BiSC Project and COVID-19: Assessing the Impact of Air Pollution on Pregnant Women During the Pandemic

[Authors: Paula de Prado Bert, Laura Gómez Herrera and Jordi Sunyer. BiSC Project, ISGlobal]

In recent weeks, we have all been living in an exceptional situation due to the COVID-19 pandemic and have experienced a historic event that has affected absolutely everyone in one way or another. While we know that these unusual circumstances have been a shock for everyone, we also believe that this experience, like all others, can offer us valuable lessons and give rise to positive proposals.

The recent events have also affected the Barcelona Life Study Cohort (the BiSC Project), a cohort study that is evaluating how air pollution affects the health and brain development of babies. Like many other researchers, we have been unable to make any visits related to the study, but we have continued to work on activities that can be done online. Despite the circumstances, we wanted to make an active contribution to our goal of implementing the project in a positive way, adapting ourselves to the circumstances, and we have been able to achieve this goal in several ways.

The BISC project, which is being undertaken in Barcelona city, has enrolled more than 500 pregnant women to date; our target is to study 1,200 in total. The first thing we did after lockdown commenced was to provide all the study volunteers with communication channels connecting them directly to their gynaecologists and the research team to provide them with support and a way to get answers on their doubts about COVID-19, pregnancy and breastfeeding. We wanted to convey a message of calm and to reassure the families since there is currently no evidence that the novel coronavirus affects pregnant women or babies more than other people. Nor has there been any evidence of the disease being transmitted to the foetus. Moreover, many people will never be infected and most of those who are infected will be asymptomatic or will experience only mild symptoms.

Second, during the lockdown we have started a new sub-study with the volunteers to assess how the experience of home confinement and social isolation has affected the emotional health of pregnant women and mothers with small babies (the psychological consequences of isolation as well as the worry about the financial and health concerns of family members, fear of infection or of infecting others, and so on).

We have started a new sub-study with the volunteers to assess how the experience of home confinement and social isolation has affected the emotional health of pregnant women and mothers with small babies

With the easing of community restrictions, we will gradually resume the activity of Project BiSC:

1. Ultrasound at 32 weeks: Prenatal hospital visit to monitor the pregnancy, which will be conducted by the medical staff with maximum safety measures.
2. Postnatal monitoring: Neurodevelopmental test at six months. This test will be adapted so that it can be carried out virtually. (At present, no MRIs will be performed at one month).
3. Home visits to measure pollution: We will start with a simplified version of this visit during which the technicians will not enter the volunteers’ homes or have any contact with their families. Each participant will receive a bag of containers for collecting urine samples and tubes that measure NO₂ levels. These will be used to measure levels inside and outside each home. Little by little, and whenever the volunteer wants it, we will start to reintroduce other measures.
4. Recruitment of new volunteers: Recruitment is one of the essential activities of the project and the gateway for all those who want to participate. Recruitment interviews will now be carried out by phone.

Study of the Effects of Reduced Air Pollution

One of the consequences of the measures implemented to combat the COVID-19 pandemic has been the reduction of air pollution worldwide to historical lows. In Barcelona we have seen a reduction of between 70% and 80% in ambient pollution. This offers us a unique opportunity to study the effects on foetal and postnatal development of these low levels of air pollution and to compare them with the effects of pre-pandemic levels.

We are, therefore, looking for new volunteers (pregnant women up to 32 weeks gestation) interested in participating in this project and contributing to the creation of knowledge about this unique episode.

Jordi Sunyer, Head of the Childhood and Environment Programme at ISGlobal, calls for participation in the BiSC Project.

We know that what characterises all the BiSC volunteers is a great spirit of altruism and solidarity, and we will always be grateful for the effort and dedication of each one of them!

If:

• You are pregnant (maximum 32 weeks gestation)
• You live in Barcelona city, Cornellà or Esplugues de Llobregat
• You are being monitored during your pregnancy and plan to give birth at any of the following hospitals: San Joan de Déu, Clínic-Maternitat, or Hospital Sant Pau.

Come and take part in the BiSC Project to help us to study the effects of air pollution on pregnancy!