Air pollution may be responsible for many cases of babies being born underweight, researchers say today.
According to the Europe-wide study, a "substantial proportion" of problems of babies being of low birth-weight could be prevented by reducing air pollution in cities.
The study, reported in The Lancet, suggests that cases could be cut by 22% by reducing pollution levels to those of the least-polluted cities.
Researchers analysed data from 14 pieces of research in 12 countries involving more than 74,000 women over a 17 year period.
Researcher Dr Marie Pederson, of the Centre for Research in Environmental Epidemiology in Barcelona, Spain, said today: "Our findings suggest that a substantial proportion of cases of low birthweight at term could be prevented in Europe if urban air pollution, particularly fine particulate matter, was reduced.
"The widespread exposure of pregnant women worldwide to urban ambient air pollution at similar or even higher concentrations than those assessed in our study provides a clear message to policy makers to improve the quality of the air we all share."
Writing in the journal, Professor Jonathan Grigg from Queen Mary, University of London, UK, said efforts to reduce traffic pollution in Britain were not proving successful – and "difficult decisions" would have to be made.
He said: "Dissemination of results to the wider public could therefore further increase the pressure on policy makers to reduce exposure of urban populations to particulate matter.
"The introduction of the low emission zone in London, UK, has had little effect on concentration of particulate matter, although the vehicle mix has been altered.
"UK policy makers have shied away from radical solutions to the issue, such as changing diesel-powered black cabs (which contribute 20% of London’s locally generated particulate matter) to cleaner petrol-powered alternatives."
But the UK Royal College of Obstetricians and Gynaecologists said other factors might still contribute "more" to babies being born underweight.
Dr Patrick O’Brien, of the college, said: "Exposure to some level of air pollution is unavoidable in day-to-day life and the risk still remains fairly low. Other factors, such as smoking, high blood pressure or excessive alcohol consumption, may contribute more to the risk of having a low birth weight baby."
He added: "This research, using data from several large population based studies, is very helpful in providing further evidence on the potential health impacts of air pollution."
The Lancet 15 October 2013 [abstract]
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