In Utero Exposure to Particulate Air Pollution during Pregnancy: Impact on Birth Weight and Health through the Life Course

Abstract

In high-income countries, and increasingly in lower- and middle-income countries, chronic non-communicable diseases (NCDs) have become the primary health burden. It is possible that in utero exposure to environmental pollutants such as particulate matter (PM) may have an impact on health later in life, including the development of NCDs. Due to a lack of data on foetal growth, birth weight is often used in epidemiologic studies as a proxy to assess impacts on foetal development and adverse birth outcomes since it is commonly recorded at birth. There are no research studies with humans that directly link PM exposure in utero to birth weight (BW) and subsequently, the effects of lower BW on health outcomes in old age. It is, however, plausible that such associations exist, and it is thus important to assess the potential public health impacts of PM across the life course, and it is plausible to use birth weight as an indicator of risk. We therefore split this narrative review into two parts. In the first part, we evaluated the strength of the evidence on the impact of PM exposure during the entire pregnancy on birth weight outcomes in ten meta-analyses. In the second part, we reviewed the literature linking lower birth weight to childhood and adult chronic cardiovascular disease to explore the potential implications of PM exposure in utero on health later in life. Within the reviewed meta-studies on birth weight, there is sufficient evidence that PM pollution is associated with lower birth weight, i.e., the majority of meta-studies found statistically significant reductions in birth weight. From the second part of the review, it is evident that there is good evidence of associations between lower birth weight and subsequent cardiovascular disease risk. It is thus plausible that in utero exposure to PM is associated with lower birth weight and persisting biological changes that could be associated with adverse health effects in adulthood. Based on the reviewed evidence, however, the magnitude of later life cardiovascular health impacts from in utero exposure and its impact on BW are likely to be small compared to health effects from exposure to particulate air pollution over a whole lifetime.

Mmp12 Is Upregulated by in utero Second-Hand Smoke Exposures and Is a Key Factor Contributing to Aggravated Lung Responses in Adult Emphysema, Asthma, and Lung Cancer Mouse Models

“…The 'developmental origins of health and disease' hypothesis suggests that risk factors for the intrauterine environment can affect fetal development during critical periods, thereby increasing the risk of developing specific diseases later in life (Barker, 1990;Wadhwa et al, 2009;Harding and Maritz, 2012;Carpinello et al, 2018). Numerous epidemiological and experimental studies have associated maternal exposures to outdoor air pollution, CS, and SHS during pregnancy with adverse effects on lung maturation and function in newborns (Swanson et al, 2009;Weldy et al, 2013;Madhloum et al, 2017;Tanwar et al, 2017;Rumrich et al, 2020;Steinle et al, 2020); however, the The present study investigated the contribution of in utero SHS exposures in three distinct models of adult lung diseases: asthma, emphysema, and lung cancer. Compared to air-elastase controls, in the elastase-induced emphysema model, we demonstrated that 15-week-old female mouse offspring exposed in utero to SHS had significantly enlarged airspaces plus upregulated expression of Mmp12 (10.3-fold; Figures 2-4).…”

“…The ‘developmental origins of health and disease’ hypothesis suggests that risk factors for the intrauterine environment can affect fetal development during critical periods, thereby increasing the risk of developing specific diseases later in life ( Barker, 1990 ; Wadhwa et al, 2009 ; Harding and Maritz, 2012 ; Carpinello et al, 2018 ). Numerous epidemiological and experimental studies have associated maternal exposures to outdoor air pollution, CS, and SHS during pregnancy with adverse effects on lung maturation and function in newborns ( Swanson et al, 2009 ; Weldy et al, 2013 ; Madhloum et al, 2017 ; Tanwar et al, 2017 ; Rumrich et al, 2020 ; Steinle et al, 2020 ); however, the long-lasting consequences of altered lung structure and function on the onset of chronic lung diseases are poorly documented. The present study investigated the contribution of in utero SHS exposures in three distinct models of adult lung diseases: asthma, emphysema, and lung cancer.…”

Mitochondrial DNA Copy Number and Developmental Origins of Health and Disease (DOHaD)

“…It has been well documented that exposure to airborne particles and passive smoke exposure during pregnancy can affect birth weights [ 110 , 111 , 112 ]. In 2005, Bouhours-Nouet et al reported a 37% decrease in the relative content of mtDNA in placental tissue from smokers compared to that in nonsmokers ( p < 0.02) [ 113 ].…”

Environmental Determinants of Coronavirus Disease 2019 (COVID-19)

“…Fine and ultrafine particles (particles smaller than, respectively, 2.5 and 0.1 μm in diameter) can reach the alveoli and cross into not only the blood stream but may also cross the brain barrier or reach the fetus, potentially contributing to low infant birth weights [34,35]. Thus, air pollution does not only promote oxidative stress in the airways [36], it also leads to an accumulation of particles throughout the body over a lifetime.…”