Background: The available evidence linking air pollution and preeclampsia is very limited with no report on the impact of this exposure on early- and late-onset preeclampsia. AIMS: To investigate the association, if any, between preeclampsia (all, early-and late-onset) and exposure to NO2, NOx, PM10, PM2.5, PM2.5-10 and PM2.5 light absorption during the entire pregnancy, and first, second, and third trimesters. METHODS: This study was based on 8,398 pregnant women (including 103 cases of preeclampsia) residing in Barcelona, Spain (2001-2005).A spatiotemporal exposure assessment framework was applied using land use regression models to predict pollutant levels at the geocoded address of each study participant's residence during each week of her pregnancy. Logistic regression models were used to quantify the un-adjusted and adjusted associations. A sensitivity analysis was conducted by matching cases and controls according to the length of exposure and applying conditional logistic regression to estimate the association. RESULTS: An interquartile-range increase in PM2.5 exposure during the entire pregnancy and third trimester and to PM2.5 absorbance during the third trimester were respectively associated with 32%, 51%, and 39% increase in the risk of preeclampsia. There was a 42% increase in the risk of late-onset preeclampsia associated with an interquartile-range increase in the third trimester PM2.5 exposure. The findings for the third trimester exposure were unlikely to be biased by the different length of exposure between cases and controls. CONCLUSION: Exposure to fine particulate air pollution seems to increase the risk of preeclampsia, particularly late-onset preeclampsia. Our findings were compatible with proposed distinct pathogenesis for early- and late-onset preeclampsia.
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