How Delhi’s Pollution Is Impacting Pregnant Women and Newborns: A Neonatologist Explains

Delhi is reeling under horrible air pollution. The air quality index has gone beyond 400, and at some places, the air quality index has even touched 700. Delhi's air pollution is nothing new. It is a systemic failure on the part of successive governments. First, it was the Aam Aadmi Party, and now, the current BJP government. No one has paid attention to the issue of pollution, including even the central government. In such a dark scenario, what is astonishingly clear is that no politician worth their salt is talking about this issue.

The intensity of pollution, according to medical research, that Delhites have been facing for years, is decreasing the life expectancy by 10 years in general. This is the extent of the issue we are grappling with. What is more heart-aching is that even the fetuses and the newborn are being subjected to this horrible pollution.

Pollution can have a devastating effect on pregnancy. Pollution acts as a toxin for the pregnant woman. Exposure to extreme levels of pollution, particularly PM2.5, during pregnancy can affect the growth of the fetus. This can result in low birth weight, intrauterine growth retardation, and premature deliveries. In the advanced stage of pregnancy, due to constant exposure to pollution, stillbirths can happen in the third trimester. Pollutants like PM2.5, polycyclic aromatic hydrocarbons due to incomplete combustion of wood, coal, oil and other fuels, nitric oxide, ozone, and others cross the placenta. They can impair organ formation in the fetus resulting in impaired lung development and other diseases. Similarly, microplastics in Delhi's air can act as endocrine disruptors, further affecting various organs of a fetus.

Reports in the media, which do not surprise me, show that newborn babies, due to prenatal exposure to pollutants, are being born with not fully mature lungs. They can have wheezing, reactive airway diseases, and even frank asthma. Due to decreased immunity caused by pollution, they can also develop pneumonia. There can be long-term consequences as well. Such babies are likely to spend more time in the neonatal ICU if they become sick.

Reports in the media, which do not surprise me, show that newborn babies, due to prenatal exposure to pollutants, are being born with not fully mature lungs. They can have wheezing and reactive airway diseases, and in later months, even frank asthma. Due to decreased immunity caused by pollution and miscellaneous reasons, such neonates are also at high risk of developing pneumonia. There can be long-term consequences as well. Such babies are likely to spend more time in the neonatal ICU if they become sick.

PM2.5 acts as an intrauterine toxin for the fetuses. It can lead to lifelong health problems like chronic respiratory disease. Vulnerable groups like low-income urban mothers, and those with preexisting conditions, face more adverse effects due to poor housing and limited healthcare.

The permissible limit of PM2.5 is five micrograms per cubic meter annually, according to the WHO. But in Delhi, the PM2.5 levels are often 100 to 200 micrograms per cubic meter. Chronic exposure to pollutants can lead to smaller lung volumes, compromised immune functioning, and immature or reactive airways in the fetus. The pollutant crosses the maternal bloodstream and enters fetal circulation, causing inflammation, oxidative stress, and reduced oxygen delivery.

Delhi's pollution crisis is not insurmountable. The political apathy and unwillingness to handle this issue must end. Delhi's major pollution stems from vehicular emissions, construction activities, burning of parali, and the lack of greenery. The mountains of garbage in Delhi also add their poison to the circulating air.

However, Delhi's pollution problem can be solved through scientific solutions. But the citizens also have to wake up. Delhi is the capital of India. The President, the Prime Minister, and cabinet ministers reside here. So does the Chief Justice of India. Parliament and the Supreme Court operate from this mass of land that we call Delhi. Yet, if no one is concerned, then it is understood that they do not care about human lives. They are busy working on their political careers while Delhi continues to be a toxic gas chamber unfit for breathing.

In my opinion, the Government of India, along with the Delhi state government and neighboring state governments, must announce the formation of a technical expert committee at the earliest. The committee must deliver comprehensive solutions in a time-bound manner, ideally within four months. The government must allocate the required budget and corrective measures should then start being implemented in a phased manner.