A Scoping Review of Climate-Change Related Exposures on Obstetrics Outcomes [18G

Abstract

INTRODUCTION: Toxic environmental exposures, specifically climate-change related exposures, pose a unique risk to pregnant women and the developing fetus. Robust evidence analysis is needed to guide clinicians on risk assessment and clinical counseling. METHODS: A literature search was conducted by our research team and medical librarian; scope included United States studies from 2007 to 2017. Climate-change related exposures included air pollution components: fine particulate matter (PM 2.5) and ozone, extreme weather, heat and temperature. Exposures ranged throughout all trimesters. Obstetrics outcomes included preterm birth, low birth-weight, and stillbirth. Exposures related to natural disasters were excluded; clinical outcomes related to neurodevelopment, mental illness, gynecology, and fertility were excluded. The Arksey and O'Malley scoping review framework was followed and quality assessment was performed using the Jadad scale. RESULTS: A total of 1,842 references were screened. 24 studies related to air pollution and preterm birth met inclusion; 21 found an effect. 27 studies related to air pollution and low birth-weight and met inclusion; 25 found an effect. 4 studies related to air pollution and stillbirth met inclusion; 3 found an effect. 5 studies related to heat and preterm birth met inclusion; 5 found an effect. 3 studies related to heat and low birth-weight met inclusion; 3 found an effect. 2 studies related to heat and stillbirth met inclusion; 2 found an effect. CONCLUSION: Climate-change related exposures, specifically air pollution and heat, are associated with an effect on important obstetrics outcomes: preterm birth, low birthweight, and stillbirth. Women's health providers should become familiar with this emerging risk.