Exposure to electromagnetic fields on fetal and infant anomalies: systematic review and meta-analysis

Congenital malformations are called chromosomal deformities and abnormalities. Birth defects include behavioral, structural, metabolic, and functional disorders in infants. These disorders can be diagnosed before or after birth. Birth defects are one of the global health problems. Every year, 8 million babies (6% of all births worldwide) are born with a serious birth defect. At least 3.3 million children aged 0 to 5 die from serious birth defects, and each year, approximately 300,000 infants die from birth defects in the first 28 days of life.

In developed countries, approximately 30% of child deaths (under 5 years) are due to congenital malformations. Results from a study in England and Wales showed that out of 628,171 gross births (stillbirths and live births), a total of 13,400 children were born with one or more birth defects. In other words, out of 47 births (stillbirths and live births), there is one case of congenital anomalies.

Results from the same ecological study in the United Kingdom showed that the prevalence of hospitalizations due to birth defects increased significantly from 1999 to 2019 (19.6%).

Additionally, results from another Australian study from 2005 to 2015 reported an increasing trend in admissions for congenital anomalies. One of the most important risk factors for birth defects is maternal age, which increases the risk of chromosomal abnormalities such as Down syndrome.

According to the National Congenital Anomaly and Rare Disease Registration Service report, the rate of congenital anomalies in the 35–39 year age group (229.9 per thousand live births) is significantly higher than in the 30–34 and 25–29 year age groups (187.1 and 192.2 per thousand live births, respectively) [6]. In addition to maternal age, low income may be one of the indirect causes of congenital anomalies. About 94% of severe congenital anomalies occur in low- and middle-income countries. Related to this issue, in low- and middle-income countries, pregnant women are more prone to malnutrition, reduced access to screening and health care, and environmental pollutants. Congenital malformations may be the result of one or a combination of socioeconomic factors (low income), demographics, genetics (gene mutations), maternal infections (such as syphilis and rubella), maternal nutritional status (such as folate deficiency), or environmental teratogens . The reasons for congenital abnormalities are complex and multifactorial, but in most cases, their etiology is unknown. Most congenital abnormalities are caused by complex interactions between genes and the environment that are largely unknown. In the modern world, most populations are exposed to EMF radiation, and public concern about the potential health hazards of extremely low-frequency-electromagnetic fields (ELF-EMFs) powers and radio frequency (RF)/microwave radiation emissions has increased.

EMF is nonionic radiation that cannot release electrons. In fact, energy comes in the form of electrical oscillations and magnetic fields that are transferred from one point to another. Depending on their frequency, electromagnetic fields can be classified into four different types. The first type refers to an extremely low frequency, below 300 Hz and generated by military equipment, railways and high-voltage power lines. The second type is known as intermediate frequency EMF, which is between 300 Hz and 10 MHz and produced by industrial cables and household electrical equipment, such as televisions and computers. The third type of EMF is high frequency, with frequencies between 10 MHz and 3 GHz, produced by mobile phones and radios. Radio frequencies, which have a maximum frequency of 100 MHz, are also included in this category.

Additionally, static electromagnetic fields are produced by magnetic resonance imaging (MRI) and geomagnetism and are determined by zero frequency. Another type of classification based on wavelength and resonance is classified into categories such as (radio and television, microwave, infrared, visible light, ultraviolet, x-rays and gamma rays). Radio waves contain any electromagnetic waves produced by currents in wires and circuits.

RF is divided into subcategories, such as microwaves and electromagnetic waves used for amplitude modulated (AM) radio and frequency modulation, cellular phones, and television. The lowest radio frequencies are produced by high-voltage alternating current transmission lines at frequencies of 50 or 60 Hz and by electromagnetic waves of extremely long wavelength (about 6,000 km!) [14, 15]. All people are exposed to these two types of EMF: EMF from electrical and electronic devices and power lines and (b) RF radiation from wireless devices such as cordless phones, cell phone towers, the antennas and transmission towers that broadcast.

EMCs have high penetrating power and the ability to move charged particles such as electrons and ions, macromolecules and polymers [16]. Therefore, with high concentrations of electrons and ions, they can have destructive effects on tissues [17]. Magnetic fields can have several different effects, such as differentiation and abnormalities in cell proliferation, abnormalities in deoxyribonucleic acid (DNA) and damaged chromosomes, blood disorders, and birth defects in cellular components.

Through exposure to magnetic fields that produce currents and electric fields, these waves can disrupt the body's physiological balance, increase the lifespan of free radicals, and lead to DNA damage in individuals. Additionally, depending on gender, body tissue density, life cycle and exposure, the effect of environmental pollution varies. Many sources can expose humans to magnetic fields. Power supplies, computers, televisions, radios and telephones are some of these resources.

Recently, electromagnetic waves emitted by phones have been shown to cause oxidative stress in human sperm. Keeping the phone in a pants pocket while talking can negatively affect sperm and impair male fertility. Cell phones emit a type of radio frequency radiation called radio waves [24]. Daily exposure to radio waves has increased concerns about infertility, stillbirth, birth defects, and abortions [25,26]. Although some investigators have reported findings on adverse fertility outcomes, no specific abnormalities or other adverse outcomes have been consistently reported. Of course, most studies have limited statistical power.

Some findings reveal that human exposure to radiofrequency (RF) waves or living near high-voltage power lines can cause cognitive and behavioral disorders, reduced learning and memory power, and poor neurobehavioral function. Significant heat effects from the waves are associated with adverse health outcomes such as sleep problems, hearing problems, reproduction problems, nervous system disorders, and increased cancer. In this regard, children and adults who live near high-voltage towers or lines are more prone to develop acute lymphocytic leukemia (ALL) and neurodegenerative disorders such as Alzheimer’s and Parkinson’s, respectively]. Exposure to RF-EMF during pregnancy can also affect fetal growth and the duration of the pregnancy. This effect can occur as a result of changes in maternal physiology either directly or indirectly through radiation to the fetus. However, there is no definitive proof that these radio frequency radiation (RFR) systems (Wi-Fi and mobile phones) are harmful or not to humans. MRI is applied as an essential tool in investigating various diseases, and its use has increased during pregnancy. There is not enough information about the consequences of exposure to magnetic fields on the fetus.

Thanks to advances in technology, humans are exposed to electromagnetic waves generated by various devices. Because RF and ELF-EMF exposure overlap in daily life, their effects cannot be specifically distinguished; however, this classification is based on the frequency of the waves according to physical definitions, their biological effects are not significantly different, and both are non-ionizing rays.

If the current density exceeds a certain limit, it causes membrane depolarization, unusual changes in the diffusion of calcium ions, and nerve and muscle stimulation [65]. Additionally, radio frequency (RF) fields generate torques (oscillations) on biomolecules.

Since the fetus and infant have large numbers of stem cells lacking adequate immune sources, environmental pollutions such as RFR from telephones or microwave radiation affect gene expression in stem cells and increase production heat shock proteins like HSP70 (these proteins are produced under stressful conditions such as oxidative stress).

Exposure in most animal cases and less of human cases to CEM-ELF due to fractures and DNA damage is known as a genotoxic agent. For example, exposure to ELF and RF has been revealed to produce oxidative stress proteins in cells, universal symptoms of distress in plant, animal and human cells, as well as DNA damage and neurological effects, even at low levels of exposure according to current safety standards.

The results of the present meta-analysis revealed that fetuses and children whose parents were exposed to EMF have more changes in gene expression and DNA damage. The results of some studies have revealed that RFR associated with oxidative stress leads to the breakdown of structures of biological molecules, such as proteins, lipids, and DNA. [67,71] A decrease in antioxidant factors and an increase in oxidative stress parameters in fibrous tissues exposed to RF are associated. with damage to proteins and nucleic acids in the placenta that can severely impair normal trophoblast functions and even lead to cell death.

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