Consultation / Li Jiajie, chief physician of the Department of Obstetrics and Gynecology of Cathay Pacific Hospital
Interview writing / Lin Yan
Photo/Photo AC (※The characters have nothing to do with the subject of the article, and the photos are schematic diagrams of the situation)
The weather is sunny outside, and expectant mothers and babies who have been indoors for a long time are ready to go out to enjoy the warm sunshine and vitamin D. However, the whizzing cars will bring lead ions, and the pedestrians puffing clouds will exhale second-hand smoke. There are many harmful substances on the way out, which are quietly endangering the health of mothers and babies. How do they make a difference? How to prevent it?
Air pollution is seriously endangering people’s health, and even more serious harm to the two vulnerable groups of pregnant women and infants. What substances in the air are not good for health?
How many harmful substances are lurking in the air?
Li Jiajie, the chief physician of the Department of Obstetrics and Gynecology of Cathay Pacific Hospital, said that PM2.5, carbon monoxide, nitrogen dioxide, ozone, sulfur dioxide, and other common suspended particles (such as cigarette dust, lead ions) can affect health. Pregnant mothers should avoid carbon monoxide produced by combustion, because the affinity of carbon monoxide and heme is greater than that of oxygen, and prolonged exposure to high concentrations of carbon monoxide will make pregnant mothers with greater oxygen demand hypoxia, which will affect the baby.
Harm of PM2.5
Among the harmful substances, the most harmful is PM2.5. This kind of fine suspended particles with a diameter of less than 2.5 microns is easy to adhere to carcinogens such as dioxin and heavy metal harmful substances. Since the nasal cavity cannot remove particles below 10 microns, PM2.5 can easily enter the trachea and bronchi along the airflow, and even penetrate the air bubbles in the lungs into the blood vessels, circulate with the blood, and deposit in the body. Research published in the journal Nature Communication shows that pollutant particles inhaled by mothers can enter the placenta through the blood circulation. However, it is still unclear whether this is a leftover from the placenta filtering out the particles, or evidence that the particles have entered the fetus.
Sunny weather means good air? Gray is air pollution?
“The weather is good, the air is so fresh!”, “It’s so gray outside, remember to wear a mask when you go out.” Many people simply judge the air quality by the sky being clear and clear or gray. Dr. Li Jiajie said that this is only for harmful substances with larger particle sizes other than PM2.5. For fine suspended particles that are difficult to be captured by the naked eye, it is still recommended to go to the “Air Quality Inspection Network” or the “Environmental Instant Messenger” APP launched by the Environmental Protection Agency of the Executive Yuan to observe, PM2.5 reaches red (54.4-150.4μg/m³) and Above; when AQI (air quality index) reaches red (151-200) and above, you should try to avoid going out.
Are “green lights” and “yellow lights” safe?
When the AQI has red, purple, and maroon alarms, it means that the air quality is poor, so is the air quality in the green and yellow lights ok? In fact, air quality monitoring only conducts regional assessments for specific areas, and there are still high and low levels of air quality in individual areas. For example, the air on the side of the road will definitely be worse than that in the park; the living environment has long-term oil fumes or the air quality near the industrial area is also lower. Therefore, pregnant women and young children should avoid areas with dense populations, high oil fumes, second-hand smoke, and industrial areas.
Can wearing a mask prevent air pollution?
At present, the epidemic is spreading, and mothers and babies will wear masks when they go out, but this does not mean that they can relax their hearts. General medical masks can only filter pollutants above 10 microns such as lead ions emitted from vehicle exhaust, and still cannot prevent PM2.5 and other harmful substances. Although N95 masks have the possibility of filtering PM2.5, the oxygen demand of pregnant women and infants is large, which may cause difficulty in ventilation. Therefore, it is still not recommended to use N95 to prevent air pollution.
Air pollution may cause premature birth, gestational hypertension
In addition to causing discomfort in the throat and eyes, as well as inflammatory reactions caused by air pollution, PM2.5 will flow with the blood following entering the human body, increasing the risk of cardiovascular disease. Long-term exposure to air pollution will increase the cardiovascular burden of pregnant mothers and increase the chances of suffering from gestational hypertension, abnormal placental function, low fetal weight, and premature birth. Dr. Li Jiajie explained that this is because the formation of the placenta during pregnancy is highly related to the angiogenesis. Therefore, it can be speculated that when the mother’s cardiovascular system is affected by air pollution, the adjustment of new blood vessels will also be affected, and the vascular resistance cannot be reduced. In the case of high vascular resistance, the mother may increase its own blood pressure in order to deliver blood to the fetus, resulting in gestational hypertension; it may also be unable to provide adequate nutrition to the baby, resulting in abnormal placental function, fetal hypoxia, ischemia, premature birth, and even Stillborn.
How does gestational hypertension affect the mother?
Gestational hypertension can be divided into three stages, with only high blood pressure in the early stage and no other symptoms. In the mid-term, Mommy’s liver and kidney functions will change, blood pressure will be difficult to control, and even symptoms such as blurred vision and abnormal blood coagulation will appear. In the later stage, it may induce symptoms of epilepsy in pregnant women, so it is called pregnancy toxemia or preeclampsia. Because gestational hypertension and abnormal placental function can only be closely tracked and adjusted to the balance of supply and demand between mother and fetus, they cannot be treated. Therefore, if there are pregnant women at home, attention should be paid to the prevention of air pollution.
3 types of pregnant women should be more careful regarding air pollution
1. Cardiovascular-related disease
Pregnancy increases the load on the heart. During pregnancy, a pregnant mommy carrying another little life will automatically adjust the body to supply the blood needed for the growth and development of the fetus, the output power of the heart will increase by regarding 30-50%, and the burden on the heart and blood vessels will be greater. . For mothers with cardiovascular disease, the risk of pregnancy is higher. Under the harm of air pollution, the cardiovascular needs to bear double the load, which will cause the supply of mothers to exceed the demand.
2. have chronic respiratory disease
Pregnant women with chronic respiratory diseases such as asthma and chronic obstructive pulmonary disease are easily irritated and cause breathing difficulties. And the oxygen demand during pregnancy is higher than ordinary people. If the mother has difficulty breathing, the baby will also lack oxygen. It is recommended that if mothers have the above diseases, they should observe more air quality, stay away from allergens (such as air pollution, volatile organic compounds), and try to avoid second-hand smoke.
3. Advanced maternal and primigravida
Older mothers may have high blood pressure, and the cardiovascular pressure will be greater than the average person, so they need to pay more attention. For primiparas, because the uterus needs greater pressure to open during the first pregnancy, just like blowing a balloon, more pressure is needed for the first time, so it is necessary to be careful that air pollution increases the cardiovascular burden.
Mommy doesn’t pay attention，Air pollution may affect children’s lives!
Recently, infants and young children are more likely to suffer from asthma and develop allergic constitutions.Dr. Li Jiajie believes that the main harm of air pollution to the baby is that the mother is affected by premature birth, which leads to a series of chain linkages.
reaction. Among the effects of air pollution on the fetus, second-hand smoke is the most harmful. Among them, carbon monoxide, toxic and carcinogenic substances will affect the development of the fetus, often causing the problem of fetal underweight and premature birth. However, premature fetuses have immature lung development and respiratory immunity, and are more likely to induce respiratory diseases in an environment with low air quality. Dr. Li Jiajie pointed out that if children often have colds and respiratory diseases before the age of 2, the nose and throat will be inflamed for a long time, and the chances of causing asthma, chronic obstructive pulmonary disease and allergic constitution will also increase in the future. Families with pregnant women should pay attention to preventing smoke hazards, so as to avoid diseases with children for a lifetime.
Can’t tell the difference between colds, allergies, and air pollution?
Common symptoms caused by air pollution are similar to allergies and early cold symptoms, namely: eye irritation, runny nose, and even a sore throat, severe dizziness and nausea. When young children cannot express themselves verbally, it can make symptoms more difficult to distinguish. Due to the current serious epidemic situation, if you have the above symptoms, Dr. Li Jiajie recommends to rest for regarding half a day to observe whether the symptoms improve following leaving the air pollution environment and resting. If it does not slow down, it is recommended to seek medical attention.
Doctors teach you 6 tricks to prevent air pollution
Although air pollution can cause harm to pregnant women and babies, as long as you take precautions to avoid prolonged exposure, you don’t need to be a soldier. Let’s take a look at how to prevent it!
1. avoid secondhand smoke
Second-hand smoke is the most common source of PM2.5 indoors, and families with pregnant women and infants should pay special attention. Also, pregnant women are not allowed to smoke!
2. Don’t go out when there is a lot of people and traffic
As working women, pregnant mothers who need to go to work should try their best to avoid crowded and crowded times to avoid ingesting too much harmful substances or lack of oxygen.
3. Avoid prolonged exposure to volatile organic compounds
Volatile organic compounds will photochemically react with nitrogen oxides to generate smog, ozone, etc., so try to avoid prolonged contact with items such as paints, detergents, nail polish, fragrances, super glue, etc. that produce volatile organic compounds.
4. Minimize high heat cooking
The fumes and gases emitted from high-temperature cooking contain a variety of harmful substances, and are also one of the common sources of indoor air pollution. If it is unavoidable, try to keep air circulation as well as possible.
5. Avoid going out and exercising when the air quality is low
Mommy should make good use of the air quality monitoring network. If the air quality outside is low, try to avoid going out and exercising outdoors, so as not to exacerbate the intake of harmful substances.
6. Close doors and windows and use an air purifier
The air quality in the central and southern regions is poor. Dr. Li Jiajie revealed that when he lived in the southern region, when the air quality was not good, the floor was covered with gray following opening the windows for a long time! Therefore, if it is dusty outside, remember to close the doors and windows and turn on the air purifier. Don’t forget, the filter of the air purifier should also be replaced regularly!
Li Jiajie
Education: Faculty of Medicine, Tzu Chi University
Experience: National Taiwan University Hospital Resident Physician Training
Resident Physician and Chief Physician, Department of Obstetrics and Gynecology, Cathay Pacific Hospital
Specialist physician of Taiwan Obstetrics and Gynecology Association
Attending Physician at National Taiwan University Yunlin Branch
Current: Attending Physician, Department of Obstetrics and Gynecology, Cathay Hospital
For more, please see:[Knowledge of Infants and Mothers During Pregnancy]
