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. 2023 Oct 15:235:116652.
doi: 10.1016/j.envres.2023.116652. Epub 2023 Jul 13.

Ambient fine particulate matter and pregnancy outcomes: An umbrella review

Shuaixing Song  1 , Zhan Gao  2 , Xiaoan Zhang  3 , Xin Zhao  3 , Hui Chang  3 , Junxi Zhang  4 , Zengli Yu  5 , Cunrui Huang  6 , Huanhuan Zhang  7
Affiliations

Ambient fine particulate matter and pregnancy outcomes: An umbrella review

Shuaixing Song et al. Environ Res. .

Abstract

The available evidence on the effects of ambient fine particulate matter (PM2.5) and pregnancy outcomes (birth outcomes and pregnancy complications) has increased substantially. The purpose of this umbrella review is to refine the evidence of the association between birth outcome (birth defects) and PM2.5; and summarize the credibility of existing research on the association between pregnancy complications and PM2.5. We searched PubMed, Web of Science, Embase, and Cochrane databases for relevant systematic reviews and meta-analyses up to March 16, 2022 in accordance with PRISMA guidelines. Two independent investigators conducted data extraction. AMSTAR 2 and GRADE assessment criteria were used to evaluate the methodological and evidence quality. We performed subgroup analyses by trimesters of pregnancy. The review protocol for this study has been registered in PROSPERO (CRD42022325550). This umbrella review identified a total of 41 systematic reviews, including 28 articles evaluating the influence of PM2.5 on birth outcomes and 13 on pregnancy complications. Positive associations between perinatal PM2.5 exposure and adverse birth outcomes were found, including low birth weight, preterm birth, stillbirth, small for gestational age, and birth defects. Pregnant women exposed to PM2.5 had a significantly higher risk of developing hypertensive disorder of pregnancy, gestational diabetes mellitus, gestational hypertension, and preeclampsia. The findings of subgroup analysis demonstrated that the effects of ambient PM2.5 exposure on pregnancy outcomes varied by trimesters. The findings of this extensive umbrella review provide convincing proof that exposure to ambient PM2.5 raises the risks of unfavorable birth outcomes and pregnancy complications. Some associations show considerable disparity between trimesters. These findings have implications for strengthen perinatal health care on air pollution and improving intergenerational equity.

Keywords: Birth outcomes; Fine particulate matter; Pregnancy complications; Umbrella review.

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Conflict of interest statement

Declaration of competing interest The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Huanhuan Zhang reports financial support and administrative support were provided by College of Public Health, Zhengzhou University.

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