Document Type : Review
Authors
1
Tissue Engineering and Regenerative Medicine Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
2
Applied Biotechnology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
3
Nursing care research center, Clinical sciences institute, Baqiyatallah University of Medical Sciences, Tehran, Iran
4
Nursing and Midwifery Care Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran
5
Non-communicable Disease Research Center, Department of Environmental Health Engineering, Sabzevar University of Medical Sciences, Sabzevar, Iran
6
Gastroenterology and Liver Diseases Research Center, Research Institute for Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Iran
7
Obstetrics and Gynecology Department, Baqiyatallah Hospital, Baqiyatallah University of Medical Sciences, Tehran, Iran
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.
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