Proximity of maternal residences to nuclear power plant, prenatal exposure to Ionising radiation and its effect on pregnancy outcomes: a systematic review

Background: The radiation issue has long been a subject of controversy and debate, particularly on acceptable exposure levels and the potential health impacts on the public, especially vulnerable groups like pregnant women. The proximity of residency to sources of this physical hazard can significantly contribute to elevated levels of radiation exposure. Therefore, this study aims to systematically review the published articles on the effects of pregnancy outcomes resulting from maternal exposure to ionizing radiation (IR) from nuclear power plants (NPP) or mines and to investigate the relationship between the proximity of maternal residences to NPPs or mines and the associated risk of adverse pregnancy outcomes. Methods: This study followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Articles were sourced from PubMed, ProQuest, and Scopus databases. The inclusion criteria encompassed: (i) articles published in English with full-text availability and (ii) observational studies that reported on IR exposure from industrial areas and its effects on pregnancy. Articles were excluded from this study if they did not report the observed exposure and health outcomes or if they involved a non-human study. The Critical Appraisal Tool CCAT) version 1.4 was used for the quality assessment. Results: 215 articles were screened, with 8 full-text articles selected for final evaluation. Among these, 6 articles examined IR exposure from the NPP, while 2 articles investigated the radiation exposure from uranium plants. The distance between residential homes and the NPPs or uranium plants ranged from 0.8 to 50km. The observed adverse pregnancy outcomes included birth defects, premature birth, pregnancy loss, and low birth weight. 5 articles recorded high quality (score range from 80 – 90%) and only 3 articles recorded acceptable quality (score range from 55- 75%). Conclusion: Our findings reveal no association between the proximity of residency to NPP or uranium plants with adverse pregnancy outcomes. This review was able to enhance the understanding of the observed relationship, despite the limited articles to provide a defined conclusive. Future studies are recommended to focus on the effects of radiation on the exposure of specific trimester windows and determine the biological mechanisms underlying the adverse pregnancy outcomes.