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Ambient air pollution and pregnancy outcomes: a review of the literature

 

Table Of Contents


Project Abstract

Ambient air pollution is a significant environmental health concern that has been associated with various adverse health outcomes, including pregnancy complications. This review aims to summarize the existing literature on the relationship between ambient air pollution and pregnancy outcomes. Several studies have investigated the potential effects of ambient air pollution on pregnancy outcomes such as preterm birth, low birth weight, and birth defects. The findings from these studies suggest that exposure to air pollutants, including particulate matter, nitrogen dioxide, sulfur dioxide, and carbon monoxide, may increase the risk of adverse pregnancy outcomes. Particulate matter (PM) has been one of the most widely studied air pollutants in relation to pregnancy outcomes. High levels of PM have been linked to an increased risk of preterm birth and low birth weight. Nitrogen dioxide (NO2), a common air pollutant from traffic emissions, has also been associated with adverse pregnancy outcomes. Studies have shown that exposure to NO2 during pregnancy may increase the risk of preterm birth and intrauterine growth restriction. Sulfur dioxide (SO2) is another air pollutant that has been linked to adverse pregnancy outcomes. Exposure to high levels of SO2 during pregnancy has been associated with an increased risk of preterm birth and low birth weight. Carbon monoxide (CO), a colorless and odorless gas produced by combustion processes, has also been implicated in adverse pregnancy outcomes. Studies have shown that exposure to high levels of CO during pregnancy may increase the risk of preterm birth and low birth weight. In addition to individual air pollutants, several studies have examined the effects of overall air quality on pregnancy outcomes. Poor air quality, characterized by high levels of multiple air pollutants, has been associated with an increased risk of adverse pregnancy outcomes. Overall, the findings from this review suggest that ambient air pollution may have significant impacts on pregnancy outcomes. Pregnant women may be particularly vulnerable to the adverse effects of air pollution, and efforts to reduce exposure to air pollutants during pregnancy may help improve pregnancy outcomes. Further research is needed to better understand the mechanisms underlying the relationship between ambient air pollution and pregnancy outcomes and to develop interventions to protect pregnant women from the harmful effects of air pollution.

Project Overview

REVIEW OF THE LITERATURE

Over the last decade or so, a large number of studies have investigated the possible adverse effects of ambient air pollution on birth outcomes. We reviewed these studies, which were identified by a systematic search of the main scientific databases. Virtually all reviewed studies were population based, with information on exposure to air pollution derived from routine monitoring sources. Overall, there is evidence implicating air pollution in adverse effects on different birth outcomes, but the strength of the evidence differs between outcomes. The evidence is sufficient to infer a causal relationship between particulate air pollution and respiratory deaths in the postneonatal period. For air pollution and birth weight the evidence suggests causality, but further studies are needed to confirm an effect and its size and to clarify the most vulnerable period of pregnancy and the role of different pollutants. For preterm births and intrauterine growth retardation (IUGR) the evidence as yet is insufficient to infer causality, but the available evidence justifies further studies. Molecular epidemiologic studies suggest possible biologic mechanisms for the effect on birth weight, premature birth, and IUGR and support the view that the relation between pollution and these birth outcomes is genuine. For birth defects, the evidence base so far is insufficient to draw conclusions. In terms of exposure to specific pollutants, particulates seem the most important for infant deaths, and the effect on IUGR seems linked to polycyclic aromatic hydrocarbons, but the existing evidence does not allow precise identification of the different pollutants or the timing of exposure that can result in adverse pregnancy outcomes.



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