Air Pollution Could Be Disrupting Your Chance To Conceive: Here’s Why

Beneath the busy streets of Delhi, covered in a haze of smog, lies a silent threat to the lives of women: the hazardous impact of air pollution on their reproductive health. While headlines often focus on respiratory ailments and lung damage, the invisible hand of pollution extends far deeper, affecting the very essence of womanhood – the ability to conceive, carry a pregnancy to term, and give birth to a healthy child.

A 2022 study published in The Lancet Planetary Health found that exposure to air pollution, particularly fine particulate matter (PM2.5), is associated with a 22 per cent decrease in the probability of conception per menstrual cycle.

Another 2023 study published in the Journal of the American Medical Association (JAMA) Network Open reveals that exposure to air pollution during pregnancy was associated with a 10 per cent increase in the risk of stillbirth. 

Dr Poonam Khera, Director of Obstetrics & Gynaecology at BLK-Max Super Speciality Hospital, warns, "Exposure to air pollution during the reproductive age group causes reduced fertility and adverse pregnancy outcomes." 

These pollutants, including particulate matter, nitrogen dioxide, and polycyclic aromatic hydrocarbons, can reach the fetal side of the placenta, posing a significant risk to both mother and child, she adds.

Pollution Impacts Reproductive Journey

The consequences of air pollution extend far beyond the initial stages of pregnancy. A 2020 study published in JAMA found that women exposed to high levels of air pollution during pregnancy were 42 per cent more likely to miscarry, while another study published in the journal Environmental Health Perspectives found that women living in areas with high levels of air pollution in India were 29 per cent more likely to experience infertility

"Early pregnancy exposure to air pollution increases the risk of miscarriage, while later exposure can lead to low birth weight and preterm birth. Furthermore, children born to mothers exposed to pollutants are at higher risk for congenital malformations, developmental delays, and even childhood cancer," states Dr Ashwini Bhalerao Gandhi, Consultant Gynaecology and Obstetrics at P. D. Hinduja Hospital and Medical Research Centre, Mahim. 

Clinical Experts say that mid-pregnancy exposure to pollution increases the risk of a 10-15 per cent higher chance of spontaneous miscarriage while early pregnancy exposure amplifies risks of congenital issues, reduced IQ, neurodevelopmental delays, childhood cancer, and obesity. 

“For couples in IVF, pollution during organogenesis raises abortion rates by over 10-15 per cent and increases the risk of failed IVF,” remarked Dr Khera highlighting the significant risks associated with air pollution during pregnancy.

How Pollution Disrupts Women's Health

The mechanisms through which air pollution disrupts women's reproductive health are complex and multifaceted. Dr Vikram Vora, Medical Director for the Indian Sub-Continent at International SOS, explains “Air pollution adversely affects women's reproductive health through inflammation, oxidative stress, endocrine disruption, and immune dysregulation.”

Clinical experts explain, “Airborne particulate matter, including PM 2.5, ozone, and nitrogen dioxide, triggers inflammatory pathways, raising C-reactive protein levels, impacting pregnancy. Free radicals from these pollutants contribute to infertility, preeclampsia, endometriosis, and polycystic ovarian syndrome. Endocrine-disrupting chemicals like phthalates disrupt hormone production, affecting sexual maturation and causing adverse pregnancy outcomes. Air pollution also increases white blood cell production, leading to sustained inflammation and heightened susceptibility to diseases.” 

Impacts Of Air Pollution On Children

The detrimental effects of air pollution extend far beyond the reproductive years not only impacting the women but the child’s health as well. A 2022 study published in Environmental International found that exposure to air pollution during pregnancy was associated with a 12 per cent increase in the risk of autism spectrum disorder in children.

Another The State of Global Air Report from 2020 states that high levels of PM 2.5 accounted for 50 per cent of the 116,000 infant deaths in 2019 alone. 

Air Pollution and Working Women: A Double Burden

The narrative extends beyond the biological aspects, with air pollution significantly impacting working women. Dr. Vora warns, "Women exposed to high levels of air pollution are at increased risk of cardiovascular and respiratory diseases, cancer, and cognitive decline later in life."  

He further highlights the disproportionate effect of air pollution on women, irrespective of age. He said, “Endocrine Disrupting Chemicals (EDCs) disturb the hormonal balance, influencing the timing of puberty in adolescent girls and causing irregular menstrual cycles. During the reproductive years, pollutants like polycyclic aromatic hydrocarbons (PAHs) play a pivotal role in affecting fertility and increasing the risk of adverse pregnancy outcomes. The challenges don't dissipate with age; instead, women in their menopausal stage become more susceptible to cardiovascular diseases due to growing air pollution.”

The silent threat of air pollution poses a significant challenge to women's reproductive health and child development. From reduced fertility and miscarriage risks to congenital disabilities and childhood cancers, the consequences are far-reaching and demand immediate attention. Addressing this issue requires multifaceted efforts, including stringent regulations to curb air pollution, increased awareness campaigns, and accessible healthcare facilities for women.