Exposure to Air Pollution and Pregnancy Outcomes in the East Mediterranean Region: a Systematic Review

Abstract

The East Mediterranean region suffers from high levels of air pollution which has a negative impact on pregnancy outcomes. This work systematically reviews the epidemiological evidence on maternal exposure to air pollution and adverse pregnancy outcomes in the region. Relevant papers and reports published between 2000 and 2014 were searched. Combinations of search terms including countries, exposures, and pregnancy outcomes were used to search for the relevant literature. Twelve articles from 6 countries met the inclusion criteria. There was a pattern of an association between outdoor air pollution and preterm birth and spontaneous abortion; indoor wood fuel smoke and birth weight; and second-hand smoke and birth weight, preterm birth, and spontaneous abortion.The quality of evidence on the impact of air pollution on pregnancy outcomes in the EMR is inadequate to form a base for future adaptation strategies and action plans. Therefore, more quality research is needed to portrait the actual situation in the regio