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Journal of Environmental and Public Health
Volume 2014, Article ID 901017, 20 pages
http://dx.doi.org/10.1155/2014/901017
Review Article

The Shared Pathoetiological Effects of Particulate Air Pollution and the Social Environment on Fetal-Placental Development

1Division of Medical Sciences, University of Victoria, Medical Science Building, Room 104, P.O. Box 1700 STN CSC, Victoria, BC, Canada V8W 2Y2
2Department of Medical Genetics, University of British Columbia, C201, 4500 Oak Street Vancouver, BC, Canada V6H 3N1

Received 12 July 2014; Accepted 21 October 2014; Published 26 November 2014

Academic Editor: Pam R. Factor-Litvak

Copyright © 2014 Anders C. Erickson and Laura Arbour. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Exposure to particulate air pollution and socioeconomic risk factors are shown to be independently associated with adverse pregnancy outcomes; however, their confounding relationship is an epidemiological challenge that requires understanding of their shared etiologic pathways affecting fetal-placental development. The purpose of this paper is to explore the etiological mechanisms associated with exposure to particulate air pollution in contributing to adverse pregnancy outcomes and how these mechanisms intersect with those related to socioeconomic status. Here we review the role of oxidative stress, inflammation and endocrine modification in the pathoetiology of deficient deep placentation and detail how the physical and social environments can act alone and collectively to mediate the established pathology linked to a spectrum of adverse pregnancy outcomes. We review the experimental and epidemiological literature showing that diet/nutrition, smoking, and psychosocial stress share similar pathways with that of particulate air pollution exposure to potentially exasperate the negative effects of either insult alone. Therefore, socially patterned risk factors often treated as nuisance parameters should be explored as potential effect modifiers that may operate at multiple levels of social geography. The degree to which deleterious exposures can be ameliorated or exacerbated via community-level social and environmental characteristics needs further exploration.