight":46,"slug":50},"World Cup","world-cup",{"id":52,"doc_module":4,"doc_module_name":9,"category_name":53,"show_sort_weight":52,"slug":54},10,"Lifestyle","lifestyle",{"id":56,"doc_module":4,"doc_module_name":9,"category_name":57,"show_sort_weight":24,"slug":58},19,"General","general",{"code":4,"msg":60,"data":61},"ok",{"site_id":62,"language":63,"slug":64,"title":65,"keywords":66,"description":67,"schema_data":68,"social_meta":123,"head_meta":125,"extra_data":127,"updated_unix":129},105,"en","maternal-ambient-air-pollution-exposure-and-risk-of-stillbirth-in-georgia-usa","Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA","","Maternal exposure to ambient air pollution has been linked to increased stillbirth risk, yet U.S. evidence remains limited regarding temporally varying exposures and differences in susceptibility across gestational windows. Using Georgia vital records from 2005–2014, a matched case-control design assessed 10 air pollutants across multiple exposure periods and gestational timing. Stratified Cox models estimated hazard ratios, with subgroup analyses for second- and third-trimester losses.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/maternal-ambient-air-pollution-exposure-and-risk-of-stillbirth-in-georgia-usa/270534/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/maternal-ambient-air-pollution-exposure-and-risk-of-stillbirth-in-georgia-usa/270534.png","ImageObject",300,407,{"name":92,"@type":93},"River Wang","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-10-22","2026-09-15",true,{"@type":102,"interactionType":103,"userInteractionCount":52},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What was the study objective regarding air pollution and stillbirth?","Question",{"text":112,"@type":113},"To evaluate how maternal exposure to ambient air pollution relates to stillbirth risk, with attention to temporally varying exposures and susceptibility across gestational windows.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"What data and study design were used?",{"text":117,"@type":113},"The study used Georgia vital records from 2005 to 2014 in a matched case-control design, including 8,384 stillbirths and 33,459 live birth controls.",{"name":119,"@type":110,"acceptedAnswer":120},"Which pollutants and pregnancy windows showed the strongest associations?",{"text":121,"@type":113},"Second-trimester exposure showed the strongest associations for particulate matter (PM10 and PM2.5) and patterns consistent with NO2 and NH4, while estimates for third-trimester stillbirths were largely null or negative.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},270534,1789978495,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":52,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":139,"language":140,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":141,"faqs":142,"seo_title":143,"seo_description":67,"update_tm":144,"read_time":145},1099514067438,"https://ap-avatar.wpscdn.com/avatar/100002539ee87300030?x-image-process=image/resize,m_fixed,w_180,h_180&k=1780474512215547542","medRxiv preprint doi: [https://doi.org/10.64898/2026.01.26.26344822](https://doi.org/10.64898/2026.01.26.26344822); this version posted January 27, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY 4.0 International license .  \nType of Manuscript: Original Research Article  \nTitle: Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA  \nRunning Head: Air pollution and stillbirth in Georgia  \nAuthor Names: Chen Li1, Thomas W. Hsiao1, Joshua L. Warren2, LyndseyA. Darrow3, Matthew J.  \nStrickland3, Armistead G. Russell4, Howard H. Chang1  \nAuthor Affiliations:  \n1 Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA  \n2 Department of Biostatistics, School of Public Health, Yale University, New Haven, Connecticut, USA  \n3 Department of Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada Reno, Reno, Nevada, USA  \n4 School of Civil and Environmental Engineering, College of Engineering, Georgia Tech University, Atlanta, Georgia, USA  \nCorresponding Author: Thomas W. Hsiao, Department of Biostatistics and Bioinformatics, Emory  \nUniversity, Atlanta, Georgia, USA. Email: [thsiao3@emory.edu](thsiao3@emory.edu)  \n[Conflicts of Interest:](Conflicts of Interest: None declared.)[ None declared.](Conflicts of Interest: None declared.)  \nSources of Financial Support: This project is supported by grant R01ES028346 awarded to  \ninvestigators Darrow and Chang from the National Institute of Environmental Health Sciences (NIEHS) .  \nThe funding sources were not involved in the study design, collection, analysis, or interpretation of the data; in the writing of the report; and in the decision to submit the article for publication.  \nData and code: Vital records data can be requested from the Georgia Department of Health through the Public Health Information Portal. The monitoring and CMAQ air quality data are publicly available from the US Environmental Protection Agency. All code for this analysis is available at  \n[https://github.com/chenli488/Air-Pollution-and-Stillbirth](https://github.com/chenli488/Air-Pollution-and-Stillbirth).  \nAcknowledgments: None.  \nNOTE: This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.  \nmedRxiv preprint doi: [https://doi.org/10.64898/2026.01.26.26344822](https://doi.org/10.64898/2026.01.26.26344822); this version posted January 27, 2026. The copyright holder for this preprint (which was not certified by peer review) is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity.  \nIt is made available under a CC-BY 4.0 International license .  \nABSTRACT  \nBackground  \nEvidence suggests maternal exposure to ambient air pollution increases the risk of stillbirth, but few studies conducted in the United States have evaluated temporally varying exposures or susceptibility across gestational windows. Moreover, the generalizability of existing findings is often limited by  \nrestricted geographic coverage or reliance on selected study populations.  \nMethods  \nUsing Georgia vital records from 2005 to 2014, we conducted a matched case-control study including  \n8,384 stillbirths and 33,459 live birth controls matched on maternal county of residence and conception month. We used stratified Cox proportional hazards models with time-varying covariates to estimate hazard ratios (HRs) for ten air pollutants across five exposure windows (first month, weekly, and first, second, and third trimester) . Our primary analysis included all stillbirths combined, with subgroup  \nanalyses separating second and third trimester losses.  \nResults  \nStillbirths had a median gestational age of 27 weeks (IQR: 6.67) compared with 38 weeks ","cbCaid0A0p35oKNU","https://ap.wps.com/l/cbCaid0A0p35oKNU","pdf",244253,25,"English","# Abstract\n## Background\n## Methods\n## Results\n## Conclusions\n## What this study adds\n# Introduction\n## Stillbirth definition","[{\"question\":\"What was the study objective regarding air pollution and stillbirth?\",\"answer\":\"To evaluate how maternal exposure to ambient air pollution relates to stillbirth risk, with attention to temporally varying exposures and susceptibility across gestational windows.\"},{\"question\":\"What data and study design were used?\",\"answer\":\"The study used Georgia vital records from 2005 to 2014 in a matched case-control design, including 8,384 stillbirths and 33,459 live birth controls.\"},{\"question\":\"Which pollutants and pregnancy windows showed the strongest associations?\",\"answer\":\"Second-trimester exposure showed the strongest associations for particulate matter (PM10 and PM2.5) and patterns consistent with NO2 and NH4, while estimates for third-trimester stillbirths were largely null or negative.\"}]","Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA | PDF",1789455933,63]