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Review Finds Association Between Environmental Exposures and Adverse Pregnancy Outcomes

A review recently published in JAMA Network Open suggests that environmental exposures like air pollution and heat are associated with adverse pregnancy outcomes, such as preterm birth, low birth weight, and stillbirth.

The article details a systematic review of 68 studies and researchers found a statistically significant association between heat, ozone, or fine particulate matter and adverse pregnancy outcomes. The study focused specifically on populations in the United States, where these exposures are increasingly common.

“Climate change has been widely recognized as an environmental emergency, however it also has associations with human health,” said Nathaniel DeNicola, MD, assistant professor of obstetrics and gynecology at the George Washington University School of Medicine and Health Sciences and a co-author of the article. “Our findings here suggest that exacerbation of air pollution and heat exposure related to climate change may be significantly associated with risk to pregnancy outcomes in the U.S.”

The review revealed disproportionate effects on populations of pregnant women with certain medical conditions or belonging to specific races/ethnicities. Black mothers were found to be more at risk for adverse pregnancy outcomes as were mothers with asthma. The authors also noted that social determinants of health, such as urban living with higher exposure to air pollutants and long-term high levels of stress, also are known contributors to adverse outcomes.

“The medical community and women’s health clinicians in particular should take note of the emerging data and become facile in both communicating these risks with patients and integrating them into plans for care,” the authors wrote. “Moreover, providers can adopt a more active role as patient advocates to educate elected officials entrusted with public policy and insist on effective action to stop the climate crisis.”

The authors recommend that more research is needed to further identify at-risk populations.

Co-authors of the article include Bruce Bekkar, MD, retired from Southern California Permanente Medical Group, Susan Pacheco, MD, at the University of Texas McGovern Medical School, and Rupa Basu, PhD, at University of California Berkeley School of Public Health. The review, titled “Association of Air Pollution and Heat Exposure with Preterm Birth, Low Birth Weight, and Stillbirth,” can be found here.