Association Between Maternal Exposure to Pahs and Preterm Birth: A Systematic Review and Meta-Analysis on Observational Studies; [ارتباط بین مواجهه با هیدروکربن های آروماتیک چند حلقه‌ای و زایمان زودرس: یک مرور سیستماتیک و متاآنالیز] Publisher



Akbariqomi M¹ ; Latifi AM² ; Vahedianazimi A³ ; Mohamadzadeh M² ; Abdi F⁴ ; Miri M⁵ ; Ashtari S⁶ ; Ghalandarpoorattar SN⁷
Source: Journal of Military Medicine Published:2024

Abstract

Background and Aim: Pollutants, including polycyclic aromatic hydrocarbons (PAHs), pose significant environmental and health risks. Exposure to PAHs has been associated with adverse pregnancy outcomes. Therefore, the study aimed to evaluate the relationship between maternal exposure to PAHs and Preterm Birth. Methods: In this systematic review and meta-analysis, Scopus, MEDLINE/PubMed, Web of Science, Cochrane Library, and ProQuest databases were searched without a time limit until June 16, 2024. Quality assessment was performed using the Newcastle-Ottawa Scale (NOS) and GRADE framework to evaluate the credibility of the evidence. Data analysis was done using random-effects models and odds ratio with 95% confidence interval to synthesize association estimates. Heterogeneity between studies was investigated using Cochran’s Q test and I-squared (I2) statistic, and publication bias was evaluated through funnel plots, Begg's test, and Egger's test. All statistical analyses were conducted using STATA version 17 (Stata Corp; College Station; TX, USA) software. Results: Out of 5695 studies screened, 6 with a total sample size of 45158 were included in our final review. The results of the meta-analysis showed a non-significant overall association between maternal exposure to PAH metabolites and preterm birth (OR: 1.09, 95%CI: 0.80-1.49, P = 0.59) and the I-squared index indicated significant heterogeneity among studies (I2 = 88.23%, P<0.001). Based on the funnel plot analysis and the results Begg's test (P = 0.964) and Egger's regression test (P = 0.855) both suggested no significant publication bias. Conclusion: This study underscores the no effect of PAHs exposure on preterm birth. However, further well-designed prospective studies with standardized exposure assessment methods and rigorous control of confounding factors are necessary to elucidate the underlying mechanisms linking PAH exposure to adverse pregnancy outcomes. © 2024 Baqiyatallah University of Medical Sciences. All rights reserved.