Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.
Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia.
Environ Pollut. 2019 Jan;244:915-925. doi: 10.1016/j.envpol.2018.10.086. Epub 2018 Oct 24.
Little is known about the impacts of maternal exposure to acute episodes of outdoor air pollution, such as that resulting from wildfires, on obstetric and neonatal outcomes. This systematic review aims to synthesise the existing literature exploring the relationship between maternal exposure to short-to medium-term changes in outdoor air quality and obstetric and neonatal outcomes.
A systematic search of peer-reviewed articles using PubMed, Cochrane Library, EMBASE, ScienceDirect, Web of Science, ProQuest, GreenFILE and Scopus was conducted in January 2018 using selected search terms. Quality of included studies were assessed using the Newcastle Ottawa Scale.
Eleven studies were included; eight assessed the impact of maternal exposure to air pollution exacerbation events, such as wildfires, oil well fires and volcanic eruptions, and three assessed the impact of improvement events, such as the 2018 Beijing Olympics and closure of industrial activities, on obstetric and neonatal outcomes. Studies were highly heterogenous in methodology. Six studies found a significant association between acute changes in air quality and markers of fetal growth restriction, while two did not. Three studies found an adverse association between acute changes in air quality and markers of gestational maturity, and one did not.
Overall, there is some evidence that maternal exposure to acute changes in air quality of short-to medium-term duration increases the risk of fetal growth restriction and preterm birth. The relationship for other adverse obstetric or neonatal outcomes is less clear.
母体暴露于户外空气污染的急性发作（如野火引起的污染）对产科和新生儿结局的影响知之甚少。本系统评价旨在综合现有文献，探讨母体暴露于户外空气质量的短期至中期变化与产科和新生儿结局之间的关系。
2018 年 1 月，使用选定的搜索词，在同行评议的文章中使用 PubMed、Cochrane 图书馆、EMBASE、ScienceDirect、Web of Science、ProQuest、GreenFILE 和 Scopus 进行了系统搜索。使用纽卡斯尔-渥太华量表评估纳入研究的质量。
共纳入 11 项研究；其中 8 项评估了母体暴露于空气污染加剧事件（如野火、油井火灾和火山爆发）对产科和新生儿结局的影响，3 项评估了改善事件（如 2018 年北京奥运会和工业活动关闭）对产科和新生儿结局的影响。研究方法高度异质。六项研究发现空气质量的急性变化与胎儿生长受限的标志物之间存在显著关联，而两项研究则没有。三项研究发现空气质量的急性变化与妊娠成熟标志物之间存在不良关联，而一项研究则没有。
总体而言，有一些证据表明，母体暴露于短期至中期持续时间的空气质量急性变化会增加胎儿生长受限和早产的风险。对于其他不良产科或新生儿结局的关系则不太清楚。
