Impact of ambient air pollution exposure during pregnancy on adverse birth outcomes: generalized structural equation modeling approach

Abstract

Background Air pollution and several prenatal factors, such as socio-demographic, behavioural, physical activity and clinical factors influence adverse birth outcomes. The study aimed to investigate the impact of ambient air pollution exposure during pregnancy adjusting prenatal risk factors on adverse birth outcomes among pregnant women in MACE birth cohort. Methods Data for the study was obtained from the Mother and Child in the Environment (MACE) birth cohort study in Durban, South Africa from 2013 to 2017. Land use regression models were used to determine household level prenatal exposure to PM2.5, SO2 and NOx. Six hundred and fifty-six births of pregnant females were selected from public sector antenatal clinics in low socio-economic neighbourhoods. We employed a Generalised Structural Equation Model with a complementary log–log-link specification. Results After adjustment for potential prenatal factors, the results indicated that exposure to PM2.5 was found to have both significant direct and indirect effects on the risk of all adverse birth outcomes. Similarly, an increased level of maternal exposure to SO2 during pregnancy was associated with an increased probability of being small for gestational age. Moreover, preterm birth act a mediating role in the relationship of exposure to PM2.5, and SO2 with low birthweight and SGA. Conclusions Prenatal exposure to PM2.5 and SO2 pollution adversely affected birth outcomes after controlling for other prenatal risk factors. This suggests that local government officials have a responsibility for better control of air pollution and health care providers need to advise pregnant females about the risks of air pollution during pregnancy.

Does Exposure to Ambient Air Pollution Affect Gestational Age and Newborn Weight?—A Systematic Review

“…The systematic review comprised a total of 69 papers [ 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 ,…”

“…Six studies were conducted in South America: four in Brazil [ 47 , 56 , 59 , 73 ], one in Chile [ 31 ], and one in Peru [ 40 ]. Two studies were from the other parts of the world—one from Australia [ 75 ] and one from South Africa [ 24 ]. The selected studies encompassed aggregated data from 20,024,479 pregnant women between 1975 and 2021.…”

“…Emphasis was placed on pollution with PM 2.5 and PM 10 . Among the included studies, 33 examined the impact of PM 10 [ 22 , 25 , 26 , 28 , 30 , 31 , 36 , 38 , 41 , 42 , 43 , 47 , 49 , 54 , 56 , 57 , 61 , 64 , 65 , 66 , 67 , 71 , 73 , 75 , 76 , 77 , 78 , 79 , 81 , 82 , 84 , 86 , 87 ] while 35 analyzed the impact of PM 2.5 [ 23 , 24 , 25 , 26 , 27 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 39 , 40 , 41 , 43 , 44 , 46 , 50 ,…”

Updates in Air Pollution: Current Research and Future Challenges

“…Adverse effects start during the prenatal period, with particulate matter shown to be present on the foetal side of the placenta. Maternal exposure to air pollution is associated with adverse birth outcomes and pregnancy complications [48][49][50], and both maternal and child exposure to fine and ultrafine particulate matter can impact the development of children's respiratory system, immune status, brain development, and cardiometabolic health [51]. While there is robust epidemiological evidence, the biological mechanisms underlying most risks associated with air pollution are not fully comprehended [52].…”

Concordance between In Vitro and In Vivo Relative Toxic Potencies of Diesel Exhaust Particles from Different Biodiesel Blends

“…There are many reports on the links between exposure to particulate air pollutants and adverse cardiac [ 1 , 2 , 3 , 4 , 5 , 6 , 7 , 8 ], pulmonary [ 9 , 10 ], reproductive/pregnancy [ 11 , 12 , 13 ], and neurological [ 6 , 14 ] outcomes, as well as cancer [ 15 , 16 , 17 ]. Diesel exhaust particles (DEPs) from traffic emissions are a source of urban air particulate pollution [ 18 ] and are considered major contributors to air pollution exposure-related adverse population health effects.…”