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Pollution and stillbirth

6/16/2016

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There has been a lot of press recently about a new study about air pollution and  risk of stillbirth.

Siddika N, Balogun HA, Amegah AK, Jaakkola JJK. Prenatal ambient air pollution exposure and the risk of stillbirth: systematic review and meta-analysis of the empirical evidence. Occup Environ Med 2016; 0 :1–9. doi:10.1136/oemed-2015-103086
​

The study was published in the journal of occupational and environmental medicine. It was a systematic review of 13 earlier studies which included a meta-analysis (pooling and reanalysis of data from the studies reviewed)
What did they find? They found that prenatal exposure to a range of toxins in the air did NOT significantly raise the risk of stillbirth and that more study was needed.
The author of a linked commentary pointed out that most of the included studies could not take account of other factors that have been found to increase stillbirth risk, such as obesity and that data from the air quality monitoring stations were too spread out to be able to determine an individual’s exposure in different areas within the same city.
So the bottom line it is WAY too soon to be making much of this study so it is somewhat unfortunate that much has been made of it.
Nevertheless every cloud has a silver lining and so does this one. This study raises awareness of stillbirth. A lot of the 25 news items that picked up this study mentioned international and national stillbirth   figures   in their coverage. Another typical recommendation that was made was that pregnant women should “discuss concerns about stillbirth with their maternity care provider.”  
As a midwife if a woman came to me to say “I’m concerned that the air I am breathing is putting me at increased risk of stillbirth what can I do to reduce my risk?”. I’d be saying something like “while you can’t do anything about the air you are breathing you   can   do a   lot to reduce your risk of stillbirth. Chief amongst these is getting to know your baby and immediately reporting to me if your baby’s pattern of movement changes. I’ll do my part by taking your concerns seriously and investigating them appropriately as well as monitoring how your baby is growing and if we do this, together we will keep you and your baby safe”.
Hopefully publication of this article will give other maternity care providers an opportunity to do the same!
 

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