Maternal Exposure To Air Pollution And Birth Outcomes

Exposure to air pollution is an overlooked health emergency for children1 around the world. While such exposure is a persistent problem in some high-income countries (HICs) – especially in lowincome communities within those countries – the vast majority of child deaths from exposure to particulate matter air pollution occur in LMICs. Exposure to air pollution from particulate matter occurs both outdoors and indoors. AAP is primarily derived from fossil fuel combustion, industrial processes, waste incineration, agricultural practices and natural processes such as wildfires, dust storms and volcanic eruptions.

The main sources of air pollution may vary from urban to rural areas, but no area is, strictly speaking, safer. AAP was responsible for 4.2 million premature deaths in 2016; of these, almost 300 000 were children under 5 years (1,2). The risks associated with breathing HAP can be just as great. Breathing clean air at home is essential for children’s healthy development, but widespread dependence on solid fuels and kerosene for cooking, heating and lighting results in far too many children living in terribly polluted home environments. About three billion people worldwide still depend on polluting fuels and devices for cooking and heating (3). Women and children spend most of their time around the hearth, exposed to smoke from cooking fires, resulting in indoor concentrations of some pollutants that are five or six times the levels in ambient air.

The widespread lack of access to clean household energy has tragic consequences on a vast scale: HAP was responsible for 3.8 million premature deaths in 2016, including over 400 000 deaths of children under 5 years (4).