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Meta-Analysis
. 2024 Nov 13:12:1488028.
doi: 10.3389/fpubh.2024.1488028. eCollection 2024.

Exposure to ambient air pollutions and its association with adverse birth outcomes: a systematic review and meta-analysis of epidemiological studies

Belay Desye  1 , Gete Berihun  2 , Abebe Kassa Geto  3 , Leykun Berhanu  1 , Chala Daba  1
Affiliations
Meta-Analysis

Exposure to ambient air pollutions and its association with adverse birth outcomes: a systematic review and meta-analysis of epidemiological studies

Belay Desye et al. Front Public Health. .

Abstract

Introduction: Air pollution is a significant global public health concern. However, there is a lack of updated and comprehensive evidence regarding the association between exposure to ambient air pollution and adverse birth outcomes (preterm birth, low birth weight, and stillbirth). Furthermore, the existing evidence is highly inconsistent. Therefore, this study aims to estimate the overall association between ambient air pollution and adverse birth outcomes.

Methods: In this study, initially a total of 79,356 articles were identified. Finally, a total of 49 articles were included. We conducted compressive literature searches using various databases, including PubMed, Scientific Direct, HINARI, and Google Scholar. Data extraction was performed using Microsoft Excel, and the data were exported to STATA 17 software for analysis. We used the Joanna Briggs Institute's quality appraisal tool to ensure the quality of the included studies. A random effects model was employed to estimate the pooled prevalence. Publication bias was assessed using funnel plots and Egger's regression test.

Results: In this study, the pooled prevalence of at least one adverse birth outcome was 7.69% (95% CI: 6.70-8.69), with high heterogeneity (I 2 = 100%, p-value < 0.001). In this meta-analysis, high pooled prevalence was found in preterm birth (6.36%), followed by low birth weights (5.07%) and stillbirth (0.61%). Exposure to PM2.5 (≤10 μg/m3) throughout the entire pregnancy, PM2.5 (≤10 μg/m3) in the first trimester, PM10 (>10 μg/m3) during the entire pregnancy, and O3 (≤10 μg/m3) during the entire pregnancy increased the risk of preterm birth by 4% (OR = 1.04, 95% CI: 1.03-1.05), 5% (OR = 1.05, 95% CI: 1.01-1.09), 49% (OR = 1.49, 95% CI: 1.41-1.56), and 5% (OR = 1.05, 95% CI: 1.04-1.07), respectively. For low birth weight, exposure to PM2.5 (≤10 μg/m3) and PM2.5 (>10 μg/m3) throughout the entire pregnancy was associated with an increased risk of 13% (OR = 1.13, 95% CI: 1.05-1.21) and 28% (OR = 1.28, 95% CI: 1.23-1.33), respectively.

Conclusion: This study highlighted a significant association between ambient air pollution and adverse birth outcomes. Therefore, it is crucial to implement a compressive public health intervention.

Systematic review registration: The review protocol was registered with the record ID of CRD42024578630.

Keywords: adverse birth outcomes; ambient air pollution; low birth weights; outdoor air pollution; preterm birth; stillbirth.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
PRISMA flow diagram of association between ambient air pollution and adverse birth outcomes, 2024.
Figure 2
Figure 2
Forest plot of the overall prevalence for at least one adverse birth outcome, 2024.
Figure 3
Figure 3
Forest plot for the association between ambient air pollution and preterm birth, 2024.
Figure 4
Figure 4
Forest plot for the association between ambient air pollution and low birth weight, 2024.
Figure 5
Figure 5
Forest plot for the association between ambient air pollution and stillbirth, 2024.
Figure 6
Figure 6
Funnel plot for the association between ambient air pollution and at least one adverse birth outcome, 2024.
Figure 7
Figure 7
Funnel plot of the association between ambient air pollution and preterm birth, 2024.
Figure 8
Figure 8
Funnel plot of the association between ambient air pollution and low birth weight, 2024.
Figure 9
Figure 9
Pooled effect size of ambient air pollution associated with preterm birth, 2024.
Figure 10
Figure 10
Pooled effect size of ambient air pollution associated with low birth weight, 2024.
See this image and copyright information in PMC

References

    1. Stieb DM, Chen L, Eshoul M, Judek S. Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis. Environ Res. (2012) 117:100–11. doi: 10.1016/j.envres.2012.05.007, PMID: - DOI - PubMed
    1. Glinianaia SV, Rankin J, Bell R, Pless-Mulloli T, Howel D. Particulate air pollution and fetal health: a systematic review of the epidemiologic evidence. Epidemiology. (2004) 15:36–45. doi: 10.1097/01.ede.0000101023.41844.ac, PMID: - DOI - PubMed
    1. Lamichhane DK, Leem J-H, Lee J-Y, Kim H-C. A meta-analysis of exposure to particulate matter and adverse birth outcomes. Environ Health Toxicol. (2015) 30:e2015011. doi: 10.5620/eht.e2015011, PMID: - DOI - PMC - PubMed
    1. Zhu X, Liu Y, Chen Y, Yao C, Che Z, Cao J. Maternal exposure to fine particulate matter (PM2.5) and pregnancy outcomes: a meta-analysis. Environ Sci Pollut Res Int. (2015) 22:3383–96. doi: 10.1007/s11356-014-3458-7, PMID: - DOI - PubMed
    1. Proietti E, Röösli M, Frey U, Latzin P. Air pollution during pregnancy and neonatal outcome: a review. J Aerosol Med Pulm Drug Deliv. (2013) 26:9–23. doi: 10.1089/jamp.2011.0932, PMID: - DOI - PubMed

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