Abstract: Understanding air pollutant exposure-related toxicity pathways in pregnancy can provide information on developmental origin of health and diseases. The objective of this study was to conduct literature review to explore the association between maternal air pollutants exposure and adverse maternal/infant health outcomes through the lens of maternal molecular-level changes to identify gaps in this area of research. Articles published thus far were retrieved from PubMed using the relevant search terms and manually. After identification and screening of 127 articles, full text of sixty-two articles (including 12 reviews) were assessed for eligibility and 27 observational studies were included in the final analysis. Majority of the studies reported on the influence of air pollution on infant health outcomes such as low birth weight, pre-term birth, and fetal heart rate, however, there were only a few studies on the effect on maternal health. Several studies have implicated air pollutants in promoting inflammatory process, which can in turn trigger different downstream signaling pathways. Recent studies have implied that pregnancy complications may lead to long-term maternal health effects including increased risk for cancer with environmental exposures playing a role in this process. Interestingly, particulate matter (PM) has been reported to trigger inflammatory processes and act as a promoter of EGFR-driven lung cancer. Reports on air pollution exposure-related adverse maternal/ infant outcome and causal pathways are limited. Most of the reports in this review identified particulate matter exposure-related adverse infant health outcomes and implicated elevated oxidative stress and inflammatory responses suggesting that these mechanisms may contribute to adverse pregnancy outcomes. However, future mother-infant cohort studies with biomarker analysis reinforced by bioinformatics and statistical analyses are required to validate these findings.

Key words: Air Pollution, Particulate matter, Pregnancy Outcomes

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