title: Air travel and pregnancy outcomes: a review of pregnancy regulations and outcomes for passengers, flight attendants, and aviators.
abstract: To review flight regulations and gestational complications associated with air travel in pregnant passengers, flight attendants, and aviators. A literature search was undertaken on the relationship of air travel and spontaneous pregnancy losses, intrauterine fetal demise (IUFD), birth weight<10th percentile, preterm delivery, and neonatal intensive care unit admissions. The literature search identified 128 abstracts, of which 9 evaluated air travel and pregnancy outcomes. The risk of a pregnancy loss (spontaneous abortion or IUFD) was greater in flight attendants than controls (odds ratio [OR]: 1.62, 95% confidence interval [CI]: 1.29, 2.04). The risk of preterm birth<37 weeks was greater in passengers than controls (OR: 1.44, 95% CI: 1.07, 1.93). However, the risk of preeclampsia (OR: 0.86, 95% CI: 0.58, 1.27), neonatal intensive care unit admissions (OR: 1.19, 95% CI: 0.78, 1.82), or birth weight<10th percentile (OR: 1.25, 95% CI: 0.62, 2.48) was not increased. Flight attendants did not have an increased risk of preterm birth compared to controls (OR: 1.37, 95% CI: 0.85, 2.22) or delivering infants with birth weight<10th percentile (OR: 1.57, 95% CI: 0.68, 3.74). The risks of spontaneous abortions and other adverse pregnancy outcomes have been poorly studied in a limited number of investigations. An analysis of the available information suggests a greater risk of spontaneous abortions or IUFD in flight attendants, and a greater risk of preterm birth<37 weeks in air passengers. However, the literature on which these findings are based is generally not of high methodologic quality.
authors.affiliation: Department of Obstetrics and Gynecology, University of Arkansas for the Medical Sciences, Little Rock, AR 72205, USA. efmagann@uams.edu
authors.forename: Everett F
authors.initials: EF
authors.lastname: Magann
authors.forename: Suneet P
authors.initials: SP
authors.lastname: Chauhan
authors.forename: Joshua D
authors.initials: JD
authors.lastname: Dahlke
authors.forename: Samantha S
authors.initials: SS
authors.lastname: McKelvey
authors.forename: Erin M
authors.initials: EM
authors.lastname: Watson
authors.forename: John C
authors.initials: JC
authors.lastname: Morrison
mesh_terms: D000022:Abortion, Spontaneous / Q000209:etiology* / Q000517:prevention & control; D000337:Aerospace Medicine; D001359:Aviation / Q000592:standards; D005260:Female; D005313:Fetal Death / Q000209:etiology* / Q000517:prevention & control; D006801:Humans; D008889:Military Personnel; D016017:Odds Ratio; D011247:Pregnancy; D011256:Pregnancy Outcome; D047928:Premature Birth / Q000209:etiology* / Q000517:prevention & control