Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York (SUNY), Buffalo, NY, USA.
Anzhen Hospital, Beijing, China.
Rev Environ Health. 2018 Sep 25;33(3):247-264. doi: 10.1515/reveh-2017-0033.
The developing fetus is particularly susceptible to environmental pollutants, and evidence has shown adverse effects of air pollutants on pregnancy and birth outcomes. Pregnancy loss, including spontaneous abortion (miscarriage) and stillbirth, is the most severe adverse pregnancy outcome. This review focuses on air pollution exposure during pregnancy in relation to spontaneous abortion and stillbirth. A total of 43 studies are included in this review, including 35 human studies and eight animal studies. Overall, these studies suggest that exposure to air pollutants such as particulate matter (PM), carbon monoxide (CO) and cooking smoke may be associated with higher risk for stillbirth and spontaneous abortion. PM exposure during an entire pregnancy was associated with increased risk of spontaneous abortion, and exposure to PM and PM in the third trimester might increase the risk of stillbirth. CO exposure during the first trimester of pregnancy was associated with an increased risk of spontaneous abortion and exposure during the third trimester was associated with an increased risk of stillbirth. Cooking smoke was found to increase the risk of stillbirths, and the evidence was consistent. Insufficient and conflicting evidence was found for various other pollutants, such as NO and SO. Studies did not show clear evidence for associations between pregnancy loss and others pollutants such as heavy metals, organochlorine compounds, PAH and total dust count. Further research is warranted to better understand the relationship between air pollution exposure and pregnancy loss.
发育中的胎儿特别容易受到环境污染物的影响，有证据表明空气污染物对妊娠和出生结局有不良影响。妊娠丢失，包括自然流产（流产）和死产，是最严重的不良妊娠结局。这篇综述重点关注妊娠期间暴露于空气污染与自然流产和死产的关系。本综述共纳入了 43 项研究，包括 35 项人类研究和 8 项动物研究。总的来说，这些研究表明，暴露于颗粒物（PM）、一氧化碳（CO）和烹饪烟雾等空气污染物可能与更高的死产和自然流产风险相关。整个孕期暴露于 PM 与自然流产风险增加有关，而 PM 和 PM 在孕晚期的暴露可能增加死产风险。妊娠早期暴露于 CO 与自然流产风险增加有关，而孕晚期暴露于 CO 与死产风险增加有关。烹饪烟雾被发现增加死产风险，证据一致。对于其他各种污染物，如 NO 和 SO，研究结果存在不足且相互矛盾。研究没有表明与其他污染物（如重金属、有机氯化合物、多环芳烃和总尘量）之间的妊娠丢失存在明确关联。需要进一步的研究来更好地了解空气污染暴露与妊娠丢失之间的关系。
