Preconceptional and maternal obesity: epidemiology and health consequences.

https://journal.chestnet.org/article/S0012-3692(18)32722-3/pdf

Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies' Environmental Committee, Part 2: Air Pollution and Organ Systems.

Importance Knowledge of whether serious adverse pregnancy outcomes are associated with increasingly widespread effects of climate change in the US would be crucial for the obstetrical medical community and for women and families across the country Objective To investigate prenatal exposure to fine particulate matter (PM25), ozone, and heat, and the association of these factors with preterm birth, low birth weight, and stillbirth Evidence Review This systematic review involved a comprehensive search for primary literature in Cochrane Library, Cochrane Collaboration Registry of Controlled Trials, PubMed, ClinicalTrialsgov website, and MEDLINE Qualifying primary research studies included human participants in US populations that were published in English between January 1, 2007, and April 30, 2019 Included articles analyzed the associations between air pollutants or heat and obstetrical outcomes Comparative observational cohort studies and cross-sectional studies with comparators were included, without minimum sample size Additional articles found through reference review were also considered Articles analyzing other obstetrical outcomes, non-US populations, and reviews were excluded Two reviewers independently determined study eligibility The Arskey and O’Malley scoping review framework was used Data extraction was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline Findings Of the 1851 articles identified, 68 met the inclusion criteria Overall, 32 798 152 births were analyzed, with a mean (SD) of 565 485 (783 278) births per study A total of 57 studies (48 of 58 [84%] on air pollutants; 9 of 10 [90%] on heat) showed a significant association of air pollutant and heat exposure with birth outcomes Positive associations were found across all US geographic regions Exposure to PM25or ozone was associated with increased risk of preterm birth in 19 of 24 studies (79%) and low birth weight in 25 of 29 studies (86%) The subpopulations at highest risk were persons with asthma and minority groups, especially black mothers Accurate comparisons of risk were limited by differences in study design, exposure measurement, population demographics, and seasonality Conclusions and Relevance This review suggests that increasingly common environmental exposures exacerbated by climate change are significantly associated with serious adverse pregnancy outcomes across the US

/pdf/association-of-air-pollution-and-heat-exposure-with-preterm-1q1bgwkbg4.pdf

Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the US: A Systematic Review.

Air Pollution and Noncommunicable Diseases: A Review by the Forum of International Respiratory Societies’ Environmental Committee, Part 1: The Damaging Effects of Air Pollution

Objective To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth. Design Systematic review and random effects meta-analysis. Data sources Medline and Web of Science searched up to September 2018, updated in August 2019. Eligibility criteria for selecting studies Clinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths. Results 14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings. Conclusions Although summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health. Systematic review registration PROSPERO CRD 42019140136 and CRD 42018118113.

https://www.bmj.com/content/bmj/371/bmj.m3811.full.pdf

Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis.

Background:Extreme temperature is associated with adverse birth outcomes but it is unclear whether it increases early delivery risk.Objectives:We aimed to determine the association between ambient ...

/pdf/ambient-temperature-and-early-delivery-of-singleton-4pce7e2rjz.pdf

Ambient Temperature and Early Delivery of Singleton Pregnancies

Air pollution has been linked to hypertension in the general population, but data on gestational hypertension (GH) are limited. We investigated criteria air pollutants and air toxics during the period before conception and in early gestation in relation to GH risk in the Consortium on Safe Labor/Air Quality and Reproductive Health Study (United States, 2002-2008). Modified Community Multi-scale Air Quality models estimated air pollution exposures for 6,074 singleton pregnancies in which GH was present and 199,980 normotensive pregnancies. Generalized estimating equations estimated relative risks per interquartile-range increment for pollutants and high exposure (≥75th percentile) for air toxics after adjustment for major risk factors. For an interquartile-range increment, GH risk was significantly increased by 18% for sulfur dioxide during the 3 months before conception and, during gestational weeks 1-20, 17% for nitrogen oxides, 10% for particulate matter with an aerodynamic diameter <2.5 μm, 7% for particulate matter with an aerodynamic diameter <10 μm, and 22% for sulfur dioxide. High exposures to several polycyclic aromatic hydrocarbons before conception and during the first trimester were significantly associated with 8%-20% higher risk of GH. Further, preconceptional exposures to several volatile organic compounds were significantly associated with 11%-19% higher risk. Our findings suggest that early exposures to criteria air pollutants, particularly from transport emissions, and high exposure to several air toxics before conception may increase GH risk.

/pdf/ambient-air-pollution-and-risk-of-gestational-hypertension-4aj3n9k83x.pdf

Ambient Air Pollution and Risk of Gestational Hypertension.

Obstetric and Neonatal Risks Among Obese Women Without Chronic Disease.

Racial/ethnic differences in preterm perinatal outcomes

Spontaneous and indicated preterm delivery risk is increased among overweight and obese women without prepregnancy chronic disease

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