Dirty Air, Empty Cribs: Shocking Link Between Pollution, Fertility

Delhi's choked streets, veiled in smog, conceal a chilling truth: air pollution jeopardizes women's reproductive health. While headlines scream of respiratory ailments and lung diseases, the silent tendrils of pollution reach far deeper, casting a shadow on the very essence of motherhood: 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.  

A 2023 study published in JAMA Network Open casts a grim shadow over the joy of motherhood. It reveals a chilling truth: exposure to air pollution during pregnancy increases the risk of stillbirth by a staggering 10 per cent.  

Dr Poonam Khera, Director of Obstetrics and Gynaecology at BLK-Max Super Speciality Hospital, says, "Exposure to air pollution during the reproductive age group causes reduced fertility and adverse pregnancy outcomes. For couples in IVF, pollution during organogenesis raises abortion rates by over 10-15 per cent and increases the risk of failed IVF." 

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

Pollution Impacts Reproductive Journey  

The effects of air pollution go well beyond the initial stages of pregnancy. According to a 2020 JAMA study, pregnant women who were exposed to high levels of air pollution had a 42 per cent higher chance of having a miscarriage, and a different study published in the journal Environmental Health Perspectives found that infertility was 29 per cent more common among Indian women who lived in high-pollution areas.  

"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," says 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.  

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, says, “Air pollution adversely affects women's reproductive health through inflammation, oxidative stress, endocrine disruption, and immune dysregulation.”  

Clinical experts say that airborne particulate matter, including PM 2.5, ozone, and nitrogen dioxide, triggers inflammatory pathways, raising C-reactive protein levels, and 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 negative impacts of air pollution extend beyond reproductive years, affecting not only women's health but also the health and development of children. A recent study published in Environmental International revealed a concerning link: pregnant women exposed to air pollution were 12 per cent more likely to have children with autism spectrum disorder. 

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 says, “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." 

Air pollution casts a long shadow over women's reproductive health and the well-being of their children. Its consequences, far-reaching and often silent, demand immediate attention.