Delayed fetal growth and adverse birth outcomes are some of the greatest public health threats to this generation of children worldwide because these conditions are major determinants of mortality, morbidity, and disability in infancy and childhood and are also associated with diseases in adult life. A number of studies have investigated the impacts of a range of environmental conditions during pregnancy (including air pollution, endocrine disruptors, persistent organic pollutants, heavy metals) on fetal and child development. The results, while provocative, have been largely inconsistent. This review, by Professor of Epidemiology Dr. Tongzhang Zheng, summarizes up to date epidemiologic studies linking major environmental pollutants to fetal and child development and suggested future directions for further investigation.
[Photo: Dr. Tongzhang Zheng]
It is now widely accepted that impaired fetal growth, reduced birth weight, and rapid catch-up growth in childhood predispose to high morbidity in infants and subsequent risk for adult diseases. Understanding the risk profiles for impaired fetal development and postnatal catch-up growth is thus critical to establish appropriate interventions to prevent childhood and adult diseases, and to further understand the underlying etiology of these diseases. This evaluation of the literature linking environmental exposures to fetal growth, birth size, and childhood growth suggests the effects of a variety of environmental pollutants, although provocative, have been largely inconsistent with results varying by study population, study design, and timing of exposure. Ongoing and planned longitudinal studies that have the ability to measure exposures across various time points during pregnancy and that comprehensively and prospectively investigate the relationship between exposures and fetal and early childhood growth trajectories are likely to provide increased insight into these associations.
Study published January-February 2016 in Annals of Global Health Vol 82, Issue 1.