Air pollutants–particulate matter (PM)2.5 with antenatal exposure leading to adverse obstetrical outcomes of low birth weight and preterm birth: A systematic review and meta-analysis

Abstract

Introduction Particulate matter (PM)2.5 exposure affects prenatal health and birth outcomes, including low birth weight (LBW) and preterm delivery (PTD). Objective To identify and explore PM2.5 exposure on adverse obstetrical effects, including preterm birth and LBW. Methods Four hundred and nine studies from 1982 to 2020 were identified in a search of PubMed, Embase, Scopus, Web of Science, and Science Direct. Of the 409 articles, 24 were identified as “qualitatively considered” and 7 were identified as “quantitively eligible” to be included in this meta-analysis. The pooled effect of PM2.5 exposure on LBW and PTD was calculated using a random effect model with significant heterogeneity. Seven studies were conducted in the meta-analysis, and the pooled effect of PM2.5 exposure on LBW and entire pregnancy was 1.033 (95% CI, 1.025–1.041) with significant high heterogeneity (I2 = 96.110, P = 0.000). The pooled effect of PM2.5 exposure on PTD and entire pregnancy was 1.024 (95% CI, 1.015–1.033) with significantly different low heterogeneity (I2 = 60.036, P = 0.082). Discussion Exposure to PM2.5 during pregnancy is significantly associated with the risk of LBW, and the risk of PTD is significantly different but consistently associated with PM2.5. Conclusion Globally, PM2.5 exposure is significantly associated with serious pregnancy and birth outcomes worldwide. The emerging risks to prenatal health suggest a need for the government to influence health policies to protect maternal and pediatric health.