The Shared Pathoetiological Effects of Particulate Air Pollution and the Social Environment on Fetal-Placental Development

Exposure to particulate air pollution and socioeconomic risk factors are shown to be independently associated with adverse pregnancy outcomes; however, their confounding relationship is an epidemiological challenge that requires understanding of their shared etiologic pathways affecting fetal-placental development. The purpose of this paper is to explore the etiological mechanisms associated with exposure to particulate air pollution in contributing to adverse pregnancy outcomes and how these mechanisms intersect with those related to socioeconomic status. Here we review the role of oxidative stress, inflammation and endocrine modification in the pathoetiology of deficient deep placentation and detail how the physical and social environments can act alone and collectively to mediate the established pathology linked to a spectrum of adverse pregnancy outcomes. We review the experimental and epidemiological literature showing that diet/nutrition, smoking, and psychosocial stress share similar pathways with that of particulate air pollution exposure to potentially exasperate the negative effects of either insult alone. Therefore, socially patterned risk factors often treated as nuisance parameters should be explored as potential effect modifiers that may operate at multiple levels of social geography. The degree to which deleterious exposures can be ameliorated or exacerbated via community-level social and environmental characteristics needs further exploration.

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Is Indoor Air Pollution From Different Fuel Types Associated With the Anemia Status of Pregnant Women in Ethiopia?

Journal of Primary Care & Community Health ◽

10.1177/21501327211034374 ◽

2021 ◽

Vol 12 ◽

pp. 215013272110343

Author(s):

Sewitemariam Desalegn Andarge ◽

Abriham Sheferaw Areba ◽

Robel Hussen Kabthymer ◽

Miheret Tesfu Legesse ◽

Girum Gebremeskel Kanno

Keyword(s):

Air Pollution ◽

Logistic Regression ◽

Pregnant Women ◽

Indoor Air ◽

Pregnancy Outcomes ◽

Indoor Air Pollution ◽

Adverse Pregnancy Outcomes ◽

Outcome Variable ◽

Multivariable Logistic Regression Analysis ◽

Adverse Pregnancy

Background Indoor air pollution from different fuel types has been linked with different adverse pregnancy outcomes. The study aimed to assess the link between indoor air pollution from different fuel types and anemia during pregnancy in Ethiopia. Method We have used the secondary data from the 2016 Ethiopian Demographic and Health Survey data. The anemia status of the pregnant women was the dichotomous outcome variable and the type of fuel used in the house was classified as high, medium, and low polluting fuels. Logistic regression was employed to determine the association between the exposure and outcome variables. Adjusted Odds Ratio was calculated at 95% Confidence Interval. Result The proportion of anemia in the low, medium, and high polluting fuel type users was 13.6%, 46%, 40.9% respectively. In the multivariable logistic regression analysis, the use of either kerosene or charcoal fuel types (AOR 4.6; 95% CI: 1.41-18.35) and being in the third trimester (AOR 1.72; 95% CI: 1.12-2.64) were significant factors associated with the anemia status of the pregnant women in Ethiopia. Conclusion According to our findings, the application of either kerosene or charcoal was associated with the anemia status during pregnancy in Ethiopia. An urgent intervention is needed to reduce the indoor air pollution that is associated with adverse pregnancy outcomes such as anemia.

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Maternal exposure to tributyltin during early gestation increases adverse pregnancy outcomes by impairing placental development

Environmental Toxicology ◽

10.1002/tox.23127 ◽

2021 ◽

Author(s):

Hui Liu ◽

Wenyu Jiang ◽

Yafen Ye ◽

Bei Yang ◽

Xin Shen ◽

...

Keyword(s):

Pregnancy Outcomes ◽

Maternal Exposure ◽

Adverse Pregnancy Outcomes ◽

Placental Development ◽

Early Gestation ◽

Adverse Pregnancy

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Association between neighbourhood deprivation, fetal growth, small-for-gestational age and preterm birth: a population-based prospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-049075 ◽

2021 ◽

Vol 11 (11) ◽

pp. e049075

Author(s):

Dionne V Gootjes ◽

Anke G Posthumus ◽

Vincent W V Jaddoe ◽

Eric A P Steegers

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Preterm Birth ◽

Fetal Growth ◽

Gestational Age ◽

Pregnancy Outcomes ◽

First Trimester ◽

Adverse Pregnancy Outcomes ◽

Neighbourhood Deprivation ◽

Adverse Pregnancy

ObjectiveTo study the associations between neighbourhood deprivation and fetal growth, including growth in the first trimester, and adverse pregnancy outcomes.DesignProspective cohort study.SettingThe Netherlands, Rotterdam.Participants8617 live singleton births from the Generation R cohort study.ExpositionLiving in a deprived neighbourhood.Main outcome measuresFetal growth trajectories of head circumference, weight and length.Secondary outcomes measuresSmall-for-gestational age (SGA) and preterm birth (PTB).ResultsNeighbourhood deprivation was not associated with first trimester growth. However, a higher neighbourhood status score (less deprivation) was associated with increased fetal growth in the second and third trimesters (eg, estimated fetal weight; adjusted regression coefficient 0.04, 95% CI 0.02 to 0.06). Less deprivation was also associated with decreased odds of SGA (adjusted OR 0.91, 95% CI 0.86 to 0.97, p=0.01) and PTB (adjusted OR 0.89, 95% CI 0.82 to 0.96, p=0.01).ConclusionsWe found an association between neighbourhood deprivation and fetal growth in the second and third trimester pregnancy, but not with first trimester growth. Less neighbourhood deprivation is associated with lower odds of adverse pregnancy outcomes. The associations remained after adjustment for individual-level risk factors. This supports the hypothesis that living in a deprived neighbourhood acts as an independent risk factor for fetal growth and adverse pregnancy outcomes, above and beyond individual risk factors.

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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: A Generalized Additive Model

ISEE Conference Abstracts ◽

10.1289/isee.2020.virtual.p-1088 ◽

2020 ◽

Vol 2020 (1) ◽

Author(s):

M. Dastoorpoor ◽

N. Khanjani

Keyword(s):

Air Pollution ◽

Prenatal Exposure ◽

Pregnancy Outcomes ◽

Generalized Additive Model ◽

Additive Model ◽

Ambient Air ◽

Adverse Pregnancy Outcomes ◽

Ambient Air Pollution ◽

Adverse Pregnancy

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Abstract 376: Adverse Pregnancy Outcomes and Cardiovascular Risks Multi-disciplinary Awareness Project

Circulation Cardiovascular Quality and Outcomes ◽

10.1161/hcq.13.suppl_1.376 ◽

2020 ◽

Vol 13 (Suppl_1) ◽

Author(s):

Venkata Sai Gogineni ◽

Ki Park ◽

Denise Manfrini ◽

Robert Egerman ◽

Sharon Aroda ◽

...

Keyword(s):

Risk Factors ◽

Pregnancy Outcomes ◽

Descriptive Analysis ◽

Primary Objective ◽

Adverse Pregnancy Outcomes ◽

Cardiovascular Risks ◽

Cvd Risk ◽

Adverse Pregnancy ◽

Traditional Risk Factors

Background: Cardiovascular disease (CVD) remains the number one cause of death amongst women. There has been much effort put forth over the past decade in reducing both the incidence and prevalence of this disease burden through screening and treating the traditional risk factors. Recent guidelines have shown that adverse pregnancy outcomes (APOs), including pre-eclampsia (PEC), gestational diabetes mellitus (GDM) and pre-term birth (PTB) have been associated with future maternal CVD risk. Much of the current literature focuses almost exclusively on PEC. Our investigation is more comprehensive, covering not only these other APOs but assessing whether providers of multiple specialties in our community are aware of the APO to CVD risk association. The primary objective of this study was to investigate if there exist any knowledge gaps regarding the progression from APO to CVD and if this knowledge varies by specialty. Methods: An anonymous voluntary survey through REDCap© was sent to providers in the fields of Internal medicine (IM, 21%), Family medicine (FM, 26%), Obstetrics-Gynecology (Ob-Gyn, 23%) and Cardiology (30%) who have been in practice for greater than five years in our local Gainesville community. This project was registered as a QI project and descriptive analysis was used to examine the responses. Results: A total of 53 providers responded to the survey. Despite having the majority of patients being women, Ob-Gyn was the least likely amongst all specialties to routinely screen for CV risk factors. However, when addressed, they were the most likely to ask about APOs. Cardiologists, despite declaring to be aware of the association between APOs and CV risk, were least likely to ask about APOs. All specialties recognized PEC and GDM as APOs linked to long-term maternal CV risk but failed to associate PTB as an APO. The majority of providers amongst IM, FM, and Cardiology did not ask about APOs and lacked the knowledge of how often to appropriately screen for secondary risk factors associated with APOs. Additionally, these providers outright admitted that they are not familiar with the current AHA and/or ACOG guidelines for screening and follow-up. Conclusion: Descriptive statistical analysis of our data suggests that there exists a notable knowledge gap between all four specialties investigated in our survey. Education concerning the link between APOs and future maternal CV risk is needed amongst all specialties, especially amongst the providers in Cardiology, IM, and FM. Targeted efforts at our institution to improve awareness of all APOs, their associated secondary risk factors, and appropriate screening is required in all specialties to help reduce CVD morbidity and mortality.

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