Environmental Exposure during Pregnancy: Influence on Prenatal Development and Early Life: A Comprehensive Review.

Preconception and prenatal exposure to environmental contaminants may affect future health. Pregnancy and early life are critical sensitive windows of susceptibility. The aim of this review was to summarize current evidence on the toxic effects of environment exposure during pregnancy, the neonatal period, and childhood. Alcohol use is related to foetal alcohol spectrum disorders, foetal alcohol syndrome being its most extreme form. Smoking is associated with placental abnormalities, preterm birth, stillbirth, or impaired growth and development, as well as with intellectual impairment, obesity, and cardiovascular diseases later in life. Negative birth outcomes have been linked to the use of drugs of abuse. Pregnant and lactating women are exposed to endocrine-disrupting chemicals and heavy metals present in foodstuffs, which may alter hormones in the body. Prenatal exposure to these compounds has been associated with pre-eclampsia and intrauterine growth restriction, preterm birth, and thyroid function. Metals can accumulate in the placenta, causing foetal growth restriction. Evidence on the effects of air pollutants on pregnancy is constantly growing, for example, preterm birth, foetal growth restriction, increased uterine vascular resistance, impaired placental vascularization, increased gestational diabetes, and reduced telomere length. The advantages of breastfeeding outweigh any risks from contaminants. However, it is important to assess health outcomes of toxic exposures via breastfeeding. Initial studies suggest an association between pre-eclampsia and environmental noise, particularly with early-onset pre-eclampsia. There is rising evidence of the negative effects of environmental contaminants following exposure during pregnancy and breastfeeding, which should be considered a major public health issue.

Sonologist's characteristics related to a higher quality in fetal nuchal translucency measured in primary antenatal care centers.

OBJECTIVE: To assess the quality of nuchal translucency (NT) measurements in primary care and the sonologist's characteristics related with a higher quality. METHODS: The median NT expressed in multiples of the median (MoM) was calculated for each sonologist of 14 participating antenatal primary care centers of the Catalan Institute of Health. A survey to the sonologists was used to establish variables related to higher-quality measurements. RESULTS: The median NT MoM obtained in 16 448 NT measurements, performed by 102 sonologists, was 0.94 MoM. NT underestimation was observed in 46% of the sonologists. Underestimation were less frequent among professionals who performed more than 230 ultrasounds per year (26% vs 53%;p = .022), those who completed the online Fetal Medicine Foundation (FMF) course (22% vs 54%; p = .021), and those who were subject to periodic audits (24% vs 56%; p = .021). Underestimation rate decreased from 60%, to 33% and 14% with the increase of the years of experience from less than 5 years, to 6 to 15 years and more than 15 years of experience, respectively (p = .029). CONCLUSIONS: Higher-quality measurements were demonstrated in sonologists who performed more ultrasounds per year, those with more years of scanning experience, those who completed the online FMF course, and those periodically audited.