Pregnancy: Air pollution may lead to congenital birth anomaly

Pregnant mothers living in air pollution hot spots risk bearing a child with a congenital birth anomaly – specifically orofacial cleft lip and palate (CLP).

This is according to a research by the South African Medical Research Council (SAMRC), in partnership with surgeons, researchers and Operation Smile.

Research

The research was presented this month at the Climate Child Health Series: The Impact of Climate Change on Newborn Health Outcomes, held online by the US Child Health Task Force and UN International Children’s Emergency Fund.

The SAMRC said the study draws together cases of patients with CLP from 2006 to 2020. Drawing from two databases, 2 515 cases were studied about air pollution, assessed at the mother’s residence.

“The research identifies an association between the increasing trend in CLP and a mother’s exposure during early pregnancy to particulate matter (PM) air pollution, PM10 and PM2.5,” SAMRC said.

The experts defined CLP as birth anomalies that typically affect a baby’s lip or mouth and nose because these parts do not form properly during pregnancy.

“This may happen during weeks four and seven of pregnancy. When a baby is developing, body tissue and special cells from each side of the head join to make the face.” SAMRC said there were several possible causes of CLP.

These include genes; what the mother eats and drinks; whether she smokes; uses a certain type of medication during pregnancy; and the environment in which the pregnant woman lives.

Dr Caradee Wright, chief specialist scientist at the SAMRC’s Environment and Health Research Unit, said: “Air pollution levels are known to be high in South Africa, coming from coalfired power stations, traffic, domestic fuel burning, mining, industry and other sources.

“We wanted to explore whether a mother’s exposure to air pollution affected her baby’s cleft lip and palate risk in South Africa.”

Wright said the CLP birth hot spot clusters were found in district municipalities in Gauteng, Limpopo, North West, Mpumalanga and Free State.

READ MORE: Drinking during pregnancy

Findings

The findings emphasise the need for more stringent air quality management to protect the health of unborn children. Researchers have also called on the National Ambient Air Quality Standards and Air Pollution Priority Areas to strictly manage the air quality.

“Information needs to be provided to mothers regarding the risks air pollution poses to their unborn child – especially in very early pregnancy. So, it’s important that if someone wants to fall pregnant, they try and limit air pollution exposure.”

This, SAMRC said, can be done by avoiding fires indoors without adequate ventilation and not walking or exercising on busy roads during peak traffic hours.

According to the SAMRC, CLP patients experience a higher mortality risk and deal with the adverse effects of physical challenges such as speech impediments, physical deficiencies in appearance, and psychosocial issues. “

Added to the difficulties confronted by children with CLP are nutritional problems caused by the inability to consume food.

The malnutrition that is a result of CLP is not properly recorded because death certificates list these as [just] malnutrition.”

The study found that an approach, where multiple disciplines collaborate and share data on all maternal information and pollutant volumes in all provinces can prevent CLP where possible. It also can reduce suffering and the financial burden on those affected.

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