The best thing in the world
There is nothing more than the conception and reproduction of life
From a cell to a new life
It's a fascinating process
But it's also dangerous
Among them, we breathe air every day
It can also be the culprit in the killing of life
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A study published by six Chinese scholars in The Lancet Planetary Health last January suggested that air pollution could be a major contributor to pregnancy failures, including miscarriages and fetal deaths, in South Asia.
Figure/screenshot of the paper
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A survey of 30,000 pregnant women in South Asia
South Asia is the most populous region in the world, at the highest risk of pregnancy failure, and one of the most polluted areas of pm2.5 in the world. (Note: Countries in the South Asian region include India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan and Maldives.) So a team of associate researchers from The Institute of Reproductive Health at peking university's School of Public Health surveyed 34,197 women in South Asia between 1998 and 2016 to assess the effects of air pollution on their pregnancy failures.
The women surveyed all experienced at least one pregnancy failure, including 27,480 miscarriages and 6,717 fetal deaths. Of all pregnancy failures, 76.9% were from India, 12.4% from Pakistan and the remaining 10.8% from Bangladesh.
By combining satellite and atmospheric model results, the researchers estimated pm2.5 exposure during pregnancy, taking into account factors such as age, education level, work status, physical condition, smoking habits, temperature, humidity, etc., to analyze whether PM2.5 exposure increased the risk of pregnancy failure in women.
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The findings suggest that PM2.5 exposure during pregnancy is associated with an increased likelihood of pregnancy failure, with an estimated 1.03% increase in the risk of pregnancy failure for every 10 μg/m increase in PM2.5 concentration.
Why are pregnant women more vulnerable to air pollution than other groups?
It is speculated that this is related to systemic physiological changes during pregnancy. For example, pregnant women have a higher basal respiratory rate than normal: according to the U.S. Environmental Protection Agency, the standardized respiratory rate for normal women aged 23-30 years is 0.2 m3/kg-day, compared with 0.3 m3/kg-day for women in the second trimester of the same age. It can be seen that pregnant women have more exposure to air pollution than ordinary people at the same pollution level.
—— Xue Tao
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Rural areas and pregnant women over the age of 30 are more affected by PM2.5
The study also found that pregnant women in rural areas or older pregnant women were at greater risk of pregnancy failure affected by PM2.5.
Although in terms of numbers, rural women under the age of 30 account for the majority of cases of pregnancy failure. However, from the analysis of the causes, among the cases of pregnancy failure attributed to PM2.5 pollution, rural women over the age of 30 (including 30 years old) still account for a large proportion, because they are more susceptible to the harm of PM2.5 exposure.
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Why are rural areas or pregnant women over the age of 30 more affected by PM2.5?
Xue Tao said that rural women and pregnant women over the age of 30 are more susceptible to the impact of PM2.5, perhaps related to the basic risk level and anti-risk ability.
The so-called basal risk level is related to the age of pregnant women, and the pregnancy risk of pregnant women over 30 years old is generally higher.
The ability to resist risks is closely related to the living conditions and medical conditions of pregnant women. Pregnant women living in cities have an advantage in this regard over pregnant women living in rural areas.
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By surveying 30,000 pregnant women, the team also estimated the number of pregnancy failures in South Asia affected by air pollution between 2000 and 2016.
They found that in South Asia, where the average annual PM2.5 exceeded 40 micrograms per cubic meter, nearly 350,000 pregnancy failures were linked to air pollution each year, a figure that accounted for 7.1 percent of all pregnancy failures in South Asia.
In South Asia, where an average annual PM2.5 exceeds 10 micrograms per cubic meter (WHO air quality guidelines), pregnancy failures due to air pollution account for nearly one-third (29.7%) of the total each year.
This ratio is determined by the relative risk of exposure per unit of PM2.5 and the level of PM2.5 exposure in a particular region. In South Asia, the problem that PM2.5 may induce pregnancy failure is more important because of south Asia's own large neonatal base and high PM2.5 pollution.
—— Xue Tao
The impact of air pollution on pregnant women's pregnancies "knows no borders."
In 2019, a study by Xue Tao's team on 42,952 women in 33 African countries from 1998 to 2006 (who had experienced at least one human pregnancy success and one pregnancy failure) also showed that PM2.5 exposure was significantly associated with an increased risk of pregnancy failure.
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In addition, in 2019, Nature Sustainable published a study that looked at the records of 250,000 pregnant women in the Beijing health care system from 2009 to 2017 and found that air pollution exposure during pregnancy was associated with an increased risk of surviving miscarriage in the first trimester.
Trivia
Induced abortion, also known as "silent abortion", is a manifestation of adverse pregnancy outcomes that have a higher incidence (15-20%) in developing countries when the fetus has not yet formed or has died, but the placenta and embryonic tissue remain in the mother's womb.
The study also noted that PM2.5, CO, SO2, O3, temperature, occupation, age and relative humidity are all risk factors for surviving miscarriage, and that exposure to pollutants in the first 3 months of pregnancy has the greatest impact on possible surviving miscarriage.
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The cascading effects of pregnancy failure on women
There is growing evidence that exposure to air pollution during pregnancy may contribute to maternal pregnancy-related illnesses, such as high blood pressure and diabetes during pregnancy.
In addition to physical pain, pregnancy failure can have a range of psychological and economic knock-on effects on women, such as increased risk of postpartum depression, loss of ability to work, and increased other costs associated with pregnancy, all of which are social and medical issues that need to be addressed urgently.
Therefore, improving air quality is crucial to improving the physical and mental health of pregnant women and mothers.
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So, how to avoid the health damage caused by air pollution to pregnant women?
Some pregnant women will choose to wear masks when air pollution is serious, but it is easy to feel stuffy when wearing masks, and Xue Tao said that due to the complex physiological characteristics of pregnant women, how to wear masks reasonably still needs further research.
Xue Tao suggested that pregnant women should reduce their travel to places and areas with serious air pollution during pregnancy, and at the same time, rationally use air purifiers according to their own economic conditions.
A study by the Peking University School of Public Health and other institutions suggested that women starting folic acid supplementation more than 3 months before pregnancy could reduce the risk of preterm birth associated with particulate matter exposure in Han Women during pregnancy.
Pregnancy is a very important cycle in life, and every new life comes with the expectations of parents and loved ones. Therefore, be vigilant about air pollution during pregnancy and do a good job of protection, so that the baby can be born healthy and healthy, to appreciate the beauty of blue sky and green water.