The silent threat: effects of PM2.5 exposure on perinatal complications and neonatal outcomes

Fine particulate matter (PM2.5) is recognized as a significant risk factor for adverse health effects, however, its association with perinatal complications and neonatal outcomes remains incompletely understood. Elucidation of this relationship is critical for enhancing perinatal healthcare strategies.

This research employed a retrospective analysis of patient data from the First People's Hospital of Shangqiu and Henan Children's Hospital, covering the period from February 1, 2018, to December 30, 2022. The study cohort consisted of 13,828 patients who underwent either vaginal or cesarean delivery, patients were categorized based on their delivery method (vaginal or cesarean) and PM2.5 exposure levels (< 50 µg/m3, 50-100 µg/m3, > 100 µg/m3). The study compared perinatal complications and neonatal outcomes among these groups.

PM2.5 exposure was associated with a significant rise in gestational hypertension across both delivery modes. In the cesarean delivery group, higher PM2.5 exposure was associated with an increased incidence of oligohydramnios (p = 0.006). Furthermore, lower birth weights were consistently observed within groups subject to higher PM2.5 exposure, irrespective of the mode of delivery. Multivariate logistic regression analysis revealed a significant correlation between elevated PM2.5 exposure levels and an increased risk of gestational hypertension (p < 0.001). Linear analysis demonstrated a negative correlation between elevated PM2.5 exposure levels and neonatal birth weight (p < 0.001). The adjusted Generalized Additive Model (GAM) suggested a non-linear pattern, indicating potential thresholds between PM2.5 exposure and the measured outcomes.

The exposure level of PM2.5 is significantly correlated with an increased incidence of gestational hypertension and a decrease in birth weight, it is essential for obstetricians to incorporate air quality considerations into the framework of prenatal care.