Spatio-temporal analysis of preterm birth in Portugal and its relation with environmental variables

Preterm birth (PTB), one of the major concerns in obstetrics, is conventionally defined as the delivery of a live infant before 37 completed weeks of gestation, and one of its causes may be environmental factors. Remote sensing is a valuable approach for monitoring environmental variables, including in health sciences. In this work, remote sensing data were used to explore the relation of the environment with PTB. Time-series with monthly rates of male/female ratio and PTB were obtained from Portugal in 2000-2014. The environmental variables included in this study were monthly mean temperatures (T), relative humidity (RH), NDVI, concentrations of NO₂ and PM₁₀ in 2003-2008. A temporal and spatial analysis of each health-related and environmental variable was performed, as well as their correlation. PTB has been increasing over time, from below 5% in 2000 to around 7% in 2014, with predominance of higher rates in districts with larger population. From 2003 to 2008, T and PM₁₀ decreased significantly. A positive and significant correlation was found between male/female ratio and NO₂ and RH, and to a lesser extent with PM₁₀ and NDVI. PTB was also positively and significantly correlated with NO₂ and T, and to a lesser extent with RH and PM₁₀. These preliminary results suggest an association of PTB with most of the environmental variables studied, showing that more polluted and populated districts have higher rates of PTB. Further studies are warranted to explore interaction between the considered environmental factors and other variables related with risk for PTB.