Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses

Multiple systematic reviews and meta-analyses linked prenatal exposure to ambient air pollutants to adverse birth outcomes with mixed findings, including results indicating positive, negative, and null associations across the pregnancy periods. The objective of this study was to systematically summa...

Full description

Bibliographic Details
Main Authors: Nyadanu, Sylvester, Dunne, Jennifer, Tessema, Gizachew, Mullins, Ben, Kumi-Boateng, B., Lee Bell, M., Adema, Bereket Duko, Pereira, Gavin
Format: Journal Article
Language:English
Published: ELSEVIER SCI LTD 2022
Subjects:
Online Access:http://purl.org/au-research/grants/nhmrc/1195716
http://hdl.handle.net/20.500.11937/93794
_version_ 1848765791830278144
author Nyadanu, Sylvester
Dunne, Jennifer
Tessema, Gizachew
Mullins, Ben
Kumi-Boateng, B.
Lee Bell, M.
Adema, Bereket Duko
Pereira, Gavin
author_facet Nyadanu, Sylvester
Dunne, Jennifer
Tessema, Gizachew
Mullins, Ben
Kumi-Boateng, B.
Lee Bell, M.
Adema, Bereket Duko
Pereira, Gavin
author_sort Nyadanu, Sylvester
building Curtin Institutional Repository
collection Online Access
description Multiple systematic reviews and meta-analyses linked prenatal exposure to ambient air pollutants to adverse birth outcomes with mixed findings, including results indicating positive, negative, and null associations across the pregnancy periods. The objective of this study was to systematically summarise systematic reviews and meta-analyses on air pollutants and birth outcomes to assess the overall epidemiological evidence. Systematic reviews with/without meta-analyses on the association between air pollutants (NO2, CO, O3, SO2, PM2.5, and PM10) and birth outcomes (preterm birth; stillbirth; spontaneous abortion; birth weight; low birth weight, LBW; small-for-gestational-age) up to March 30, 2022 were included. We searched PubMed, CINAHL, Scopus, Medline, Embase, and the Web of Science Core Collection, systematic reviews repositories, grey literature databases, internet search engines, and references of included studies. The consistency in the directions of the effect estimates was classified as more consistent positive or negative, less consistent positive or negative, unclear, and consistently null. Next, the confidence in the direction was rated as either convincing, probable, limited-suggestive, or limited non-conclusive evidence. Final synthesis included 36 systematic reviews (21 with and 15 without meta-analyses) that contained 295 distinct primary studies. PM2.5 showed more consistent positive associations than other pollutants. The positive exposure-outcome associations based on the entire pregnancy period were more consistent than trimester-specific exposure averages. For whole pregnancy exposure, a more consistent positive association was found for PM2.5 and birth weight reductions, particulate matter and spontaneous abortion, and SO2 and LBW. Other exposure-outcome associations mostly showed less consistent positive associations and few unclear directions of associations. Almost all associations showed probable evidence. The available evidence indicates plausible causal effects of criteria air pollutants on birth outcomes. To strengthen the evidence, more high-quality studies are required, particularly from understudied settings, such as low-and-middle-income countries. However, the current evidence may warrant the adoption of the precautionary principle.
first_indexed 2025-11-14T11:40:52Z
format Journal Article
id curtin-20.500.11937-93794
institution Curtin University Malaysia
institution_category Local University
language English
last_indexed 2025-11-14T11:40:52Z
publishDate 2022
publisher ELSEVIER SCI LTD
recordtype eprints
repository_type Digital Repository
spelling curtin-20.500.11937-937942024-05-24T09:32:57Z Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses Nyadanu, Sylvester Dunne, Jennifer Tessema, Gizachew Mullins, Ben Kumi-Boateng, B. Lee Bell, M. Adema, Bereket Duko Pereira, Gavin Science & Technology Life Sciences & Biomedicine Environmental Sciences Environmental Sciences & Ecology Air pollution Birth outcomes Birth weight Stillbirth Preterm birth Umbrella review FINE PARTICULATE MATTER PREGNANCY OUTCOMES PRETERM BIRTH WEIGHT ASSOCIATION HEALTH PM2.5 METAANALYSIS IMPACT SCIENCE Air pollution Birth outcomes Birth weight Preterm birth Stillbirth Umbrella review Abortion, Spontaneous Air Pollutants Air Pollution Environmental Exposure Female Humans Infant, Newborn Maternal Exposure Particulate Matter Pregnancy Premature Birth Prenatal Exposure Delayed Effects Humans Abortion, Spontaneous Premature Birth Prenatal Exposure Delayed Effects Air Pollutants Air Pollution Environmental Exposure Maternal Exposure Pregnancy Infant, Newborn Female Particulate Matter Multiple systematic reviews and meta-analyses linked prenatal exposure to ambient air pollutants to adverse birth outcomes with mixed findings, including results indicating positive, negative, and null associations across the pregnancy periods. The objective of this study was to systematically summarise systematic reviews and meta-analyses on air pollutants and birth outcomes to assess the overall epidemiological evidence. Systematic reviews with/without meta-analyses on the association between air pollutants (NO2, CO, O3, SO2, PM2.5, and PM10) and birth outcomes (preterm birth; stillbirth; spontaneous abortion; birth weight; low birth weight, LBW; small-for-gestational-age) up to March 30, 2022 were included. We searched PubMed, CINAHL, Scopus, Medline, Embase, and the Web of Science Core Collection, systematic reviews repositories, grey literature databases, internet search engines, and references of included studies. The consistency in the directions of the effect estimates was classified as more consistent positive or negative, less consistent positive or negative, unclear, and consistently null. Next, the confidence in the direction was rated as either convincing, probable, limited-suggestive, or limited non-conclusive evidence. Final synthesis included 36 systematic reviews (21 with and 15 without meta-analyses) that contained 295 distinct primary studies. PM2.5 showed more consistent positive associations than other pollutants. The positive exposure-outcome associations based on the entire pregnancy period were more consistent than trimester-specific exposure averages. For whole pregnancy exposure, a more consistent positive association was found for PM2.5 and birth weight reductions, particulate matter and spontaneous abortion, and SO2 and LBW. Other exposure-outcome associations mostly showed less consistent positive associations and few unclear directions of associations. Almost all associations showed probable evidence. The available evidence indicates plausible causal effects of criteria air pollutants on birth outcomes. To strengthen the evidence, more high-quality studies are required, particularly from understudied settings, such as low-and-middle-income countries. However, the current evidence may warrant the adoption of the precautionary principle. 2022 Journal Article http://hdl.handle.net/20.500.11937/93794 10.1016/j.envpol.2022.119465 English http://purl.org/au-research/grants/nhmrc/1195716 http://purl.org/au-research/grants/nhmrc/1099655 http://purl.org/au-research/grants/nhmrc/1173991 http://creativecommons.org/licenses/by-nc-nd/4.0/ ELSEVIER SCI LTD fulltext
spellingShingle Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Environmental Sciences & Ecology
Air pollution
Birth outcomes
Birth weight
Stillbirth
Preterm birth
Umbrella review
FINE PARTICULATE MATTER
PREGNANCY OUTCOMES
PRETERM BIRTH
WEIGHT
ASSOCIATION
HEALTH
PM2.5
METAANALYSIS
IMPACT
SCIENCE
Air pollution
Birth outcomes
Birth weight
Preterm birth
Stillbirth
Umbrella review
Abortion, Spontaneous
Air Pollutants
Air Pollution
Environmental Exposure
Female
Humans
Infant, Newborn
Maternal Exposure
Particulate Matter
Pregnancy
Premature Birth
Prenatal Exposure Delayed Effects
Humans
Abortion, Spontaneous
Premature Birth
Prenatal Exposure Delayed Effects
Air Pollutants
Air Pollution
Environmental Exposure
Maternal Exposure
Pregnancy
Infant, Newborn
Female
Particulate Matter
Nyadanu, Sylvester
Dunne, Jennifer
Tessema, Gizachew
Mullins, Ben
Kumi-Boateng, B.
Lee Bell, M.
Adema, Bereket Duko
Pereira, Gavin
Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title_full Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title_fullStr Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title_full_unstemmed Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title_short Prenatal exposure to ambient air pollution and adverse birth outcomes: An umbrella review of 36 systematic reviews and meta-analyses
title_sort prenatal exposure to ambient air pollution and adverse birth outcomes: an umbrella review of 36 systematic reviews and meta-analyses
topic Science & Technology
Life Sciences & Biomedicine
Environmental Sciences
Environmental Sciences & Ecology
Air pollution
Birth outcomes
Birth weight
Stillbirth
Preterm birth
Umbrella review
FINE PARTICULATE MATTER
PREGNANCY OUTCOMES
PRETERM BIRTH
WEIGHT
ASSOCIATION
HEALTH
PM2.5
METAANALYSIS
IMPACT
SCIENCE
Air pollution
Birth outcomes
Birth weight
Preterm birth
Stillbirth
Umbrella review
Abortion, Spontaneous
Air Pollutants
Air Pollution
Environmental Exposure
Female
Humans
Infant, Newborn
Maternal Exposure
Particulate Matter
Pregnancy
Premature Birth
Prenatal Exposure Delayed Effects
Humans
Abortion, Spontaneous
Premature Birth
Prenatal Exposure Delayed Effects
Air Pollutants
Air Pollution
Environmental Exposure
Maternal Exposure
Pregnancy
Infant, Newborn
Female
Particulate Matter
url http://purl.org/au-research/grants/nhmrc/1195716
http://purl.org/au-research/grants/nhmrc/1195716
http://purl.org/au-research/grants/nhmrc/1195716
http://hdl.handle.net/20.500.11937/93794