Assessing the impact of air pollution exposure in pregnancy on child development and health

The University of Manchester is part of a UK-wide project looking at the impact of exposure to indoor and outdoor pollution during pregnancy on baby development and child health.

The problem

Air pollution negatively effects child health and this can begin before birth. The adverse effects of air pollution on pregnancy outcomes, particularly premature and low weight births have been well established.

Physiological changes occur in pregnant women, for example, increased heart rate and oxygen consumption, meaning they are uniquely placed to potentially increase understanding of and lessen the later adverse effects of air pollution.

Previous studies have largely focused on outdoor pollution. However, most people are indoors around 90% of the time, where they are exposed not only to outdoor pollutants that accumulate indoors, but also to different sources of pollution. These could include, for example, wood burners, frying food, and chemicals in household items or cleaning products.

There are considerable gaps in scientific understanding of how the air we breathe indoors affects our immediate and long-term health.

A UK-wide collaboration

The University of Manchester is working on the RESPIRE (Relating Environment-use Scenarios in Pregnancy/Infanthood and Resulting airborne material Exposures to child health outcomes) project with consortium members across the UK.

Prof Ed Johnstone

Ed is Professor of Obstetrics and Fetal Medicine at The University of Manchester and Consultant Obstetrician at Saint Mary's Hospital.

View academic profile

The project aims to discover how pregnant women's exposure to indoor and outdoor air pollution passes to the baby, and how this affects the development of the baby's organs, particularly the brain, airways and heart and circulatory system. They will also study how exposure affects poor health in childhood.

The project is led by Professor Cathy Thornton from Swansea University, who said: "Our UK-wide collaboration will be the first to explore how pregnant women might respond differently to air pollution as a way of understanding the health consequences for their children."

Clean Air Programme funding

RESPIRE is funded by the National Institute for Health and Care Research and UK Research and Innovation (UKRI) through their Strategic Priorities Fund Clean Air Programme, which aims to support research to develop practical solutions for air quality issues.

Professor Sir Stephen Holgate, UKRI's Clean Air Champion, said: "Poor air quality affects millions of lives, but the impact of pollutants indoors is little understood. Funding research in this area is a key priority of UKRI."

RESPIRE is one of several Natural Environment Research Council-funded Clean Air Programme grants involving Manchester researchers. These include Ingenious (understanding air pollution in homes), led by Professor Carslaw of the University of York, and Hiptox (developing a hazard ranking of air pollutants to inform air policy and reduce ill health), led by Professor Gordon Mcfiggans at The University of Manchester.

Indoor and outdoor pollution included

A pregnant woman's exposure to pollution through airborne material exposures (AMEs) will depend on the indoor and outdoor places they spend time in, and how these change over pregnancy.

The RESPIRE group aims to establish the relationship between AMEs and health outcomes. They will study the effects of AMEs on various samples taken from pregnant women participating in the study, including nasal, urine, blood and umbilical cord samples once the baby is born.

They will also measure exposures within the homes of pregnant women and how they respond to these.

Considering other potential factors

The team will consider if other factors such as social disadvantages, housing type or urban living play a role.

Prof Martie Van Tongeren

Martie is a Professor of Occupational and Environmental Health at The University of Manchester.

View academic profile

Ethnic and cultural backgrounds and obesity will also be considered, because these are factors that contribute to individuals' responsiveness to AMEs in the general population.

Importantly, the study will recruit participants from different locations across the UK, because levels of ambient air pollution across the country vary.

Future impact

RESPIRE intends to develop tools to inform and test future interventions to ensure that results from pregnancy interventions are available quickly.

They will validate personal monitoring tools allowing study of a woman's exposure to pollution during pregnancy. Developing exposure response tools to measure a woman's response to her environment and how this response changes in different environments will also be a priority.

In the longer term, it is hoped that the new knowledge generated from this project will inform policy both locally and nationally. This will allow governments, businesses, charities and individuals to make informed changes that will eventually lead to a reduction in the negative effects of air pollution on pregnancy outcomes and child health.