Reproductive and birth outcomes track mother and infant health. This includes measures such as infertility, premature birth, low birth weight, birth defects, and fetal, infant, and maternal mortality. Because the fetus is vulnerable during pregnancy, environmental toxins and exposures can affect the fetus before birth. However, environmental exposures may not always be the direct cause of poor reproductive and birth outcomes; many other factors, like access to healthcare, can play a role as well.
Why is this important?
Reproductive and birth outcomes are important because they directly affect both the mother's and child's health and can have impacts throughout the rest of their lives. Some of these outcomes, like premature birth and birth defects, are very common.
What is known?
Infant mortality refers to infant deaths before 1 year of age. Outdoor air pollution (PM10) has been associated with a higher risk of infant death, specifically from respiratory causes and Sudden Infant Death Syndrome (SIDS).
Maternal mortality, as defined by the Centers for Disease Control and Prevention, refers to the death of a woman while she is pregnant or within a year of pregnancy, from causes related to the pregnancy itself. In Kentucky, all deaths during or up to one year after pregnancy are reviewed by a Maternal Mortality Review Committee in order to learn about preventing these deaths.
Premature birth, or birth before 37 weeks of pregnancy, is a leading cause of death in newborn babies. Premature birth increases the risk of many health problems such as intellectual disabilities, cerebral palsy, breathing problems, vision and hearing loss, and feeding and digestive problems. Many of these problems can be lifelong issues for the child. It is important to remember that every birth is different and many premature babies do not have any serious health complications.
Low birth weight refers to newborn babies that weigh less than 5.5 pounds (2500 grams) at birth. Low birth weight can make it easier for the baby to get sick and can delay motor skills, social development, and learning ability.
Infertility refers to the inability to have children and it can affect both men and women. Risk factors for infertility include certain medical conditions and waiting to have children later in life. However, a growing body of literature suggests that environmental contaminants such as phthalates, PCB (polychlorinated biphenyls), dioxins, and pesticides can lead to infertility too.
The sex ratio is the number of male babies to the number of female babies.
Who is at risk?
Factors such as parents' age, genetics, health, socioeconomic status, behavior, diet, access to health care, and environmental exposures can all play a role in reproductive and birth outcomes. The following factors increase a woman's risk of poor reproductive and birth outcomes:
- Environmental exposures such as secondhand smoke, air pollution, biocides, mercury, and lead
- Behaviors such as smoking, drinking alcohol, and using illicit drugs
- Medical conditions such as diabetes, high blood pressure, blood clotting disorders, and cervical or uterine problems
- Social and economic factors like domestic violence, stress, lack of social support, and marital status
Reduce your risk:
Not all negative reproductive and birth outcomes can be prevented. However, there are ways to reduce the risk of negative reproductive and birth outcomes before and during pregnancy.
- Visit your primary care provider on a regular basis and begin prenatal care as soon as you believe you may be pregnant.
- Get 400 micrograms (mcg) of folic acid every day, starting at least one month before getting pregnant. Prenatal vitamins and multivitamins contain folic acid, and do many fruits and vegetables.
- Do not drink alcohol, smoke, or use nicotine products.
- Do not use marijuana or other drugs.
- Know how to prevent infections during pregnancy, including washing your hands, preventing foodborne illness, and staying up to date with vaccinations.
- If possible, be sure all medical conditions are under control before becoming pregnant. Some conditions, such as diabetes, can increase the risk for birth defects.
- Talk to a healthcare provider about any medications you are taking or thinking about taking.
- Avoid hot tubs, saunas, heating pads, or other environments that might cause overheating. If you have a fever, talk to your healthcare provider about how to safely treat it.