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ORIGINAL RESEARCH article

Front. Cell. Infect. Microbiol.
Sec. Clinical Infectious Diseases
Volume 14 - 2024 | doi: 10.3389/fcimb.2024.1476603
This article is part of the Research Topic High-Impact Respiratory RNA Virus Diseases, Volume II View all articles

Longitudinal Ozone Exposure and SARS-CoV-2 Infection in Late Pregnancy: A Retrospective Cohort Study

Provisionally accepted
Lin Zhang Lin Zhang 1*Jiaqi Tian Jiaqi Tian 1Shuyin Duan Shuyin Duan 2
  • 1 Qingdao University, Qingdao, China
  • 2 School of Public Health, Shandong First Medical University, Tai'an, Shandong Province, China

The final, formatted version of the article will be published soon.

    Atmospheric ozone is a common air pollutant with known impacts on maternal and fetal health. However, the relationship between gestational ozone exposure and susceptibility to respirovirus infection remains unclear. This study aims to assess the association between longitudinal ozone exposure during pregnancy and COVID-19 risk in late gestation.This retrospective cohort study included 600 pregnant women (300 infected with SARS-CoV-2 and 300 uninfected) who delivered at one hospital in Jinan, China from November 2022 to January 2023. Individual ozone exposure levels throughout gestation were estimated based on local ambient monitoring data. Logistic regression models were constructed to examine the association between gestational ozone exposure and COVID-19 status in late pregnancy, adjusting for demographic and clinical variables.In Jinan, ozone levels increased by 1.85 ppb annually and peaked in April and October, corresponding to winds from the south and southwest. Higher ozone exposure over pregnancy was associated with lower odds of SARS-CoV-2 infection in late gestation (OR per IQR increase = 0.60, 95% CI: 0.40-0.90). Compared to the lowest quartile (reference), the highest ozone quartile corresponded to a 99% decreased infection risk (OR = 0.01, 95% CI: 0.00-0.03). Increased maternal age and pre-pregnancy BMI were associated with higher COVID-19 risk.Longitudinal ozone exposure during gestation may be protective against SARS-CoV-2 infection in late pregnancy. Further studies are needed to confirm this finding and elucidate underlying mechanisms. These results highlight the potential importance of environmental exposures in COVID-19 susceptibility.

    Keywords: Gestational ozone exposure, SARS-CoV-2 infection, pregnancy outcomes, environmental epidemiology, Viral susceptibility

    Received: 06 Aug 2024; Accepted: 28 Nov 2024.

    Copyright: © 2024 Zhang, Tian and Duan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Lin Zhang, Qingdao University, Qingdao, China

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