Abstract
Adverse pregnancy outcomes (APOs) are a significant cause of fetal death. A wide range of maternal psychological, social, and environmental factors may contribute to these outcomes. Mounting epidemiological studies have indicated that PM2.5 may result in these unfavorable consequences. Previously published meta-analyses have been updated and extended. Cohort studies were searched from three databases (up to July 24, 2023), and their quality was assessed by Newcastle-Ottawa Scale (NOS). Publication bias was examined by Egger’s test and funnel plot. Despite a large number of studies showing similar results, the inconsistencies between these findings require careful generalization before concluding. This meta-analysis included 67 cohort studies from 20 countries, and the findings revealed that maternal PM2.5 exposure and five APOs were correlated significantly throughout pregnancy: preterm birth (PTB) (RR = 1.05; 95% CI: 1.03, 1.07); low birth weight (LBW) (RR = 1.02; 95% CI: 1.01, 1.04); small for gestational age (SGA) (RR = 1.03; 95% CI: 1.01, 1.04); stillbirth (RR = 1.24; 95% CI: 1.06, 1.45); and change in birthweight (weight change = −6.82 g; 95% CI: −11.39, −2.25). A positive association was found between APOs and PM2.5 exposure in this meta-analysis, and the degree of increased risk of APOs varied due to different gestation periods. Therefore, it is necessary to protect pregnant women at specific times.
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We would like to thank the participants for joining our study and express our sincere gratitude to the Editor and anonymous reviewers for their insightful comments.
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Wanrong Wang: methodology, software, writing—original draft preparation; Siqi Mu: formal analysis, software, writing—original draft preparation; Weizhen Yan: visualization, investigation; Naiyu Ke: software, validation; Han Cheng: supervision; Rui Ding: writing—reviewing and editing.
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Fig. S1 Sensitivity analysis of the association between maternal exposure to PM2.5 and the adverse pregnancy outcomes. A, Sensitivity analysis for assessing publication bias of PM2.5 and PTB; B, Sensitivity analysis for assessing publication bias of PM2.5 and LBW; C, Sensitivity analysis for assessing publication bias of PM2.5 and SGA; D, Sensitivity analysis for assessing publication bias of PM2.5 and stillbirth; E, Sensitivity analysis for assessing publication bias of PM2.5 and the change in birth weight. (PNG 1555 kb)
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Wang, ., Mu, S., Yan, W. et al. Prenatal PM2.5 exposure increases the risk of adverse pregnancy outcomes: evidence from meta-analysis of cohort studies. Environ Sci Pollut Res 30, 106145–106197 (2023). https://doi.org/10.1007/s11356-023-29700-5
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DOI: https://doi.org/10.1007/s11356-023-29700-5