Environmental Exposure during Pregnancy: Influence on Prenatal Development and Early Life: A Comprehensive Review.

Lorenzo Guerra, Máximo Vento, Diana Escuder-Vieco, Carmen Rosa Pallás-Alonso, Begoña Loureiro, Aitziber Pérez, Manuela Lopez-Azorín, Fernando Cabañas, Elvira Larqué, Maria Foraster, Maria Julia Zanini, Carla Domínguez, Elisa Llurba, M Dolores Gómez-Roig, María Jesús Cabero, María Dolores Mesa, Olimpia Ortiz-Arrabal, Iris Iglesia, Gerardo Rodríguez, Leopoldo Martínez, Vicente Andreu-Fernández, Giorgia Sebastiani, Oscar García-Algar, Marc Josep Cahuana, Rosalia Pascal

Journal: Fetal diagnosis and therapy 2021;48(4):245-257

PMID: 33735860

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Abstract

Preconception and prenatal exposure to environmental contaminants may affect future health. Pregnancy and early life are critical sensitive windows of susceptibility. The aim of this review was to summarize current evidence on the toxic effects of environment exposure during pregnancy, the neonatal period, and childhood. Alcohol use is related to foetal alcohol spectrum disorders, foetal alcohol syndrome being its most extreme form. Smoking is associated with placental abnormalities, preterm birth, stillbirth, or impaired growth and development, as well as with intellectual impairment, obesity, and cardiovascular diseases later in life. Negative birth outcomes have been linked to the use of drugs of abuse. Pregnant and lactating women are exposed to endocrine-disrupting chemicals and heavy metals present in foodstuffs, which may alter hormones in the body. Prenatal exposure to these compounds has been associated with pre-eclampsia and intrauterine growth restriction, preterm birth, and thyroid function. Metals can accumulate in the placenta, causing foetal growth restriction. Evidence on the effects of air pollutants on pregnancy is constantly growing, for example, preterm birth, foetal growth restriction, increased uterine vascular resistance, impaired placental vascularization, increased gestational diabetes, and reduced telomere length. The advantages of breastfeeding outweigh any risks from contaminants. However, it is important to assess health outcomes of toxic exposures via breastfeeding. Initial studies suggest an association between pre-eclampsia and environmental noise, particularly with early-onset pre-eclampsia. There is rising evidence of the negative effects of environmental contaminants following exposure during pregnancy and breastfeeding, which should be considered a major public health issue.

Address: BCNatal, Barcelona Centre for Maternal Foetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain.; Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain.; BCNatal, Barcelona Centre for Maternal Foetal and Neonatal Medicine, Hospital Sant Joan de Déu and Hospital Clínic, Universitat de Barcelona, Barcelona, Spain, [email protected].; Institut de Recerca Sant Joan de Déu (IR-SJD), Barcelona, Spain, [email protected].; Neonatology Unit, Hospital Clinic-Maternitat, ICGON, Universitat de Barcelona, Barcelona, Spain.; Grup de Recerca Infancia i Entorn (GRIE), Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.; Valencian International University (VIU), Valencia, Spain.; Servicio de Cirugía Pediátrica, Hospital la Paz, Instituto de Investigación la Paz (IdiPAZ), Madrid, Spain.; Growth, Exercise, Nutrition, and Development (GENUD) Research Group, Instituto de Investigación Sanitaria Aragón (IIS Aragón), Universidad de Zaragoza, Zaragoza, Spain.; Department of Biochemistry and Molecular Biology II, Institute of Nutrition and Food Technology "José Mataix", Biomedical Research Center, University of Granada, Parque Tecnológico de la Salud, Granada, Spain.; Ibs.Granada, Instituto de Investigación Biosanitaria, Complejo Hospitalario Universitario de Granada, Granada, Spain.; Hospital Universitario Marqués de Valdecilla, Santander, Spain.; Obstetrics and Gynaecology Department, High Risk Unit, Sant Pau University Hospital, Barcelona, Spain.; Women and Perinatal Health Research Group, Biomedical Research Institute Sant Pau (IIB-SantPau), Sant Pau University Hospital, Barcelona, Spain.; School of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.; ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain.; Universitat Pompeu Fabra (UPF), Barcelona, Spain.; CIBER Epidemiología y Salud Pública (CIBERESO), Madrid, Spain.; Blanquerna School of Health Science, Universitat Ramon Llull, Barcelona, Spain.; Department of Physiology, Biomedical Institute of Research of Murcia Region (IMIB), Murcia University, Murcia, Spain.; Department of Neonatology, Quironsalud Madrid University Hospital and Quironsalud San Jose Hospital, Madrid, Spain.; Biomedical Research Foundation-IDIPAZ, La Paz University Hospital, Madrid, Spain.; Neonatology Unit, University Hospital Cruces, Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.; Donated Milk Bank, Health Research Institute i + 12, University Hospital 12 de Octubre, Universidad Complutense, Madrid, Spain.; Neonatal Research Group, Health Research Institute La Fe, University and Polytechnic Hospital La Fe, Valencia, Spain.

DOI: 10.1159/000514884

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MeSH Terms: Child, Environmental Exposure, Female, Growth and Development, Humans, Infant, Newborn, Lactation, Placenta, Pregnancy, Premature Birth