The Ecology of Pregnancy

Dr. Carlo Bellieni serves as is a member of the Pontifical Academy for Life as well as the European Society for Pediatric Research. 

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I have recently been solicited by a prominent US ecologist, to express myself on the correlation between fetal life and pollution; in particular, on how pollution is a threat to the health of fetal life.  This is an underexplored field of ecology but also of ethics, and I agree that it deserves particular attention.  The following observations – solicited after a teleconference on some studies we had performed on fetal-neonatal risks by electromagnetic fields[1] – should be seen at the light of some recent cases of severe and preventable environment pollution and of the recent data on fetal anomalies induced by the contact with heavy metals or phthalates. For some observers, even some aspects of in vitro fertilization techniques raise concerns. “Might the injection damage the egg’s machinery for cell division, for instance? And is it wise to bypass natural selection in such a determined way? “[2].

1          Fetuses can be exposed to hundreds of pollutants during their prenatal life[3]. Pollutants can arrive to the fetus when they are inhaled or ingested by the mother, but scarce or no warnings exist to inform mothers against these risks. Some information exists about smoke, drugs and alcohol in pregnancy: recreational for adults, but environmental poisons for fetuses. But many other foes are not so well known: solvents, heavy metals, pesticides, air pollutants, plastics. Some of them are “endocrine disruptors”[4]: they arrive to the fetus and, because of their similarity with human hormones, arrest the fetus’ production of certain hormones. Others are assumed by mothers even years before pregnancy and have the ability of being stored in her bones or fat and during pregnancy are delivered into the mother’s blood and from there to the fetus. This risk should be taken into account by mothers, families and by governments, because this is an important public health problem, for the wide and well-described consequences for babies born after having been exposed to certain pollutants. A new ecology of pregnancy[5] is mandatory: the womb is our first home, and this is the exact meaning of the word ecology, that derives from the greek “oikos” (“home”).

Pollution has therefore a further victim: the fetus, who is to be considered as a prominent target, highlighting the responsibility – unto him/her and unto the adult he/she will be – of the authorities who should prevent pollution and of those who produce pollutants. «The stable functioning of Earth systems – including the atmosphere, oceans, forests, waterways, biodiversity and biogeochemical cycles – is a pre-requisite for a thriving global society,» an Australian-led team wrote in a recent edition of the journal Nature[6]; but also for a thriving baby: the macro-environment should be cared for as well as the micro-environment[7].

2          I  recently wrote[8] in the official journal of the Holy See: “in Western countries life is progressively less natural, but instead than preventing this phenomenon, drugs are proposed to limit damages or chemically delivers what nature spontaneously offers. (…) nevertheless, there is also an environmental movement not moved only by the fear that resources finish, but by the awareness that nothing should be wasted or dirtied, as nothing is worthless. (…) It is an environmentalism that led Enzo Tiezzi (a prominent Italian ecologist) to endorse the struggle against genetic manipulations and some ecological organizations to fight in Europe against the patentability of human embryo tissues.” Consequently,  the ecology of pregnancy is following the biological and genetic laws of the first steps of life without pushing, forcing or overriding anything until our action has been proven to be harmless.

3          This attention has also a moral value. For instance, Christian theology has always highlighted the need of a better protection of the whole creation and of the weakest members of the creation: microenvironment and macroenvironment, ecology of the universe and ecology of the womb. It is interesting what the present brand-new pope has told on this topic: «To protect creation, to protect every man and every woman, to look upon them with tenderness and love, is to open up a horizon of hope, it is to let a shaft of light break through the heavy clouds.»[9]. The respect of the creation is prominent for most religions (Genesis 1.1); in particular for christians this is due because «omnis creatura bona» (“every creature is good”) (1Tm 4, 4) and a respect for every fragment of the globe is due ( John 6:13: “Gather up the fragments that remain, so that nothing is lost.”), but in particular for babies and poor (the particular concern for prenatal life present in christian tradition is correlated to these two categories, with a particular reference to biology data that indicates the beginning of life from the appearance of a brand-new genome).

4          Nonetheless, pregnancy ecology is not a “religious” outlook: pregnancy ecology and global ecology are the two faces of a global problem. Caring for the globe is cripple without caring for the weak first steps of life, and caring for the fetus is cripple if it does not consider all the global threatens that concern human health. This is why we see in the future a convergence among the people of culturally different ideas, in the preservation of the whole creation, from the little embryo  to the macro environment.

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[1] Bellieni CV, Pinto I, Bogi A, Zoppetti N, Andreuccetti D, Buonocore G. Exposure to electromagnetic fields from laptop use of «laptop» computers. Arch Environ Occup Health. 2012;67(1):31-6.

[2] Powell K. Fertility treatments: Seeds of doubt. Nature. 2003 Apr 17;422(6933):656-8

[3] Woodruff TJ, Zota AR, Schwartz JM. Environmental chemicals in pregnant women in the United States: NHANES 2003-2004. Environ Health Perspect. 2011 Jun;119(6):878-85

[4] Meeker JD. Exposure to environmental endocrine disruptors and child development. Arch Pediatr Adolesc Med. 2012 Oct;166(10):952-8

[5] Bellieni CV, Marchettini N: Ecologia della gravidanza [Ecology of pregnancy]. Cantagalli ed (Italy), 2009


[7] Pinborg A, Wennerholm UB, Romundstad LB, Loft A, Aittomaki K, Söderström-Anttila V, Nygren KG, Hazekamp J, Bergh C. Why do singletons conceived after assisted reproduction technology have adverse perinatal outcome? Systematic review and meta-analysis. Hum Reprod Update. 2013 Mar;19(2):87-104

[8] Osservatore romano, April 22, 2023, page 1

[9] Pope Francis sets out to defend weak, poor and the environment in first mass  The Guardian, March 19, 2013

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Carlo Bellieni

Carlo Bellieni è neonatologo, dirigente medico presso l'Unità Operativa di Terapia Intensiva Neonatale Policlinico Universitario di Siena e consigliere nazionale Associazione Scienza & Vita

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