Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-

Abstract

Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta- analysis Kashani ZA, Pakzad R, Fakari FR, Haghparast MS, Abdi F, Kiani Z, Talebi A, Haghgoo SM. Electromagnetic fields exposure on fetal and childhood abnormalities: Systematic review and meta-analysis. Open Med (Wars). 2023 May 12;18(1):20230697. doi: 10.1515/med-2023-0697 Abstract Today, in the modern world, people are often exposed to electromagnetic waves, which can have undesirable effects on cell components that lead to differentiation and abnormalities in cell proliferation, deoxyribonucleic acid (DNA) damage, chromosomal abnormalities, cancers, and birth defects. This study aimed to investigate the effect of electromagnetic waves on fetal and childhood abnormalities. PubMed, Scopus, Web of Science, ProQuest, Cochrane Library, and Google Scholar were searched on 1 January 2023. The Cochran's Q-test and I 2 statistics were applied to assess heterogeneity, a random-effects model was used to estimate the pooled odds ratio (OR), standardized mean difference (SMD), and mean difference for different outcomes, and a meta-regression method was utilized to investigate the factors affecting heterogeneity between studies. A total of 14 studies were included in the analysis, and the outcomes investigated were: change in gene expression, oxidant parameters, antioxidant parameters, and DNA damage parameters in the umbilical cord blood of the fetus and fetal developmental disorders, cancers, and childhood development disorders. Totally, the events of fetal and childhood abnormalities were more common in parents who have been exposed to EMFs compared to those who have not (SMD and 95% confidence interval [CI], 0.25 [0.15-0.35]; I 2 , 91%). Moreover, fetal developmental disorders (OR, 1.34; CI, 1.17-1.52; I 2 , 0%); cancer (OR, 1.14; CI, 1.05-1.23; I 2 , 60.1%); childhood development disorders (OR, 2.10; CI, 1.00-3.21; I 2 , 0%); changes in gene expression (mean difference [MD], 1.02; CI, 0.67-1.37; I 2 , 93%); oxidant parameters (MD, 0.94; CI, 0.70-1.18; I 2 , 61.3%); and DNA damage parameters (MD, 1.01; CI, 0.17-1.86; I 2 , 91.6%) in parents who have been exposed to EMFs were more than those in parents who have not. According to meta-regression, publication year has a significant effect on heterogeneity (coefficient: 0.033; 0.009-0.057). Maternal exposure to electromagnetic fields, especially in the first trimester of pregnancy, due to the high level of stem cells and their high sensitivity to this radiation, the biochemical parameters of the umbilical cord blood examined was shown increased oxidative stress reactions, changes in protein gene expression, DNA damage, and increased embryonic abnormalities. In addition, parental exposure to ionizing and non- ionizing radiation can lead to the enhancement of different cell-based cancers and developmental disorders such as speech problems in childhood. Conclusions Studies are associated with mothers’ exposure to EMFs during pregnancy and non-ionizing radiation (RF and ELF-EMFs) with fetal complications such as significant enhancement of oxidant factors, decrease of antioxidant factors, and increase in DNA damage parameters, as well as changes in expression proteins in cord blood genes. On the other hand, close maternal exposure in prenatal and postnatal (residence or occupational exposure) with EMFs of high voltages power lines more than 1 mG or 50 Hz with congenital anomalies (CNS defect, spina bifida) and fetal developmental disorders (such as reduced embryonic bud length) and neurodevelopmental disorders in childhood (e.g., speech problems in children) are associated. Moreover, parents’ exposure to ionizing and non-ionizing radiation (X-ray, ELF-EMF, and RF examinations) before and after birth is also associated with enhancement of the risk of cancers (such as rhabdomyosarcoma, ALL, brain tumors, and neuroectoderm) in childhood and adolescence. However, due to the limitations of studies, such as inaccurate measurement of exposure to ELF-EMF (e.g., interviews based on participants’ reminders) or inaccurate measure of the actual rate of exposure to EMF or case–control model of most studies, the effects of EMF on fetal and childhood abnormalities should be interpreted with caution. Considering the widespread exposure to non-ionizing radiation, a little enhancement of exposure to EMF could lead to unacceptable health consequences for future generations. Although the number of epidemiological studies examining the undesirable effects of EMF exposure in humans is limited, the findings of this study should prompt further research on this significant environmental danger for pregnant women. Open access paper: degruyter.com

AI evidence extraction

Main findings

This systematic review and meta-analysis of 14 studies reports that fetal and childhood abnormalities were more common among parents exposed to EMFs compared with non-exposed groups (reported pooled SMD 0.25, with high heterogeneity). It also reports increased odds for fetal developmental disorders, childhood cancer, and childhood development disorders, and higher levels of several cord-blood biomarkers (gene expression changes, oxidant parameters, and DNA damage parameters) in exposed versus non-exposed groups. The authors note substantial heterogeneity for several outcomes and caution that exposure measurement limitations and study designs (often case–control) mean results should be interpreted cautiously.

Outcomes measured

• Fetal and childhood abnormalities (overall)
• Fetal developmental disorders
• Childhood cancers
• Childhood development disorders (e.g., speech problems)
• Umbilical cord blood gene expression changes
• Oxidant parameters
• Antioxidant parameters
• DNA damage parameters

Limitations

• Exposure assessment often described as inaccurate (e.g., interview/recall-based measures for ELF-EMF).
• Inaccurate measurement of actual EMF exposure levels is noted.
• Most included studies were case–control, which may be more prone to bias.
• High heterogeneity reported for several pooled outcomes (e.g., overall abnormalities, gene expression, DNA damage).
• Authors state epidemiological evidence in humans is limited.

Suggested hubs

• power-lines (0.86)
  Abstract discusses high-voltage power lines (>1 mG or 50 Hz) in relation to congenital anomalies and developmental disorders.
• occupational-exposure (0.62)
  Mentions occupational exposure as a context for maternal EMF exposure.

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    "summary": "This 2023 systematic review and meta-analysis (14 studies) evaluated associations between parental/maternal EMF exposure (including RF and ELF-EMFs) and fetal/childhood abnormalities and related biomarkers. The pooled results reported higher overall abnormality events and increased odds of fetal developmental disorders, childhood cancers, and childhood development disorders in exposed versus non-exposed groups, alongside increases in several umbilical cord blood biomarker measures. The authors emphasize substantial heterogeneity and limitations in exposure measurement and study designs, recommending cautious interpretation and further research.",
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        "The meta-analysis reported higher overall fetal/childhood abnormality events in EMF-exposed parents versus non-exposed groups (SMD reported) with high heterogeneity.",
        "Reported pooled estimates suggested increased odds of fetal developmental disorders and childhood cancers in exposed groups.",
        "The authors discuss associations with residential/occupational exposure and proximity to high-voltage power lines (e.g., >1 mG or 50 Hz mentioned).",
        "Publication year was reported as a significant contributor to heterogeneity in meta-regression.",
        "The paper highlights limitations including recall-based exposure assessment and the predominance of case–control studies.",
        "The authors frame EMF exposure during pregnancy as a potential environmental danger and call for more research."
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        "facebook": "A 2023 systematic review and meta-analysis of 14 studies examined parental/maternal EMF exposure (RF and ELF-EMFs) and fetal/child outcomes. It reported higher overall abnormality events and increased odds of fetal developmental disorders, childhood cancers, and childhood development disorders in exposed groups, while emphasizing heterogeneity and limitations in exposure assessment.",
        "linkedin": "This 2023 systematic review and meta-analysis (14 studies) evaluated associations between parental/maternal EMF exposure (including RF and ELF-EMFs) and fetal/childhood abnormalities plus cord-blood biomarkers. The pooled results reported higher abnormality events and increased odds of developmental disorders and childhood cancers in exposed groups, but the authors highlight substantial heterogeneity and limitations in exposure measurement and study design, warranting cautious interpretation and further research."
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