All was good for Kirti Malhotra (29), a Delhi-based expectant mother, until the second week of November. “I developed a dry cough and cold due to the worsening air pollution,” she says. “The last thing I wanted at this stage of pregnancy was to fall sick.” Malhotra says that the cough still persists. “I cannot take any medicines right now and am unable to breathe freely with a mask on,” she shares. Malhotra now stays indoors all day and wears a mask even while stepping out to the balcony to dry clothes briefly. She hopes that the air quality improves soon, so she can resume her daily 30-minute walk without having to wear a mask.
Delhi’s soaring air pollution levels have been a concern for vulnerable groups, including pregnant women. According to a 2021 study by Brazilian researchers titled Safe in the womb? Effects of air pollution on the unborn child and neonates, there is a link between air pollution and gestation health. “Epidemiological and experimental evidence agree that gestational exposure to air pollution in urban [areas] increases the risks of low birth weight, preterm birth, congenital malformation, intrauterine growth restriction, and neonatal mortality. Furthermore, exposures are associated with increased risks of preeclampsia [high blood pressure during pregnancy], hypertension, gestational diabetes,” the findings read.
How does air pollution affect pregnancy?
Toxic air contains particulate matter (PM), including PM 2.5 and PM 10, which can easily penetrate the lungs. “They clog the smaller airways and bronchioles, reducing the amount of oxygen one can inhale. This can be a potential threat to lungs”, explains Dr Bhavna Anand, consultant, fetal medicine, HCMCT Manipal Hospital Dwarka, Delhi.
Dr Anand recalls multiple pregnant women consulting her for their ultrasounds expressing concerns about fetal health following the Delhi air pollution. A healthy pregnancy and optimal fetal development demand that the air quality index (AQI) is below 50, explains Dr Rahul Chandola, cardiovascular and thoracic surgeon, Institute of Heart Lungs Diseases (IHLD) Research Centre, PSRI Hospital, Delhi. However, due to environmental pollution, slight variations in this level are acceptable, he adds. Experts warn that the risk soars drastically when the AQI is above 300.
He explains that when toxic air enters the endothelium (large organ that comprises the blood vessels and lymphatic vessels), it affects fluid filtration and blood flow; hence reducing rate of oxygen exchange, too. Dr Anand explains, “During pregnancy, the body demands more oxygen due to continuous cell activation and growth in the fetus. In toxic air, the amount of pregnancy is lower. So there are increased risks, posing challenges to a healthy pregnancy.”
Effects of air pollution on fetal development
According to the American Pregnancy Association, the potential dangers of being exposed to air pollution during pregnancy include increased risks of asthma in the mother, preterm birth (delivery at less than 37 weeks of gestation) and newborns with low birth weight.
When the air is toxic, it carries more allergens. “Some common signs of an allergic reaction include dry cough, sneezing and watery eyes,” says Dr Sonal Kumta, senior consultant, obstetrics and gynecology, Fortis Hospital Mulund, Mumbai. “Sore throat, breathing difficulty, irritation in the eye, skin and nose are the other symptoms to look out for, adds Dr Anand. “These symptoms can be aggravated in pregnant women who are prone to asthma,” she cautions.
Dr Chandola explains that inhaling toxic air can affect the vascular health of an unborn child. “The high levels of toxins in the air can damage the endothelium. The rate of cardiovascular complications is also higher in babies exposed to pollution while in the womb,” says Dr Chandola. He adds that poor air quality not only impacts the blood vessels in the heart but can affect the lungs, liver and kidney, too. Further, air pollution has a link with immunity. “Highly polluted air can hamper the cell growth in the fetus. Eventually, this affects their immunity, especially when they are born preterm,” Dr Anand adds.
How to mitigate the risks of air pollution during pregnancy
According to Dr Kumta, certain measures can be taken to improve immunity even before conception. This can include regular walking, yoga and breathing exercises that can boost immunity and improve lung capacity. Here are some other ways to reduce the risks:
Eat healthy: A diet rich in anti-oxidants including vitamin C is essential. One can also take multivitamin capsules if prescribed by a treating doctor. Consuming warm beverages can mitigate the risk of toxins.
Keep the indoor environment safe: While staying indoors throughout the pregnancy may be impossible, one must avoid stepping out unnecessarily to reduce exposure to toxic air. Using an air purifier in every room helps reduce the risk of poor air quality during pregnancy. Also, the inside of your house must be kept clean and dust-free. “Cleaning the filters of air conditioners, vacuum cleaning or wet mopping the home regularly reduces the toxins indoors,” advises Dr Kumta.
Avoid allergens: Those prone to allergy must avoid products with fragrances — perfumes, hair sprays, detergents and fabric softeners as they contain air pollutants between the sizes of PM 2.5 and PM10 micrometers, says Dr Anand.
Stay cautious while stepping out: One must avoid crowded areas. When AQI levels are low, avoid exercising outdoors. Using an N95 or three-ply mask can prevent inhaling toxins during outdoor visits.
Takeaways
- Air pollution can increase the risk of health complications during pregnancy. As a result, babies could be born prematurely or have low birth weight.
- Pregnant women must focus on improving lung capacity through breathing exercises.
- Staying indoors, using masks and keeping the indoors dust-free are some measures to mitigate the risks.
