CC BY
26UDC: 614.715
environmental impact on maternal and
child health
Zhanar Sabyrdilda, Ainur B. Kumar, Lyazzat Kosherbaeva Asfendiyarov Kazakh National Medical University, Almaty, Kazakhstan Abstract
The World Health Organization named the goals for improving maternal health and determined the future direction of the and the Human Development Goals. Despite being expressed in the reduction of under-five mortality and high mortality rates, these causes fall short of achieving the goal.
Human health and well-being are determined by many complex factors. Maternal and child health encompasses the health and well-being of women, infants, children, adolescents and their families. Environmental factors have a direct impact on the health of various populations around the world, including maternal and child health as a result of exposure to chemicals in the air, water, soil, food and consumer products.
There are a number of climatic risk factors that directly affect maternal health, including extreme heat, air pollution, floods and hurricanes. Epidemiological studies linking exposure to adverse maternal and child health outcomes highlight the importance of environmental impacts on health. Identifying and reducing the impact of the environment on a pregnant woman is not only relevant for the health of a child, but is also important for maintaining the health of the mother in the short and long term.
Environmental health literacy should be promoted in our country within the framework of the global concepts of "One Health" and "One World" not only for the health of the population as a whole, but also for the maintenance ofthe environment and the planet.
Key words: environmental impact, air quality, environmental determinants of health, maternal and child health, global health.
Correspondent author - Zhanar Sabyrdilda e-mail: s_zhanara@mail.ru
эненин жана баланын ден соолугуна
коргонун тасири
Сабырдилда Ж.С., Кумар А.Б., Кошербаева Л.К.
С.Д. Асфендияров атындагы Казак Улуттук Медицина Университети, Алматы, Казакстан
Аннотация
БYткYл dYÜWMYK саламаттыкты сактоо уюму эненин жана баланын ден соолугун жакшыртууну Туруктуу внYктYPYY максаттарынын жана Миц жылдыктын внYгYYмаксаттарынын туруктуу багыты катары атаган. Беш жашка чейинки балдардын влYMYн азайтуу жана энелердин влYMYHYн глобалдык коэффициенти жакшыртылганына карабастан, бул аракеттер тийиштYY максаттарга жетише алган жок.
Адамдын ден соолугу жана жыргалчылыгы квптвгвн татаал факторлор менен аныкталат. Эне жана баланын саламаттыгы аялдардын, ымыркайлардын, балдардын, вспYPYмдврдYH жана алардын Yй-бYлвлврYHYH ден соолугун жана бакубаттуулугун камтыйт. Экологиялык факторлор абадагы, суудагы, топурактагы, тамак-аш жана керектввчY буюмдардын химиялык заттардын таасиринин натыйжасында дYйнв жYЗY боюнча ар кандай калктын ден соолугуна, анын ичинде эненин жана баланын ден соолугуна тYздвн-тYз таасирин тийгизет.
Эненин ден соолугуна тYздвн-тYз таасир этYYЧY бир катар климаттык тобокелдик факторлору, анын ичинде втв ысык, абанын булганышы, суу ташкындары жана бороон-чапкындар бар. Эне жана баланын ден соолугуна терс таасир тийгизYYHY байланыштырган эпидемиологиялык изилдввлвр экологиянын ден-соолукка тийгизген таасиринин маанилYYЛYгYH баса белгилейт. Кош бойлуу аялга айлана-чвйрвHYH таасирин аныктоо жана азайтуу баланын ден соолугу YЧYH гана актуалдуу эмес, ошондой эле кыска жана узак мввнвттYY келечекте эненин ден соолугун сактоо YЧYH да маанилYY.
Экологиялык ден соолук сабаттуулугу биздин влквдв «Бир ден-соолук» жана «Бир дYйнв» глобалдык концепцияларынын алкагында жалпы калктын саламаттыгы YЧYH гана эмес, айлана-чвйрвHY жана планетаны сактоо YЧYH да жайылтылууга тийиш.
Ачкыч свздвр: айлана-чвйрвгв тийгизген таасири, абанын сапаты, ден соолуктун экологиялык детерминанттары, эне жана баланын ден соолугу, глобалдык ден соолук.
влияние окружающей среды на здоровье ма тери и ребенка
Сабырдилда Ж.С., Кумар А.Б., Кошербаева Л.К.
Казахский Национальный Медицинский Университет им. С.Д. Асфендиярова, г.Алматы, Казахстан
Аннотация
Всемирная организация здравоохранения назвала улучшение здоровья матери и ребенка постоянным направлением Целей в области устойчивого развития и Целей развития тысячелетия. Несмотря на улучшения в снижении детской смертности в возрасте до пяти лет и глобального коэффициента материнской смертности, эти попытки не смогли достичь соответствующих целей.
Здоровье и состояние человека определяются многими сложными факторами. Здоровье матери и ребенка охватывает состояние здоровья и благополучие женщин, младенцев, детей, подростков и их семей. Факторы окружающей среды прямое влияние на здоровье различных групп населения по всему миру, в том числе на здоровье матери и ребенка в результате воздействия химических веществ в воздухе, воде, почве, продуктах питания и потребительских товарах.
Существует целый ряд климатических факторов риска, которые непосредственно влияют на здоровье матери, включая экстремальную жару, загрязнение воздуха, наводнения и ураганы. Эпидемиологические исследования, связывающие воздействие с неблагоприятными последствиями для здоровья матери и ребенка, подчеркивают важность воздействия окружающей среды на здоровье. Выявление и снижение влияния окружающей среды на беременную женщину не только актуально для здоровья ребенка, но также важно для сохранения здоровья матери в краткосрочной и долгосрочной перспективе.
Грамотность в области экологического здоровья должна продвигаться в нашей стране в рамках глобальными концепциями «Единое здоровье» и «Единый мир» не только для здоровья населения в целом, но и для поддержания окружающей среды и планеты.
Ключевые слова: влияние окружающей среды, качество воздуха, экологические детерминанты здоровья, здоровье матери и ребенка, глобальное здоровье.
Introduction
Protecting health from the influence of environmental factors is an important task of public health. This is especially true for vulnerable populations such as the elderly, children, people with chronic diseases, and pregnant women. Maternal exposure to environmental pollutants causes pregnancy complications and poor pregnancy and birth outcomes.
Achieving the Millennium Development Goals and the Sustainable Development Goals, which include targets to reduce maternal, neonatal and under-5 mortality, is still considered a major global challenge.
Due to the urbanization and economic development of countries, the environment is increasingly affecting the health of vulnerable populations, including maternal and fetal health.
The purpose of the study is to c o n d u c t a l i t e r a t u r e r e v i e w o n environmental factors affecting maternal and child health. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically reviewed articles from PubMed and Cochrane reviews. Articles describing environmental impacts on maternal and child health were reviewed.
Research results and discussion
There is an that extreme temperatures adversely affect birth outcomes, including but not limited to changes in gestational age, birth weight, stillbirths, and neonatal stress whe n e x p o s e d to unus ual l y hi g h temperatures. Research shows that not only further research is needed on how climate change may affect maternal health and neonatal outcomes, but also the need for uniform standards for assessing
environmental impacts on fetal health in utero.
According to a 2018 World Health Organization (WHO) report, the adverse effects of air pollution are responsible for 8 million premature deaths each year [1]. Air pollution wasresponsible for more than 23% of deaths from lung cancer, 43% from respiratory diseases, 24% from strokes, and 23% from coronary heart disease [2]. A number of countries have shown the highest number of deaths due to air pollution [3]. Ninety-one percent of the world's population breathes poor-quality air, the level of pollution of which exceeds WHO standards. Rapid industrialization and modernization further exacerbate this situation due to the increase in particulate matter in the air [4-6].
The negative impact of extreme heat on maternal health was demonstrated in studies by Osub Ahmed. Exposure to extreme heat was associated with premature birth, which itself can lead to long-term morbidity and mortality in infants, due to maternal dehydration, failure to effective thermoregulation during pregnancy, and problems with placental nutrient exchange and fetal gas [7]. A study found that a 10-degree Fahrenheit increase in average weekly temperature was associated with an 8.6 percent increase in preterm birth rates.
As air pollution is gaining momentum in some countries, the significant implications of poor birth outcomes and their long-term public health consequences need to be considered [8]. Air pollution was the focus of many studies around the world. There is now sufficient evidence on the adverse effects of air pollution on fertility and pregnancy, but the heterogeneity of results remains controversial and doubtful
of causation. Discrepancies may be due to differences in exposure levels, pollution sources (from road traffic to coal combustion) and their toxic constituents and mixtures, or differences due to vulnerable gestation periods to emissions.
Air quality in the United States is regulated by the Environmental Protection Agency under the Clean Air Act. The Environmental Protection Agency sets and monitors health standards for six pollutants: carbon monoxide, lead, nitrous oxide, ozone, particulate matter, and sulfur dioxide. These contaminants are chosen not only because they are widespread, but also because they have the most adverse effects on public health [5, 8].
Of the six pollutant criteria, fine particulate matter and ozone are the most hazardous to human health, and of these, particulate matter is considered the most hazardous. Particles harmful to health are released into the air:
- by power plants, industrial plants and automobiles,
- due to incomplete combustion of fossil fuels, garbage and other organic substances,
- with emissions from gas stoves, home heating systems and wood-burning fireplaces, as well as with tobacco smoke.
Exposure to polluted air during early pregnancy due to high oxygen demand and rapid cell turnover can lead to structural or genetic damage. At later stages of pregnancy, it is more likely to cause functional changes [8, 9].
There are many studies on the effects of air pollution on health in newborns. Mendola and colleagues found that both chronic and acute ozone exposure contribute to an increased risk of stillbirth:
approximately 8,000 stillbirths per year in the US are attributable to ozone exposure. Polanska et al in a Polish cohort study found a significant effect of environmental tobacco smoke on pregnancy and neurodevelopment in the first two years of life. These findings are associated with low birth weight, prematurity, intrauterine growth retardation, fetal and neonatal mortality, congenital anomalies, and childhood cancer. There is the strongest and the most consistent evidence for a causal relationship between particulate matter exposure and postnatal mortality from respiratory disease.
Vehicle emissions (eg, particulate matter, nitrogen oxides) were classified by the National Toxicology Program as a suspected hazard to pregnant women with hypertension. There is evidence that cadmium and other heavy metals, POPs such as perfluoroalkyl substances (PFAS), and plasticizers (eg phthalates) are associated with preeclampsia [9].
An analysis of foreign literature showed that disadvantaged regions are more often and more intensely exposed to environmental hazards. Studies showed that the most affected residents of these areas are women and children. For example, the risk of exposure to lead and mercury is the most dangerous for the fetus in the womb.
In the United States , the National Institutes of Health launched an initiative called Environmental Impact on Children's Health Outcomes (ECHO). ECHO is designed to capitalize on existing participant populations and longitudinal cohorts to explore a wide range of environmental factors. The focus is on the effects of environmental toxins on pregnant women, as well as the consequences of childbirth and the development of the nervous system [10].
Conclusion
The environmental determinants of health are strongly influenced by public and private decisions regarding education, economic development, employment, housing and more. Every policy decision regarding housing, educatio n, and employment is also a health policy.
The Millennium Development Goals provide "a broad international policy and development framework to address environmental health threats". This framework is based on the understanding that environmental health is inextricably linked to human health, and that decisions should seek to reduce environmental hazards while changing people's behavior.
Further research is needed to address gaps in knowledge about the state of the environment on maternal and child health.
Conflict of interest: The authors report no conflict of interest with any researchers.
Reference:
1. Inoue K, Yan Q, Arah OA, Paul K, Walker DI, Jones DP, Ritz B. Air Pollution and Adverse Pregnancy and Birth Outcomes: Mediation Analysis UsingMetabolomic Profiles. Curr Environ Health Rep. 2020 Sep;7(3):231-242. doi: 10.1007/s40572-020-00284-3. Erratum in: Curr Environ Health Rep. 2020 Dec;7(4):441. PMID: 32770318; PMCID: PMC7599041.
2. Boyles AL, Beverly BE, Fenton SE, Jackson CL, Jukic AMZ, Sutherland VL, BairdDD, Collman GW, Dixon D, Ferguson KK, Hall JE, Martin EM, Schug TT, White AJ, Chandler KJ. Environmental Factors Involved in Maternal Morbidity and Mortality. J Womens Health (Larchmt). 2021 Feb;30(2):245-252. doi: 10.1089/jwh.2020.8855. Epub 2020 Nov 18. PMID: 33211615; PMCID: PMC7891208.
3. SahaP, Johny E, Dangi A, Shinde S, Brake S, Eapen MS, Sohal SS, Naidu V, Sharma P. Impact of Maternal Air Pollution Exposure on Children's Lung Health: An Indian Perspective. Toxics. 2018 Nov 16;6(4):68. doi: 10.3390/toxics6040068.
PMID: 30453488; PMCID: PMC6315719.
4. Theall KP, Johnson CC. Environmental Influences on Maternal and Child Health. Int J Environ Res Public Health. 2017 Sep 20;14(9):1088. doi: 10.3390/ijerph14091088. PMID: 28930166; PMCID: PMC5615625.
5. Miguel PM, Pereira LO, Silveira PP, Meaney MJ. Early environmental influences on the development of children's brain structure and function. Dev Med Child Neurol. 2019 Oct;61(W):U27-U33. doi: 10.1111/dmcn.14182. Epub 2019Feb 11. PMID: 30740660.
6. Li AM. Ecological determinants of health: food and environment on human health. Environ Sci Pollut Res Int. 2017 Apr;24(10):9002-9015. doi: 10.1007/s11356-015-5707-9. Epub 2015 Nov 10. PMID: 26552789; PMCID: PMC7089083.
7. Graham H, White PC. Social determinants and lifestyles: integrating environmental andpublic health perspectives. Public Health. 2016 Dec; 141 : 270-278. doi: 10.1016/j.puhe.2016.09.019. Epub 2016 Nov 1. Erratum in: Public Health. 2019 Sep;174:154. PMID: 27814893.
8. Gislason MK, Kennedy AM, Witham SM. The Interplay between Social and Ecological Determinants of Mental Health for Children and Youth in the Climate Crisis. Int J Environ Res Public Health. 2021 Apr 26;18(9):4573. doi: 10.3390/ijerph18094573. PMID: 33925907; PMCID: PMC8123462.
9. Abdollahpour S, Heidarian Miri H, Khademol Khamse F, Khadivzadeh T. The relationship between global gender equality with maternal and neonatal health indicators: an ecological study. J Matern Fetal Neonatal Med. 2 022 Mar; 3 5 (6) : 1 093- 1 099. doi: 10.1080/14767058.2020.1743655. Epub 2020 Apr 14. PMID: 32290738.
10. Kuehn L, McCormick S. Heat Exposure and Maternal Health in the Face of Climate Change. Int J Environ Res Public Health. 2017 Jul 29;14(8):853. doi: 10.3390/ijerph14080853. PMID: 28758917; PMCID: PMC5580557.
