title: Noise exposure during pregnancy, birth outcomes and fetal development: meta-analyses using quality effects model.
abstract: Many women are exposed daily to high levels of occupational and residential noise, so the effect of noise exposure on pregnancy should be considered because noise affects both the fetus and the mother herself. However, there is a controversy in the literature regarding the adverse effects of occupational and residential noise on pregnant women and their fetuses.
  
  
  
  The aim of this study was to conduct systematic review of previously analyzed studies, to add additional information omitted in previous reviews and to perform meta-analyses on the effects of noise exposure on pregnancy, birth outcomes and fetal development.
  
  
  
  Previous reviews and meta-analyses on the topic were consulted. Additionally, a systematic search in MEDLINE, EMBASE and Internet was carried out. Twenty nine studies were included in the meta-analyses. Quality effects meta-analytical model was applied.
  
  
  
  Women exposed to high noise levels (in most of the studies ≥ 80 dB) during pregnancy are at a significantly higher risk for having small-for-gestational-age newborn (RR = 1.19, 95% CI: 1.03, 1.38), gestational hypertension (RR = 1.27, 95% CI: 1.03, 1.58) and infant with congenital malformations (RR = 1.47, 95% CI: 1.21, 1.79). The effect was not significant for preeclampsia, perinatal death, spontaneous abortion and preterm birth.
  
  
  
  The results are consistent with previous findings regarding a higher risk for small-for-gestational-age. They also highlight the significance of residential and occupational noise exposure for developing gestational hypertension and especially congenital malformations.
authors.affiliation: Faculty of Medicine
authors.forename: Angel M
authors.initials: AM
authors.lastname: Dzhambov
authors.affiliation: Department of Health Care Management, Health Economics and Primary Care, Faculty of Public Health
authors.forename: Donka D
authors.initials: DD
authors.lastname: Dimitrova
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, Medical University, Plovdiv, Bulgaria
authors.forename: Elena D
authors.initials: ED
authors.lastname: Dimitrakova
mesh_terms: D000013:Congenital Abnormalities / Q000209:etiology; D005260:Female; D047109:Fetal Development; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000209:etiology; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D009622:Noise / Q000009:adverse effects*; D011247:Pregnancy