4.5 Article

Environmental Factors Involved in Maternal Morbidity and Mortality

Journal

JOURNAL OF WOMENS HEALTH
Volume 30, Issue 2, Pages 245-252

Publisher

MARY ANN LIEBERT, INC
DOI: 10.1089/jwh.2020.8855

Keywords

environmental exposures; maternal health; window of susceptibility; air pollution; endocrine-disrupting chemical

Funding

  1. Intramural Program at the National Institutes of Health's National Institute of Environmental Health Sciences [Z1AES103325-01, Z01-ES102785, 1ZIAES103332, Z01ES103333]
  2. Postdoctoral Research Associate Training Program [Fi2GM133546]

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Environmental factors, such as chemical exposures and nonchemical stressors, can impact maternal health during pregnancy. Studies indicate that racial/ethnic minorities are more vulnerable to adverse effects from both chemicals and nonchemical stressors, leading to disparities in maternal health outcomes.
Nongenetic, environmental factors contribute to maternal morbidity and mortality through chemical exposures via air, water, soil, food, and consumer products. Pregnancy represents a particularly sensitive window of susceptibility during which physiological changes to every major organ system increase sensitivity to chemicals that can impact a woman's long-term health. Nonchemical stressors, such as low socioeconomic status, may exacerbate the effects of chemical exposures on maternal health. Racial/ethnic minorities are exposed disproportionately to both chemicals and nonchemical stressors, which likely contribute to the observed health disparities for maternal morbidities and mortality. Epidemiological studies linking exposures to adverse maternal health outcomes underscore the importance of environmental health impacts, and mechanistic studies in model systems reveal how chemicals perturb biological pathways and processes. Environmental stressors are associated with a variety of immediate maternal health impacts, including hypertensive disorders of pregnancy, fibroids, and infertility, as well as long-term maternal health impacts, such as higher risk of breast cancer and metabolic disorders. Identifying and reducing a pregnant woman's environmental exposures is not only beneficial to her offspring but also important to preserve her short- and long-term health.

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