Wednesday, February 22, 2017

Air pollution identified as a possible risk factor for nearly 3 million preterm births every year.


Air pollution 
Outdoor air pollution has been identified as a possible risk factor for preterm births across the globe according to a study published in Journal of Environment International online February 10, 2017.[1] 

The 2010 study estimated that 2.7–3.4 million preterm births may be prevented if PM2.5 exposure is brought down.

It is estimated that 14·9 million babies were born preterm worldwide in 2010.

There exists a wide disparity between Preterm Births(PTBs) rates across the globe, European countries have the lowest rate at 4-5% vs. countries in Africa and South Asia with rates as high as 15–18%.

In South Asia, about 1 million   PM2.5 associated PTBs happened in India, followed by China which contributed another 500,000.
                                       
A pregnant woman in India or China will likely be exposed to 10 times more pollution as compared to a woman in Canada or UK.

It is estimated that in 2010, out of 135 million livebirths globally 14.9 million babies (11.1%) were preterm, including both spontaneous and iatrogenic births. [2]

Exposure of mother to fine particulate matter(PM) has been identified as one of the many risk factors for PTBs as well low birth weight babies. The fine PM finds its way into blood stream through lungs and causes pulmonary and placental inflammation, coagulopathies, endothelial dysfunction and hematological responses.

Fine particles are produced from all types of combustion, including motor vehicles, power plants, solid cooking fuels, residential wood burning, forest fires, agricultural burning, and some industrial processes.

Desert dust also contributes to Particulate Matter ( PM) and in Sub Saharan Africa, Middle East and North Africa it is the major exposure. 

"Air pollution may not just harm people who are breathing the air directly - it may also seriously affect a baby in its mother's womb," said Chris Malley, lead author of the study which is based on data for 2010.

The study further demonstrated that majority of the PM2.5 associated preterm birth could be prevented by implementing strict emission control strategies in these regions except in in Sub Saharan Africa, Middle East and North Africa where nothing much can be done to change the geography of the area.

Johan Kuylenstierna, co-author of the study, and SEI's policy director said "In a city, maybe only half the pollution comes from sources within the city itself - the rest will be transported there by the wind from other regions or even other countries."

Nevertheless, the study demonstrated that reduction of maternal PM2.5 exposure through emission reduction strategies could bring down the global preterm rate, limit in utero exposure to PM2.5 bringing down postnatal and long term neonatal morbidity.

Exposure to PM2.5 is also responsible for 9–14% of total preterm births globally out of the total risk percentage. It should also be targeted along with other risk factors to reduce the incidence of preterm birth.




[1] http://www.sciencedirect.com/science/article/pii/S0160412016305992
[2] http://www.sciencedirect.com/science/article/pii/S0140673612608204

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