PM2.5 Exposure on Umbilical Cord Blood Biomarkers and Birth Outcomes in Nepal

Low birth weight (LBW), accounts for 40–60% of infant deaths worldwide. In Nepal, LBW affects an estimated 12–32% of live births, a rate that has remained stagnant despite national goals to reduce it. Prenatal exposure to ambient air pollution such as particulate matter (PM2.5) has been increasingly linked to adverse birth outcomes, including fetal growth restriction and preterm birth. Dysfunction or damage to the placenta, the organ that supplies the fetus with nutrients and oxygen, has been linked to LBW, however the mechanisms by which PM2.5 changes cell signaling indicative of placental inflammation and disrupts fetal development remain poorly understood. This project will investigate the relationship between prenatal PM2.5 exposure, changes in placental inflammatory markers, and LBW in Nepalese newborns. Working in collaboration with Kathmandu University School of Medical Sciences, I will utilize paired maternal and umbilical cord blood samples to assess levels of serum signaling molecules associated with blood vessel inflammation and damage, indicators of insufficient oxygen and nutrient delivery to the fetus by the placenta. Ambient PM2.5 levels during gestation quantified from Kathmandu air quality monitoring stations as well as neonatal birth weight data from the university birth cohort will be correlated with serum findings. I will then identify placental changes associated with PM2.5 exposure and evaluate their correlation with LBW. This research aims to uncover associations between environmental pollution and impaired fetal growth, informing future public health interventions to reduce neonatal mortality in Nepal as well as improve understanding of global maternal health.

Research Significance

This research addresses a major and persistent global health issue while simultaneously investigating a poorly understood biological mechanism between environmental pollution exposure and impact on adverse birth outcomes. Low birth weight (LBW) is a significant factor in infant mortality, and despite public health efforts, Nepal continues to experience higher than global average rates of LBW. Air pollution with PM2.5 is prevalent and increasing in areas such as Kathmandu, where many pregnant individuals are exposed without understanding the risks to fetal development. If strong associations are identified, this research could support policies aimed at improving air quality, protecting pregnant populations, and reducing neonatal mortality in Nepal and similar high-exposure settings. In addition, the biological mechanisms behind pollution exposure and changes to the maternal placenta is not fully understood. If biomarkers are able to be identified in these populations, this could lead to early identification of at-risk pregnancies as well as further development of medical interventions to reduce risk of LBW. Lastly, this research contributes to the field of maternal-fetal medicine and will strengthen our understanding of environmental determinants of reproductive health worldwide.

Publications

View on PubMed

Mentors

• • Archana Shrestha, PhD, MPH
  • Pratiksha Paudel, MPH

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