Introduction:
These days we are exposed to many environmental hazards that most individuals are not aware of. They can be from our homes, offices, or in the air around us. When a pregnant woman is exposed to such hazardous substances, it can cause negative health effects for the baby and the mother. Apart from negative pregnancy outcomes, there may also be effects on other reproductive functions like fertility and menstrual disorders. Environmental factors that can cause adverse pregnancy outcomes include smoking, anesthetic gases, antineoplastic drugs, video display terminals, and exposure to lead, inorganic mercury, and selenium. However, cigarette smoking during pregnancy is the leading environmental factor for negative pregnancy outcomes. Women who smoke during pregnancy are twice likely to give birth to premature and low birth weight babies. Even the mental health of pregnant women is very crucial because it can affect the well-being of the fetus and the mother. It can be due to depression, loneliness, past memories, stress from the surroundings, or even violence. All these factors should be handled properly to avoid any adverse outcomes during pregnancy.
What Are the Common Environmental Risk Factors That Can Affect Pregnancy?
1) Substance Abuse: Substance use is prevalent across the world, and an estimated 500000 babies are exposed to some kind of substance each year.
Alcohol - Alcohol is a potent teratogen among the substances of abuse. It can cause fetal alcohol syndrome (FAS). The adverse effect caused by alcohol consumption during pregnancy is dose-dependent. It can cause craniofacial abnormalities, CNS dysfunction, and pregnancy failure. Fetal alcohol syndrome will present with the following symptoms.
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Intrauterine growth restriction and postnatal growth retardation.
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CNS Dysfunctions - Tremor, hypertonia or hypotonia, poor sucking ability, mental impairment, attention deficit, and developmental delay.
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Dysmorphic Anomalies - Narrow eye width, short upper vermilion, ptosis (drooping of the upper eyelid), broad upper lip, absent philtrum (vertical groove or dimple on the upper lip), midface hypoplasia, microcephaly, short upturned nose, micrognathia (a condition where the lower jaw (mandible) is abnormally small), and microphthalmia (a medical condition in which one or both eyes are abnormally small).
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Other Anomalies - Cardiac defects, spinal defects, urogenital defects, and limb defects.
Smoking - Smoking during pregnancy can cause numerous birth-related complications, including intrauterine growth retardation, low birth weight, preterm delivery, spontaneous abortion, and placental problems. Maternal smoking during pregnancy can cross the placenta to act as a neuro teratogen and interfere with fetal development. Women who smoke during pregnancy are more likely to give birth to low birth-weight babies. Even exposure to tobacco smoke in the environment is a risk factor for the fetus, which can cause ear infections, asthma, sudden infant death syndrome (SIDS), and other respiratory conditions in newborns.
2) Metal - Lead, nickel, mercury, and manganese exposure can lead to poor reproductive outcomes.
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Lead - Lead crosses the placenta, causes teratogenic effects, and affects the hormonal environment required to maintain the pregnancy. Even low levels of lead exposure have been associated with a high risk for spontaneous abortion. Women who work in the paint industry or painters and artists are commonly exposed to lead. Stillbirths are also commonly linked with women exposed to lead.
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Mercury - Mercury exposure is commonly seen in dental assistants who deal with amalgams. This has been associated with spontaneous abortion as well as reduced fertility.
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Manganese - High levels of manganese during pregnancy are linked with an increased incidence of stillbirth and spontaneous miscarriage, as well as increased rates of hypertension during pregnancy and low birth weight.
3) Radiation - Radiation exposure during the periconceptional period (14 weeks before and 10 weeks after conception) and during early gestation has been linked with risks of childhood cancer and congenital defects. Another common cause of concern is non-ionizing radiation, like electromagnetic field waves, as in daily exposure to mobile phones, video display terminals, electric blankets, heated beds, and health professionals using diagnostic and therapeutic devices. The use of the above-mentioned substance during pregnancy has not been connected with adverse pregnancy outcomes during pregnancy. However, studies have shown an increased risk for spontaneous abortion, prematurity, and low birth weight associated with electromagnetic radiation.
4) Pollution - Air pollution has been connected with congenital birth defects, as well as intrauterine growth restriction, and low birth weight babies. A survey of pregnant women in Poland exposed the reduced head circumference in children and low birth weight. An increased congenital cardiovascular birth defect is also noted in babies who have been exposed to air pollution in utero.
5) Organic Solvents - Women working in textile, paint, plastic industries, clothing, and health care professionals are exposed to organic solvents. It will increase the risk of miscarriages while working with organic solvents.
6) Pesticide - Pregnant women working in the landscape and agricultural fields are at risk for pesticide exposure. They have an increased risk of spontaneous miscarriages, preterm delivery, and low birth weight. Other potential effects of pesticide exposure include infertility.
What Psychological Conditions Can Affect Pregnancy?
Psychosocial conditions like violence, anxiety, depression, and inequities of care can greatly affect pregnant women and their children.
1) Violence - Physical abuse during pregnancy happens to 5 % to 17 % of women during pregnancy. Violence is often linked with other pregnancy risks, such as alcohol, tobacco, and substance abuse.
Injuries and effects occur to both mother and unborn baby and range from violent behavior, severe injury, depression, and grief to crime and death.
Severe injuries caused by violence can lead to uterine contractions, placental abruption, and preterm delivery. Persistent abuse throughout pregnancy is linked with IUGR (intrauterine growth retardation), an increased incidence of miscarriage, and preterm delivery; these effects may also occur due to severe environmental stress. Loss to obstetrical care, late registration to care, and poor weight gain are particularly seen in pregnant women who are abused. They may present with vague somatic complaints, including headaches, pelvic pain, nausea, depression, and fatigue.
2) Depression - Although pregnancy is usually a time of joy and anticipation, many women will face stress and depression during that period. Depression is usually underrecognized during pregnancy. The postpartum period is a particularly high-risk time for severe depression and even psychosis.
In an effort to avoid risks from psychiatric medications during pregnancy, many women suspend their medication or discontinue their medication when they find out they are pregnant. This will lead to a lot of complications and risks for both mother and child.
3) Maternal Psychiatric Illnesses - Babies of women with psychotic disorders are known to have an increased rate of poor pregnancy outcomes, including higher mortality rates. Many researchers estimated the risk for neonatal death and stillbirth of women with histories of severe mental illness compared with the normal population. They also added that the higher risk of perinatal loss might be associated with factors such as unhealthy lifestyles and insufficient attendance for antenatal care rather than maternal mental illness itself.
Conclusion:
Environmental and psychosocial effects during pregnancy can cause adverse pregnancy outcomes. It is often advisable to avoid such complications and take steps to avoid them even before conception to get a fruitful pregnancy outcome. If one faces any issue before or during pregnancy, consult a physician to avoid any mishaps.
