In the heart of the desert, at Ben-Gurion University of the Negev’s Department of Epidemiology, Prof. Tamar Wainstock and her colleagues are trying to solve a hidden health crisis, unveiling how air pollution and environmental contaminants can affect pregnancy outcomes and male fertility.
Prof. Wainstock, a seasoned researcher with a Ph.D. from Ben- Gurion University and postdoctoral work at Emory University, has spent nearly a decade studying the impacts of environmental exposures on human health, specifically focusing on prenatal and reproductive health.
“I’ve been working in the epidemiology department here for nine years,” she told The Jerusalem Post, adding that her primary research objective is investigating “all kinds of exposures—environmental and others—during pregnancy and how they affect the mother, the pregnancy itself, and, ultimately, the health of the offspring.”
Her work, part of a collaboration with Soroka University Medical Center and Ben-Gurion University’s Department of Environmental, Geoinformatics, and Urban Planning Sciences, is crucial for Israel, where levels of air pollutants significantly exceed World Health Organization recommendations. With her research partners, Prof. Wainstock is exploring the real impact of these pollutants on fetal health and beyond.
One of Wainstock’s most significant projects investigates risk factors for preterm birth—defined as any birth before 37 weeks of pregnancy. Preterm births, which are increasing globally, especially in modern societies, remain a significant challenge despite medical advancements.
“What we know is that women who have experienced preterm birth once are at three to four times higher risk of recurrence,” Wainstock says. “It’s a high-risk population, so we’re studying everything that could be influencing this risk, from genetics to environmental exposures like air pollution and stress during pregnancy.”
Air pollution, especially tiny particulate matter, poses a unique risk. These microscopic pollutants can enter the bloodstream through the lungs and cross the placental barrier, potentially impacting the developing fetus. She often works in partnership with Prof.
Eyal Sheiner, who is not only the head of the Obstetrics and Gynecology ward at Soroka, but also one of her most important collaborators with whom Wainstock has written more than 200 scientific publications and Prof. Itai Kloog, an environmental health expert at Ben-Gurion University.
Wainstock and her team have found that exposure to high levels of air pollutants increases the risk of gestational diabetes and intrauterine fetal death. “The increase in risk isn’t huge,” she notes, “but it’s statistically significant and concerning, especially because we know this exposure can be limited and contained, particularly during pregnancy.
One of Wainstock’s key objectives is studying preterm birth through various lenses, focusing on genetics, environmental influences, and lifestyle. “We’re beginning a project on metabolomics to see if there’s a link to recurrent preterm births,” she explains, along with investigations into stress, physical activity, and occupation. Prof. Wainstock and her team are also studying the effects of “artificial light at night, which is known to disturb circadian rhythms and can affect pregnancy,” she says.
This line of research is vital for Israel, where air pollution levels are high, particularly in areas surrounding factories and high-traffic urban zones, and she compares it to one case registered in the US: “There was a community that had high rates of preterm births and low birth weights due to nearby industrial emissions. When they implemented environmental regulations to reduce emissions, they saw a marked improvement in birth outcomes,” she recalls. “It’s a powerful example of how even small legislative changes can make a difference.”
Beyond pregnancy complications, Wainstock and her colleague Dr. Anat Reiner-Benaim extended their research to male fertility as well. In recent decades, sperm quality has declined noticeably worldwide, a worrying trend with unclear origins. “We can’t really explain it by any single factor,” she says, “but we’re exploring various environmental contributors, including air pollution.”
Collaborating with Prof. Iris Har-Vardi, head of Soroka’s Male Fertility Laboratory, Wainstock has found that sperm quality deteriorates in men exposed to high levels of air pollution. “We saw that exposure to a green environment, on the other hand, positively affects sperm quality, while high temperatures and pollutants negatively impact male fertility.”
In another facet of her research, Prof. Wainstock examines how pregnancy complications might affect a child’s health well beyond infancy. By studying long-term hospital records, she and her colleagues have found links between various pregnancy complications and offspring health issues up to age 18.
“For instance, we looked at the mode of delivery—whether a child was born vaginally or by cesarean section—and we found that kids born by cesarean had a higher incidence of respiratory diseases and infectious conditions,” Wainstock shares. This could be due to factors like lung compression during vaginal birth, which stimulates respiratory function, or exposure to maternal microbiota during natural birth.
“One of our significant studies showed that children conceived via fertility treatments are at an increased risk of developing malignancies in childhood,” she explains. “In Israel, where fertility treatments are widely available, this finding was both unexpected and critical for understanding the long-term health of children born from these treatments.”
While Israel offers unique advantages for research, including extensive national health data and coverage, specific challenges remain. “Every few years, we face tragedies that complicate our research,” Prof. Wainstock remarks. The recent COVID-19 pandemic and, more recently, the ongoing conflict add stress layers that influence research participants and results. “When studying something like preterm birth, you have to consider its effect on the women and pregnancy, and therefore our data. So, we rarely have the chance to study a ‘clean’ sample.”
Despite these challenges, Prof. Wainstock is optimistic about the potential impact of her work. “We hope to find solid evidence that can drive change, whether through individual recommendations for pregnant women or policy changes that can benefit entire communities,” she says. In the future, she hopes that her findings will affect medical advice for pregnant women and broader environmental and health policies.
Prof. Tamar Wainstock’s work at Ben-Gurion University reshapes our understanding of how the environment impacts reproductive health and fetal development. “What we’re learning is that these exposures don’t just stop with the individual; they have the power to shape entire communities for generations,” she says.
The broader implications of her work are a testament to the dire need for policies that protect public health at a fundamental level—especially for vulnerable populations like pregnant women and young children. Prof. Wainstock’s research offers hope to build a healthier future by making more environmentally conscious decisions today.
This article was written in cooperation with Ben-Gurion University of the Negev.