Exploring climate change and air pollution adaptation strategies on adverse pregnancy outcomes in Asia

Climate change and air pollution are known to cause adverse pregnancy and birth outcomes. Asia continues to experience significant levels of air pollution and changes in weather, which has negative consequences for maternal and newborn health. Adaptation strategies are needed to minimize the impact of climate change and air pollution, however, research pertaining to the impact of adaptation strategies on maternal and newborn health is lacking. This review aims to map the current literature on climate change, weather, and air pollution adaptation in regard to women’s and newborn health in the Asia region. A search was conducted in five databases using relevant keywords related to climate change/air pollution/weather, adaptation, and pregnancy/birth outcomes. The search was limited geographically to the region of Asia. Two independent reviewers conducted abstract and full-text screening. Data was extracted from the final articles and synthesized. Ten studies were included in the final review. All but one of the studies focused on air pollution as an exposure, mainly in China. The most commonly studied adaptation measure was greenness. Exposure to greenness was associated with reduced risks of preterm birth, low birth weight, and gestational diabetes mellitus among pregnant women and newborns in Asia. Greenness was also found to mediate the relationship between pollutants and adverse pregnancy outcomes. Folic acid supplementation (air pollution exposures) and shifting the location of the maternity ward (heat exposures) were similarly found to reduce maternal and newborn health risks. The adaptation measures mentioned in this review reduce adverse pregnancy and birth outcomes through reducing exposure to pollutants. However, studies focusing on climate change as an exposure were limited. Additionally, all but two of the included studies were conducted in China, reflecting a significant gap in the literature across the rest of the Asian continent. Future research should focus on adaptation to climate change, understudied countries, and diverse adaptation strategies to increase knowledge around the impacts of climate change and air pollution adaptation strategies among pregnant women and newborns.