Greater air pollution in winter, COVID-19 are potential risk factors for preterm births
Studies have not suggested an increased risk of congenital anomalies, early pregnancy loss, or miscarriage in pregnant women due to COVID-19, however, the novel coronavirus infection has been associated with an increased risk of premature birth
Preterm birth is one of the major concerns when it comes to pregnancies. Many factors could cause preterm births, including COVID-19 and air pollution. Pregnant women should adopt the necessary safety measures and get enough support to protect themselves and their fetuses during pregnancy. Proactive medical management is essential for their wellbeing.
Typically, pregnancy lasts around 40 weeks. If the baby is born before 37 weeks of pregnancy, it's considered to be preterm or premature. Preterm babies are further categorised depending on the gestational age when they are born. If the baby is born within 32-37 weeks of pregnancy, they are late or moderate preterm. Babies born within 28-32 weeks are very preterm and those born before the 28th week of pregnancy are considered extremely preterm.
Fortunately, given all the advances that have been made in the medical industry, around 90 percent of preterm babies end up surviving and most of them even have normal development later on.
There are various reasons why premature births happen, with most of them occurring spontaneously. In many such cases, the exact cause remains unidentified. Some preterm births happen when the delivery is expedited early by Caesarean section or labour induction due to medical reasons. Some of the common medical reasons for premature birth include infections, twin or multiple pregnancies, fetal growth restrictions, hypertensive disorders of pregnancy, and chronic conditions like high blood pressure and diabetes. Premature birth comes with health risks for the baby, with possible complications in the short term as well as long term.
Preterm birth and air pollution in winter
A relationship between the environment and biological risk factors does exist. Exposure to air pollution during pregnancy has been associated with the risk of preterm or premature birth. This risk is higher with exposure during the third trimester. Inhalation of polluted air increases toxic chemicals in the blood and stresses the immune system. It may also be associated with an unfavourable vaginal microbiota. All this can end up causing changes in the placenta, resulting in preterm birth.
With the increasing pollution, particularly in winters, pregnant women should try to limit their exposure to these pollutants as much as possible for the wellbeing of their baby. They are likely to gain considerable health benefits from this.
Preterm birth and COVID-19
The novel coronavirus has been spreading all across the world for almost a year now, and it has taken a hefty toll. In general, it is the elderly and immunocompromised individuals who are at the highest risk of developing complications from the viral infection. When it comes to pregnant women and COVID-19, premature delivery of their babies, stillbirths, and losing the pregnancy are the major concerns that need to be addressed.
Multiple research studies have been conducted to understand the effects this virus has on the outcome of pregnancy and newborns. So far, there is no indication that pregnant women are more susceptible to being infected severely. Studies have also not suggested any increased risk of congenital anomalies, early pregnancy loss, or miscarriage in pregnant women. However, the infection has been associated with an increased risk of premature birth. Pregnant women are therefore advised to take extra precautions and follow all the necessary guidelines to try and avoid getting infected by COVID-19.
This article was written by Dr Ranjana Sharma, Sr Consultant Obstetrics & Gynecology, Apollo Cradle & Children’s Hospital, Delhi.
For more information, read our article on Pregnancy and COVID-19.
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