On Clean Air Day, Dr Eddie Morris, President of the Royal College of Obstetricians and Gynaecologists, and Feryal Clark MP, Shadow Minister for Primary Care and Patient Safety, call on the UK government to recognise the harmful effects of air pollution in pregnancy and set stronger targets for air quality in England.
The UK Government is currently consulting on new targets for concentrations of fine particulate matter, also known as PM2.5, which is thought to be the air pollutant which has the greatest impact on health. However, we believe that the government’s proposed concentration target will not go far enough to protect the health of pregnant women and their babies.
The WHO estimates that over 70 percent of towns and cities in the UK have unsafe levels of PM2.5. Further inaction could have long-ranging impacts on the future health of the population.
The RCOG has published its response to the UK Government’s consultation on environmental targets, highlighting key evidence on the harms of air pollution exposure in pregnancy which must be considered before a final air quality target is agreed.
Air pollution exposure during fetal development and early childhood can have long-term impacts on health in childhood in beyond. Air pollution exposure may also increase risks for maternal health, and has been linked to increased risk of pre-eclampsia, a serious cardiovascular condition of pregnancy.
It is therefore extremely alarming that the evidence to support the proposed target does not refer to pregnant women as a vulnerable group for air pollution exposure. Air pollution exposure has a unique impact during pregnancy, both on the health of the pregnant woman, on fetal development, and can even influence the future health of her baby after birth.
There is limited evidence-based advice those working in maternity care can give to pregnant women.
Along with important local initiatives to reduce exposures, such as Clean Air Zones, School Streets and good shared and active travel options, making our air safer requires decisive action at a national level.
We are therefore recommending, because of these harmful effects, the proposed target of 10 micrograms per cubic metre is instead set to be met by 2030 – ten years earlier than proposed.
The Clean Air Fund’s The Pathway to Healthy Air in the UK report has found reaching this target by 2030 is possible, and that there would be clear health benefits compared to no change from UK levels in 2018. This includes around 20 fewer infant deaths per year.
Baby loss can be a devastating event for women and their families. The impact of PM2.5 on maternal and perinatal health outcomes must therefore be explicitly referenced when justifying the final target set.
Dr Edward Morris, President of the Royal College of Obstetricians and Gynaecologists, said:
“The fact that the risks of air pollution exposure in pregnancy are not considered at all in the published evidence supporting the proposed target is extremely disappointing.
“There is consistent evidence that exposure to particulate matter during pregnancy increases the risk of poor pregnancy outcomes including stillbirth, low birth weight and preterm birth. This omission therefore casts doubt on any hope that the proposed targets will lead to healthy air for future generations.
“If the government is serious about addressing the UK’s persistent inequalities in pregnancy outcomes, there must be joined up working across departments where the effects of the wider social and environmental determinants of health are taken seriously and acted upon.
“If the evidence on air pollution and pregnancy continues to be disregarded, this will be a missed opportunity make pregnancy safer and improve outcomes for women and their babies.
Feryal Clark MP, Shadow Minister for Primary Care & Patient Safety, said:
“Every day, as I walk my child to the bus stop, I worry about the impact the pollution is having on her lungs.
“The fumes she has to breath in are having a serious effect on her physical development and like other mothers, I am deeply concerned for her future.
“For the evidence to show that this risk is extending to pregnant women is deeply concerning and like many environmental issues, will disproportionately affect women from working class and ethnic minority backgrounds.
“If firm action is not taken, then a generation of mums and babies will be put at risk.”
For media enquiries please contact the RCOG press office on +44 (0)7740 175342 or email firstname.lastname@example.org.
Notes to Editor
- Read the RCOG response to the UK Government consultation
- To read the 2021 RCOG statement on air pollution and pregnancy, visit: https://www.rcog.org.uk/media/euxn0kya/outdoor-air-pollution-and-pregnancy-rcog-position-statement.pdf
- Clean Air Fund, The Pathway to Healthy Air in the UK (2022)
- The RCOG is a member of the UK Alliance on Climate Change, and supports recommendations set out in the paper Moving beyond the air quality crisis (2018), Principles for a healthy and green recovery (2020), and Call for climate action (2021)