Prenatal exposure to ambient air pollution and subsequent risk of lower respiratory tract infections in childhood and adolescence: A systematic review.

Autor: Pepper M; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom. Electronic address: maxine.pepper1@lshtm.ac.uk., Rebouças P; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Falcão IR; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Sanchez Clemente N; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Centre for Neonatal and Paediatric Infection, St. George's University of London, London, United Kingdom., Lowe R; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Barcelona Supercomputing Center (BSC), Barcelona, Spain; Catalan Institution for Research and Advanced Studies (ICREA), Barcelona, Spain., Schneider R; Ф-lab, European Space Agency (ESA-ESRIN), Frascati, Italy., Pescarini JM; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Santos GFD; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Andrade RF; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Cortes TR; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Ranzani OT; Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain., Brickley EB; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom., Barreto ML; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil., Paixao ES; Department of Infectious Disease Epidemiology & International Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Centro de Integração de Dados e Conhecimentos para Saúde (CIDACS), Oswaldo Cruz Foundation, Salvador, Brazil.
Jazyk: angličtina
Zdroj: International journal of hygiene and environmental health [Int J Hyg Environ Health] 2025 Jan; Vol. 263, pp. 114473. Date of Electronic Publication: 2024 Oct 05.
DOI: 10.1016/j.ijheh.2024.114473
Abstrakt: Background: Pregnancy represents a critical window of vulnerability to the harmful effects of air pollution on health. However, long-term consequences such as risk of having lower respiratory tract infections (LRTIs) are less explored. This systematic review aims to synthesize previous research on prenatal exposure to ambient (outdoor) air pollution and LRTIs in childhood and adolescence.
Methods: We systematically searched Embase, MEDLINE, Web of Science Core Collection, CINAHL, and Global Health up to May 17, 2024. We included peer-reviewed publications of studies which investigated the association between prenatal exposure to ambient air pollution and LRTIs up to the age of 19. We excluded conference abstracts, study protocols, review articles, and grey literature. Screening and data extraction was conducted by two reviewers independently. We used the Office of Health Assessment and Translation tool to assess risk of bias and conducted a narrative synthesis.
Results: The search yielded 6056 records, of which 16 publications describing 12 research studies were eligible for the synthesis. All studies were conducted in high- or upper-middle-income countries in Europe or Asia. Half (6) of the studies focused on LRTIs occurring within the first three years of life, and the others also included LRTIs in older children (up to age 14). Air pollutants investigated included nitrogen dioxide, sulphur dioxide, particulate matter (PM 2.5 : diameter ≤2.5 μm and PM 10 : diameter ≤10 μm), carbon monoxide, ozone, and benzene. Findings on a potential association between prenatal ambient air pollution exposure and LRTIs were inconclusive, without a clear and consistent direction. There was some suggestion of a positive association with prenatal PM 2.5 exposure. The small number of studies identified, their poor geographical representation, and their methodological limitations including concerns for risk of bias preclude more definitive conclusions.
Conclusion: The available published evidence is insufficient to establish whether prenatal exposure to ambient air pollution increases risk of LRTIs in children and adolescents. With many populations exposed to high levels of air pollution, there is an urgent need for research in more diverse settings, more transparent reporting of methods, and exploring how, when, and for whom prenatal exposure to ambient air pollution leads to the greatest health risks.
Prospero Registration Number: CRD42023407689.
Competing Interests: Declaration of competing interest None.
(Copyright © 2024 The Authors. Published by Elsevier GmbH.. All rights reserved.)
Databáze: MEDLINE
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