Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review
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PREECLAMPSIA (VD GAROVIC, SECTION EDITOR)
Urban-Related Environmental Exposures during Pregnancy and Placental Development and Preeclampsia: a Review María Julia Zanini 1,2,3 & Carla Domínguez 1,2,3 & Toni Fernández-Oliva 1,2,3 & Olga Sánchez 1,2,3,4 & María Torres Toda 5,6,7 & María Foraster 5,6,7 & Payam Dadvand 5,6,7 & Elisa Llurba 1,2,3,4
# Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose of Review To summarize the current knowledge of the pathophysiological implications and the clinical role of urbanrelated environmental exposures in pregnancy. Recent Findings The ongoing urbanization worldwide is leading to an increasing number of pregnant women being exposed to higher levels of urban-related environmental hazards such as air pollution and noise and, at the same time, having less contact with natural environments. Pregnancy represents a particular and vulnerable life period both for women and their children. Extensive physiological and metabolic changes, as well as changes to the cardiovascular and respiratory systems during pregnancy, could result in increased sensitivity to damage by environmental factors. Summary Exposure to air pollution and noise is associated with placental dysfunction and damage, which, in turn, could lead to maternal complications such as preeclampsia. In contrast, more contact with greenspace during pregnancy seems to mitigate these adverse impacts. These findings open up new challenges for our understanding of the potential effect of urban living on placental function and preeclampsia, and offer new clinical and research opportunities. Keywords Preeclampsia . Placental dysfunction . Environmental exposure . Noise . Air pollution . Greenspaces
Introduction
María Julia Zanini and Carla Domínguez contributed equally to this work. This article is part of the Topical Collection on Preeclampsia * Elisa Llurba [email protected] 1
Obstetrics and Gynecology Department, High Risk Unit, Sant Pau University Hospital, C/Sant Quintí, 89, 08041 Barcelona, Spain
2
Women and Perinatal Health Research Group, Biomedical Research Institute Sant Pau (IIB-SantPau), Sant Pau University Hospital, Barcelona, Spain
3
School of Medicine, UniversitatAutònoma de Barcelona, Barcelona, Spain
4
Maternal and Child Health and Development Network (SAMID), RD16/0022/0015, Instituto de Salud Carlos III, Barcelona, Spain
5
ISGlobal, 08003 Barcelona, Spain
6
Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain
7
CIBER Epidemiología y SaludPública (CIBERESO), 28029 Madrid, Spain
Rapid urbanization worldwide has led to an increasing number of people living in urban areas. In addition to a stressful and a usually sedentary lifestyle, urban living is often associated with increased exposure to urban-related environmental hazards such as air pollution and noise and, at the same time, less access to natural environments such as greenspaces. Air pollution is the main environmental contributor to the global burden of disease, being responsible for an estimated 4.2 million
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