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...
| Main Authors: | , , , , , , , |
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| Format: | Journal Article |
| Language: | English |
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ELSEVIER SCI LTD
2022
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| Online Access: | http://purl.org/au-research/grants/nhmrc/1195716 http://hdl.handle.net/20.500.11937/93794 |
| _version_ | 1848765791830278144 |
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| 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 |