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The associations of air pollution exposure during pregnancy with fetal growth and anthropometric measurements at birth: a systematic review and meta-analysis

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Abstract

Fetal growth has been demonstrated to be an important predictor of perinatal and postnatal health. Although the effects of maternal exposure to air pollution during pregnancy on fetal growth have been investigated using ultrasound in many previous studies, the results were inconsistent and disputable. We aimed to qualitatively and quantitatively investigate the associations of air pollution exposure during different periods of pregnancy with fetal growth and anthropometric measurements at birth. We searched for all studies investigating the associations of air pollution exposure during pregnancy with fetal growth and birth anthropometric measurements in English and Chinese databases published before July 31, 2017. A random-effects model was employed in the meta-analysis to estimate the pooled effects of each 10 μg/m3 increment in air pollutant exposure. The ACROBAT-NRSI tool was applied to assess the quality of each included study, and the GRADE tool was employed to assess the overall quality of the meta-analysis. Maternal PM2.5 exposure (10 μg/m3) during the entire pregnancy was negatively associated with head circumference at birth (β = − 0.30 cm, 95% CI − 0.49, − 0.10), and NO2 exposure during the entire pregnancy was significantly linked to shorter length at birth (β = − 0.03 cm, 95% CI − 0.05, − 0.02). Maternal exposure to higher NO2 and PM2.5 during pregnancy may impair neonatal head circumference and length development, respectively. More studies are needed to confirm the effects of NO2 and PM2.5 and to identify the sources and major toxic components of PMs.

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Abbreviations

ACROBAT-NRSI:

A Cochrane Risk of Bias Assessment Tool: for Non-Randomized Studies of Interventions

GRADE:

Grading of Recommendations, Assessment, Development, and Evaluation

HC:

Head circumference

AC:

Abdomen circumference

BPD:

Biparietal diameter

FL:

Femur length

SE:

Standard error

RoB:

Risk of bias

SGA:

Small for gestational age

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Funding

This work was supported by the National Key Research and Development Program (2016YFC0207001), the National Natural Science Foundation of China (81502819,81874276), the Natural Science Foundation of Guangdong Province (2015A030310220), the Science and Technology Program of Guangdong Province (2016A020223008), and the Science and Technology Program of Guangzhou (201607010004).

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Author notes

  1. Li Fu and Yi Chen contributed equally to this work.

Authors and Affiliations

  1. Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, No. 160, Qunxian Road, Panyu District, Guangzhou, 511430, China

    Li Fu, Xinyi Yang, Sha Liu, Lei Pei, Baixiang Feng, Ganxiang Cao, Xin Liu, Xing Li, Jiufeng Sun, Tao Liu & Wenjun Ma

  2. Guangzhou Panyu Central Hospital, Guangzhou, 511400, China

    Yi Chen & Yufeng Ye

  3. Division of Epidemiology, The Jockey Club School of Public Health and Primary Care, The Chinese University of Hong Kong, Sha Tin, 999000, Hong Kong, China

    Zuyao Yang

  4. Department of Preventive Medicine, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China

    Hualiang Lin

  5. Center for Food Safety and Health, School of Public Health, Southern Medical University, Guangzhou, 510515, Guangdong, China

    Bo Zhang

  6. Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangzhou, 510080, China

    Bo Zhang

  7. Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China

    Xiaojun Xu

  8. General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, Guangdong, China

    Tao Liu & Wenjun Ma

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  1. Li Fu
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  2. Yi Chen
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  3. Xinyi Yang
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Contributions

LF and YC reviewed the literature and drafted the manuscript. XY, SL, LP, BF, GC, XL, XL, YY, JS, and XX checked and managed the data. ZY, HL, and BZ provided critical input to the manuscript. TL and WM provided lead supervision of the project, provided expert review of the manuscript, and reviewed and approved the manuscript. All authors contributed to the research article and approved the final version.

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Correspondence to Tao Liu or Wenjun Ma.

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Fu, L., Chen, Y., Yang, X. et al. The associations of air pollution exposure during pregnancy with fetal growth and anthropometric measurements at birth: a systematic review and meta-analysis. Environ Sci Pollut Res 26, 20137–20147 (2019). https://doi.org/10.1007/s11356-019-05338-0

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