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Maternal fine particulate matter (PM2.5) exposure and adverse birth outcomes: an updated systematic review based on cohort studies

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Abstract

Exposure to ambient air pollutants during pregnancy may be associated with numerous side health effects and adverse birth outcomes. Growing numbers of studies have explored a possible linkage between prenatal exposure to PM2.5 (particulate matter with aerodynamic diameter ≤ 2.5 μm) and impacts on fetal development. We aimed to conduct a systematic review based on published cohort studies to summarize evidence regarding the association between maternal PM2.5 exposure and birth outcomes, including birth weight, low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). Eligible studies meeting the following criterion were selected: PM2.5 exposure during pregnancy and live birth singletons, certain presentation of sample sizes, and quantitative evaluation of the associations between exposure and outcomes. Among the 42 selected studies, 23 evaluated the impact of prenatal PM2.5 exposure on birth weight of infants while 12 of them provided a significantly negative association for exposure and birth weight. Twenty-one studies aimed to identify the possible relationship between maternal exposure and LBW and 8 studies proved significant associations. Among 18 studies that explored the correlation between prenatal exposure and PTB, 9 reached a consistent conclusion that gestational exposure would add to the risk of PTB. Nine studies assessed the impact of PM2.5 on SGA and 5 of them demonstrated a significant effect. So far, linkages between maternal PM2.5 exposure during varied gestational stages and multiple adverse birth outcomes have been observed in many studies. A summary of them will be meaningful for further research on maternal exposure and adverse birth outcomes.

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Abbreviations

PM2.5 :

particulate matter with aerodynamic diameter 2.5 μm

BW:

birth weight

LBW:

low birth weight

TLBW:

term low birth weight

PTB:

preterm birth

PTD:

preterm delivery

SGA:

small for gestational age

ABOs:

adverse birth outcomes

OR:

odds ratio

RR:

risk ratio

CI:

confidence interval

IQR:

inter-quartile range

WP:

whole pregnancy

TS:

trimester specific

T1:

the first trimester

T2:

the second trimester

T3:

the third trimester

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Funding

This study was funded by the National Key Research and Development Program of China (2017YFC1600500, 2016YFC1000203), the National Natural Science Foundation of China (81630085, 81602823 and 81773387), Scientific research program of Shanghai Municipal Commission of Health and Family Planning (201640174), the Science and Technology Commission of Shanghai Municipality (17ZR1415800), and was supported by Xinhua Hospital Biobank.

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Authors and Affiliations

  1. Department of Environmental Health, School of Public Health, Shanghai Jiao Tong University School of Medicine, 280 South Chongqing Road, Shanghai, 200025, China

    Lei Yuan, Yan Zhang, Yu Gao & Ying Tian

  2. MOE and Shanghai Key Laboratory of Children’s Environmental Health, Xin Hua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China

    Ying Tian

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  1. Lei Yuan
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  2. Yan Zhang
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  3. Yu Gao
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Correspondence to Yu Gao or Ying Tian.

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Yuan, L., Zhang, Y., Gao, Y. et al. Maternal fine particulate matter (PM2.5) exposure and adverse birth outcomes: an updated systematic review based on cohort studies. Environ Sci Pollut Res 26, 13963–13983 (2019). https://doi.org/10.1007/s11356-019-04644-x

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