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Pollutants in the atmosphere have been linked to poor pregnancy outcomes in women. However, such investigations are scarce in metropolitan northern China. The major exposure window of air pollution affecting pregnant women is also unknown. For the analysis, this retrospective cohort study enrolled 6960 pregnant women recorded at Tongchuan People’s Hospital from January 2018 to December 2019. Pollutant concentration values from the nearest monitoring station to the pregnant women were used to estimate exposure doses for each exposure window. Logistic regression models were created to investigate the connection between pollutants and spontaneous abortion while controlling for confounding factors. PM 2.5  was a risk factor for spontaneous abortion in T 3  (30–60 days before the first day of the last menstrual period [LMP]), (OR: 1.305, 95% CI: 1.143 – 1.490) and T 4  (60–90 days before the first day of the LMP),(OR: 1.450, 95% CI: 1.239 – 1.696) after controlling for covariates. In the same window, PM 10  was a risk factor (OR: 1.308, 95% CI: 1.140 – 1.500), (OR: 1.386, 95% CI: 1.184 – 1.621). In T 2  (30 days before the first day of the LMP), T 3 , and T 4 , SO 2  was a risk factor for spontaneous abortion (OR: 1.185, 95% CI: 1.025 – 1.371), (OR: 1.219, 95% CI: 1.071 – 1.396), (OR: 1.202, 95% CI: 1.040 – 1.389). In T 3  and T 4 , NO 2  was a risk factor (OR: 1.171, 95% CI: 1.019 –  1.346), (OR: 1.443, 95% CI: 1.259 – 1.655). In T 1  (from the first day of the LMP to the date of abortion), O 3  was found to be a risk factor (OR: 1.366, 95% CI: 1.226 – 1.521). Exposure to high levels of air pollutants before and during pregnancy may be a risk factor for spontaneous abortion in pregnant women. This study further illustrates the importance of reducing air pollution emissions.

Relationship between air pollutants and spontaneous abortion in a coal resource valley city: a retrospective cohort study