Review date
December 2023
Article publication date
October 2023
Summary
This systematic review and meta-analysis examined the association between electromagnetic fields (EMF) and miscarriage or spontaneous abortion. This report included six epidemiological studies (3 case-control, 1 nested case-control and 2 cohort studies) to synthesise the evidence on the topic. The quality of the included studies was assessed using the Newcastle-Ottawa Scale and the authors reported that all included studies were of high quality. The included studies assessed both radiofrequency (RF) EMF and extremely low frequency (ELF) EMF exposure sources as a result of mobile phone use, home ELF-EMF levels, home RF-EMF levels and electricity power lines. The study reported that both EMF exposure was significantly associated with miscarriage with a risk ratio of 1.70 (95% confidence interval: 1.12 - 2.36).
Link to:
Electromagnetic Field Exposure and Abortion in Pregnant Women: A Systematic Review and Meta-Analysis
Published in
Malays J Med Sci
ARPANSA commentary
Although the results from this study indicated a potential risk of miscarriage associated with EMF exposure, they are difficult to interpret and rely on due to methodological issues in the review and the limited epidemiological evidence available. First, the authors amalgamated all different types of exposure sources (i.e., ELF EMF and RF EMF). A meta-analysis is meant to be uniform in how it examines exposure and this deviation from standard scientific practice reduces the evidence value of the study overall and prevents any real conclusions from being drawn (Wong and Raabe 1996). The authors also reported a high heterogeneity of 84.55% which indicates that the included studies were all quite different. A heterogeneity this high means the overall outcome of the study could be due to random chance (Imrey, 2020).
There is also an issue with how the author assessed the quality of a study. The authors seem to have assessed the studies overall and not by assessed outcome. This could have affected the results of the review and contributed to an incorrect assessment of the level of bias. An example of this is the included study by Lee et al (2002) that reported the highest risk ratio. The study had a 50% loss to follow-up for the outcome used by this review, however, the authors still rated this part as being unlikely to introduce bias. This is incorrect and a 50% loss rate would result in selection bias. This is even stated in the study by Lee et al (2002).
The authors only assessed one outcome from each of the included studies and made no justification on how individual outcomes were selected. This could indicate that they cherry picked the results of the included studies to get the result they wanted.
Overall, there remains limited evidence on the potential effect of miscarriage due to EMF exposure. The Scientific Committee on Emerging and Newly Identified Health Risks (SCENIHR) in 2015 assessed potential health effect of EMF exposures to humans and concluded that the available evidence does not show any effect of EMF on the reproductive function in humans. A recent systematic review on animals conducted by the World Health Organization (WHO) also found that RF EMF exposure does not have a detrimental effect on fecundity of animals (Cordelli et al 2023).
