Increasing exposure to fine particle air pollution during pregnancy is associated with an increased risk of stillbirths in low- and middle- income countries (LMICs), suggests a Nature Communications paper based on an analysis of a total of more than 45,000 stillbirths and livebirths. The findings suggest that air quality improvements may increase maternal health and may reduce the number of stillbirths in these countries.
Fine particulate matter (PM2.5) is a form of air pollution comprising chemical particles with a diameter of less than 2.5 micrometres. Pregnant mothers exposed to higher levels of PM2.5 are known to be at an increased risk of stillbirth, but the global disease burden remains poorly understood, particularly in LMICs.
Tao Xue and colleagues combined estimations of stillbirths and exposure rates for 54 LMICs, including Pakistan, India and Nigeria, assessing 13,870 stillbirths and 32,449 livebirths in the period from 1998 to 2016. They found that an increase in exposure to PM2.5 of about 10-µg/m3 was associated with an 11% increase in the risk of stillbirth. This association was enhanced by increasing maternal age. The authors then estimated the disease burden in 137 countries, in which more than 98% of global stillbirths occur, and estimated that PM2.5 exposure may have contributed to almost 40% of stillbirths in these countries.
Reducing the exposure of pregnant women to PM2.5 in LMICs will improve maternal health and reduce stillbirth rates, the authors argue.
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