Air pollution exposure during pregnancy and spontaneous abortion and stillbirth.
Air pollution exposure during pregnancy and spontaneous abortion and stillbirth.
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DOI：
10.1515/reveh-2017-0033
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发表时间：
2018-09-25
影响因子：
3.9
通讯作者：
Mu L
中科院分区：
文献类型：
--
作者：
Grippo A;Zhang J;Chu L;Guo Y;Qiao L;Zhang J;Myneni AA;Mu L
发育中的胎儿特别容易受到环境污染物的影响，有证据表明空气污染物对妊娠和出生结果产生不利影响。妊娠丢失，包括自然流产（流产）和死产，是最严重的不良妊娠结局。本综述重点关注怀孕期间与自然流产和死产相关的空气污染暴露。本综述共纳入 43 项研究，其中包括 35 项人体研究和 8 项动物研究。总体而言，这些研究表明，接触颗粒物 (PM)、一氧化碳 (CO) 和烹饪烟雾等空气污染物可能与死产和自然流产的较高风险相关。整个怀孕期间接触 PM10 会增加自然流产的风险，而在妊娠晚期接触 PM2.5 和 PM10 可能会增加死产的风险。妊娠前三个月接触一氧化碳与自然流产风险增加相关，而妊娠晚期接触一氧化碳则与死产风险增加相关。研究发现烹饪烟雾会增加死产的风险，并且证据是一致的。对于其他各种污染物，例如二氧化氮和二氧化硫，我们发现了不充分且相互矛盾的证据。研究没有明确证据表明流产与重金属、有机氯化合物、多环芳烃和总粉尘计数等其他污染物之间存在关联。需要进一步研究以更好地了解空气污染暴露与流产之间的关系。
The developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes. Pregnancy loss, including spontaneous abortion (miscarriage) and stillbirth, is the most severe adverse pregnancy outcome. This review focuses on air pollution exposure during pregnancy in relation to spontaneous abortion and stillbirth. A total of 43 studies are included in this review, including 35 human studies and eight animal studies. Overall, these studies suggest that exposure to air pollutants such as particulate matter (PM), carbon monoxide (CO) and cooking smoke may be associated with higher risk for stillbirth and spontaneous abortion. PM10 exposure during an entire pregnancy was associated with increased risk of spontaneous abortion, and exposure to PM2.5 and PM10 in the third trimester might increase the risk of stillbirth. CO exposure during the first trimester of pregnancy was associated with an increased risk of spontaneous abortion and exposure during the third trimester was associated with an increased risk of stillbirth. Cooking smoke was found to increase the risk of stillbirths, and the evidence was consistent. Insufficient and conflicting evidence was found for various other pollutants, such as NO2 and SO2. Studies did not show clear evidence for associations between pregnancy loss and others pollutants such as heavy metals, organochlorine compounds, PAH and total dust count. Further research is warranted to better understand the relationship between air pollution exposure and pregnancy loss.