New patient resources warning of the dangers of air pollution and bushfire smoke to pregnant people or those planning to conceive have been issued by the Royal Australian College of Obstetricians and Gynaecologists (RANZCOG), in what is thought to be a world-first.
Patients are warned to avoid exposureto air pollution on heavily trafficked roads, bushfire smoke or indoor smoke from things such as cigarettes, unflued fireplaces or incense.
The groundbreaking document explains that exposure to air pollution during pregnancy is conclusively linked to gestational diabetes, pre-term birth and growth restriction, while studies conducted in countries with high pollution also show a link to high blood pressure, miscarriage and fertility issues.
“Most airborne particles [such as PM2.5 or PM10] are not directly poisonous but can be harmful because they provoke low grade immune and stress responses in the body,” the document says.
“These include increased inflammation, increased blood glucose, changes to regulation of heart rhythms, blood vessel function, and blood clotting regulation.”
Tasmanian-based obstetrician Dr Kristine Barnden, who helped RANZCOG develop the document said she hopes the information “serves as a wake-up call to policymakers and the general public that action in the form of regulation and response to climate change is important to protect women and their children”.
“We’re aware that no one can completely escape air pollution and that some women have less options than others,” she said.
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The pamphlet – which acknowledges that studies in Australia suggest low-level day-to-day exposure to air pollution may influence foetal growth – also outlines a number of actions that can be taken to mitigate risk, including use of high-efficiency particulate air (HEPA) cleaners and apps that monitor air quality, as well as wearing masks and recommends avoidance strategies such as not walking down busy roads at rush hour.
Barnden said RANZCOG first became aware of the lack of information available in 2020.
“There was a lot of concern amongst pregnant women, and a lot of talk on social media about potential risk of smoke for pregnancy, but we found there was really no resource to which we could direct women and caregivers for more information,” she said.
“We also wanted to be able to reassure women that if they are healthy and if they do take whatever steps they can to minimise the exposure to pollution, that the effects on pregnancy will actually be relatively small.”
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Barnden hopes the pamphlet will raise awareness about the various sources of air pollution, because “there is certainly a lot more than just bushfires that can affect pregnancy”, and how this exposure can be minimised.
The issuing of the pamphlet follows reporting by Guardian Australia in January and March of this year, detailing how Australian public health messaging was not fully informing or explaining the risks of exposure to pregnant patients or those planning to conceive, nor did it outline concrete mitigation or minimisation strategies.
“Articles published in the Guardian did an excellent job of pulling together the available research on air pollution and pregnancy and communicating it to the public, when there was really very little else around,” said Barnden.
“The concern voiced by women and health professionals in response to these articles made it clear to us that a resource for women and health professionals was necessary.”