1
|
Zhang Y, Liu J, Hu M, Chai D, Zhang F, Yin T, Ye P, Fang Z, Zhang Y. The relationship between air pollution and the occurrence of hypertensive disorders of pregnancy: Evidence from a study in Wuhan, China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 284:116933. [PMID: 39226864 DOI: 10.1016/j.ecoenv.2024.116933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Revised: 08/05/2024] [Accepted: 08/21/2024] [Indexed: 09/05/2024]
Abstract
Ambient air pollution has been reported to be a risk factor for hypertensive disorders of pregnancy (HDP). Past studies have reported supportive evidence, but evidence from China is scarce and does not integrate the different periods of the pregnancy course. In this study, 1945 pregnant women with HDP and healthy pregnancies between 2016 and 2022 from the Renmin Hospital of Wuhan University registry network database were analysed. The geographic information, biological information and demographic information of the case were fused in the analysis. Machine learning methods were used to obtain the weight of the variable. Then, we used the generalized linear mixed model to evaluate the relationship between increased exposure to each pollutant at different periods of HDP and examined it in different groups. The results showed that SO2 had the predominate impact (12.65 %) on HDP compared with other air pollutants. SO2 exposure was associated with an increased risk of HDP. Increased unit SO2 concentrations were accompanied by an increased risk of HDP (OR = 1.33, 95 % CI: 1.13, 1.566), and the susceptible window for this effect was mainly in the first trimester (OR = 1.242, 95 % CI: 1.092, 1.412). In addition, SO2 exposure was associated with an increased risk of HDP in urban maternity (OR = 1.356, 95 % CI: 1.112, 1.653), obese maternity (OR = 3.58, 95 % CI: 1.608, 7.971), no higher education maternity (OR = 1.348, 95 % CI: 1.065, 1.706), nonzero delivery maternity (OR = 1.981, 95 % CI: 1.439, 2.725), maternal with first time maternity (OR = 1.247, 95 % CI: 1.007, 1.544) and other groups. In summary, SO2 exposure in early pregnancy is one of the risk factors for HDP, and the increased risk of HDP due to increased SO2 exposure may be more pronounced in obese, urban, low-education, and nonzero delivery populations.
Collapse
Affiliation(s)
- Yuying Zhang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Jianfeng Liu
- The State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, Hubei, China
| | - Min Hu
- Department of Obstetrics, Renmin Hospital of Wuhan University, Wuhan, Hubei, China
| | - Dongyue Chai
- The State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, Hubei, China
| | - Feng Zhang
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China
| | - Tailang Yin
- Reproductive Medicine Center, Renmin Hospital of Wuhan University, Wuhan, Hubei 430060, China.
| | - Peng Ye
- Department of Pharmacy, Renmin Hospital of Wuhan University, Wuhan 430060, China.
| | - Zhixiang Fang
- The State Key Laboratory of Information Engineering in Surveying, Mapping and Remote Sensing, Wuhan University, Wuhan, Hubei, China.
| | - Yan Zhang
- Department of Clinical Laboratory, Renmin Hospital of Wuhan University, Wuhan, Hubei, China.
| |
Collapse
|
2
|
Zhang T, Ren AX, Tong M, Li Y, Mendola P, Chen X, Wang M. Gestational exposure to wildfire PM 2.5 and its specific components and the risk of gestational hypertension and eclampsia in the southwestern United States. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 951:175781. [PMID: 39187088 DOI: 10.1016/j.scitotenv.2024.175781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2024] [Revised: 08/13/2024] [Accepted: 08/23/2024] [Indexed: 08/28/2024]
Abstract
In the southwestern United States, the frequency of summer wildfires has elevated ambient PM2.5 concentrations and rates of adverse birth outcomes. Notably, hypertensive disorders in pregnancy (HDP) constitute a significant determinant associated with maternal mortality and adverse birth outcomes. Despite the accumulating body of evidence, scant research has delved into the correlation between chemical components of wildfire PM2.5 and the risk of HDP. Derived from data provided by the National Center for Health Statistics, singleton births from >2.68 million pregnant women were selected across 8 states (Arizona, AZ; California, CA, Idaho, ID, Montana, MT; Nevada, NV; Oregon, OR; Utah, UT, and Wyoming, WY) in the southwestern US from 2001 to 2004. A spatiotemporal model and a Goddard Earth Observing System chemical transport model were employed to forecast daily concentrations of total and wildfire PM2.5-derived exposure. Various modeling techniques including unadjusted analyses, covariate-adjusted models, propensity-score matching, and double robust typical logit models were applied to assess the relationship between wildfire PM2.5 exposure and gestational hypertension and eclampsia. Exposure to fire PM2.5, fire-sourced black carbon (BC) and organic carbon (OC) were associated with an augmented risk of gestational hypertension (ORPM2.5 = 1.125, 95 % CI: 1.109,1.141; ORBC = 1.247, 95 % CI: 1.214,1.281; OROC = 1.153, 95 % CI: 1.132, 1.174) and eclampsia (ORPM2.5 = 1.217, 95 % CI: 1.145,1.293; ORBC = 1.458, 95 % CI: 1.291,1.646; OROC = 1.309, 95 % CI: 1.208,1.418) during the pregnancy exposure window with the strongest effect. The associations were stronger that the observed effects of ambient PM2.5 in which the sources primarily came from urban emissions. Social vulnerability index (SVI), education years, pre-pregnancy diabetes, and hypertension acted as effect modifiers. Gestational exposure to wildfire PM2.5 and specific chemical components (BC and OC) increased gestational hypertension and eclampsia risk in the southwestern United States.
Collapse
Affiliation(s)
- Tong Zhang
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China
| | - Amber X Ren
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Mingkun Tong
- Institute of Reproductive and Child Health / Ministry of Health Key Laboratory of Reproductive Health and Department of Epidemiology and Biostatistics, School of Public Health, Peking University Health Science Center, Beijing, China
| | - Yang Li
- Department of Environmental Science, Baylor University, Waco, TX, USA
| | - Pauline Mendola
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA
| | - Xushen Chen
- School of Public Health, Zhejiang Chinese Medical University, Hangzhou, Zhejiang Province, China.
| | - Meng Wang
- Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, NY, USA; RENEW Institute, University at Buffalo, Buffalo, NY, USA; Department of Environmental and Occupational Health Sciences, School of Public Health, University of Washington, Seattle, WA, USA.
| |
Collapse
|
3
|
Sun Y, Bhuyan R, Jiao A, Avila CC, Chiu VY, Slezak JM, Sacks DA, Molitor J, Benmarhnia T, Chen JC, Getahun D, Wu J. Association between particulate air pollution and hypertensive disorders in pregnancy: A retrospective cohort study. PLoS Med 2024; 21:e1004395. [PMID: 38669277 PMCID: PMC11087068 DOI: 10.1371/journal.pmed.1004395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 05/10/2024] [Accepted: 04/04/2024] [Indexed: 04/28/2024] Open
Abstract
BACKGROUND Epidemiological findings regarding the association of particulate matter ≤2.5 μm (PM2.5) exposure with hypertensive disorders in pregnancy (HDP) are inconsistent; evidence for HDP risk related to PM2.5 components, mixture effects, and windows of susceptibility is limited. We aimed to investigate the relationships between HDP and exposure to PM2.5 during pregnancy. METHODS AND FINDINGS A large retrospective cohort study was conducted among mothers with singleton pregnancies in Kaiser Permanente Southern California from 2008 to 2017. HDP were defined by International Classification of Diseases-9/10 (ICD-9/10) diagnostic codes and were classified into 2 subcategories based on the severity of HDP: gestational hypertension (GH) and preeclampsia and eclampsia (PE-E). Monthly averages of PM2.5 total mass and its constituents (i.e., sulfate, nitrate, ammonium, organic matter, and black carbon) were estimated using outputs from a fine-resolution geoscience-derived model. Multilevel Cox proportional hazard models were used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of PM2.5 constituents. The distributed lag model was applied to estimate the association between monthly PM2.5 exposure and HDP risk. This study included 386,361 participants (30.3 ± 6.1 years) with 4.8% (17,977/373,905) GH and 5.0% (19,381/386,361) PE-E cases, respectively. In single-pollutant models, we observed increased relative risks for PE-E associated with exposures to PM2.5 total mass [adjusted hazard ratio (HR) per interquartile range: 1.07, 95% confidence interval (CI) [1.04, 1.10] p < 0.001], black carbon [HR = 1.12 (95% CI [1.08, 1.16] p < 0.001)] and organic matter [HR = 1.06 (95% CI [1.03, 1.09] p < 0.001)], but not for GH. The population attributable fraction for PE-E corresponding to the standards of the US Environmental Protection Agency (9 μg/m3) was 6.37%. In multi-pollutant models, the PM2.5 mixture was associated with an increased relative risk of PE-E ([HR = 1.05 (95% CI [1.03, 1.07] p < 0.001)], simultaneous increase in PM2.5 constituents of interest by a quartile) and PM2.5 black carbon gave the greatest contribution of the overall mixture effects (71%) among all individual constituents. The susceptible window is the late first trimester and second trimester. Furthermore, the risks of PE-E associated with PM2.5 exposure were significantly higher among Hispanic and African American mothers and mothers who live in low- to middle-income neighborhoods (p < 0.05 for Cochran's Q test). Study limitations include potential exposure misclassification solely based on residential outdoor air pollution, misclassification of disease status defined by ICD codes, the date of diagnosis not reflecting the actual time of onset, and lack of information on potential covariates and unmeasured factors for HDP. CONCLUSIONS Our findings add to the literature on associations between air pollution exposure and HDP. To our knowledge, this is the first study reporting that specific air pollution components, mixture effects, and susceptible windows of PM2.5 may affect GH and PE-E differently.
Collapse
Affiliation(s)
- Yi Sun
- Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, United States of America
| | - Rashmi Bhuyan
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, United States of America
- Occupational and Environmental Medicine Residency Program, University of California, Irvine, California, United States of America
- Department of Occupational Medicine, Kaiser Permanente Northern California, Antioch, California, United States of America
| | - Anqi Jiao
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, United States of America
| | - Chantal C. Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America
| | - Vicki Y. Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America
| | - Jeff M. Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America
| | - David A. Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America
- Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States of America
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon, United States of America
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California, San Diego, California, United States of America
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Keck School of Medicine, Los Angeles, California, United States of America
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California, United States of America
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, United States of America
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, United States of America
| |
Collapse
|
4
|
Liu X, Na J, Liu X, Jia X, Ren M, Chen J, Han B, Xu J, Li N, Li Z, Wang B. Co-exposure to phthalates and polycyclic aromatic hydrocarbons and the risk of gestational hypertension in Chinese women. ENVIRONMENT INTERNATIONAL 2024; 185:108562. [PMID: 38460239 DOI: 10.1016/j.envint.2024.108562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
Phthalates (PAEs) and polycyclic aromatic hydrocarbons (PAHs) are frequently detected in females of reproductive age. Many studies have found that environmental PAE and PAH levels are independent risk factors for gestational hypertension. However, exposure to both components is a more realistic scenario. To better assess the health effects of PAEs and PAHs in pregnant women, we explored the associations of exposure to both individual and combined PAEs and PAHs with gestational hypertension. This nested case-control study was a component of a prospective cohort study conducted in Beijing, China. We included 206 women with gestational hypertension and 214 pregnant controls. We used gas chromatography/tandem mass spectrometry (GC-MS/MS) to detect 8 PAEs and 13 PAHs in > 80 % of all collected hair samples. Multiple linear regression models were employed to test the individual associations between each component and gestational hypertension. A quantile-based g-computation (qgcomp) model and a weighted quantile sum (WQS) regression model were used to estimate whether exposure to both PAEs and PAHs increased the risk of gestational hypertension. The individual exposure analyses revealed that diethyl phthalate (DEP), diisobutyl phthalate (DIBP) (both PAEs), benzo(k)fluoranthene (BKF), anthracene, (ANT), and benzo(a)pyrene (BAP) (all PAHs) were positively associated with increased risk of gestational hypertension. In mixed-effect analyses, the qgcomp model indicated that co-exposure to PAEs and PAHs increased the risk of gestational hypertension (odds ratio = 2.01; 95 % confidence interval: 1.02, 3.94); this finding was verified by the WQS regression model. Our findings support earlier evidence that both PAEs and PAHs increase the risk of gestational hypertension, both individually and in combination. This suggests that reductions in exposure to endocrine system-disrupting chemicals such as PAEs and PAHs might reduce the risk of gestational hypertension.
Collapse
Affiliation(s)
- Xiaowen Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Jigen Na
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Xiaojing Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Xiaoqian Jia
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Mengyuan Ren
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Junxi Chen
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
| | - Nan Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China.
| | - Zhiwen Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Bin Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China
| |
Collapse
|
5
|
Zhu J, Chen J, Wang K, Yan H, Liu Q, Lan Y, Ren L, Wu S. Exposure to ambient black carbon and particulate matter during pregnancy in associations with risk of pre-eclampsia: A meta-analysis based on population-based studies. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 343:123230. [PMID: 38158011 DOI: 10.1016/j.envpol.2023.123230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 12/17/2023] [Accepted: 12/23/2023] [Indexed: 01/03/2024]
Abstract
Air pollution control protocols and policies formulated for PM2.5 and PM10 (particulate matter [PM] with an aerodynamic diameter of ≤2.5 and 10 μm), however, such protocols and policies have not been available for black carbon (BC). A growing number of studies have evaluated the association between long-term exposure to ambient air pollution with BC and PM and pre-eclampsia. We applied a meta-analysis to estimate pooled odds ratios (ORs) and 95 % confidence intervals (CIs) based on four exposure windows (first/second/third trimester and entire pregnancy). 24 studies meeting our selection criteria (8 for BC, 21 and 15 for PM2.5 and PM10) were finally included after screening studies published up to June 22, 2023. An increase of 1 μg/m3 BC during the second trimester and entire pregnancy were associated with a 16 % (OR: 1.16, 95 % CI: [1.02, 1.32]) and a 15 % (OR: 1.15, 95 % CI: [1.03, 1.29]) increased risk of pre-eclampsia, respectively. A 10 μg/m3 increase in second-trimester exposure to PM2.5 and PM10 was associated with a 1 % (OR: 1.01, 95 % CI: [1.00, 1.03]) and a 5 % (OR: 1.05, 95 % CI: [1.01, 1.10]) increased risk of pre-eclampsia. An 11 % (OR: 1.11, 95 % CI: [1.03, 1.21]) increased risk of pre-eclampsia was found to be associated with a 10 μg/m3 increase in PM10 exposure during the entire pregnancy. The results support the potential effect of exposure to ambient particulate pollutants on risk of pre-eclampsia and emphasize the necessity of strategies and protocols for controlling BC. Greater efforts in controlling ambient particulate pollution and especially BC are needed in order to prevent pregnant women from developing pre-eclampsia.
Collapse
Affiliation(s)
- Jiaqi Zhu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
| | - Juan Chen
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
| | - Kai Wang
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
| | - Hairong Yan
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
| | - Qisijing Liu
- Research Institute of Public Health, School of Medicine, Nankai University, Tianjin, China
| | - Yang Lan
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China
| | - Lihua Ren
- School of Nursing, Peking University, Beijing, China
| | - Shaowei Wu
- Department of Occupational and Environmental Health, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China; Key Laboratory for Disease Prevention and Control and Health Promotion of Shaanxi Province, Xi'an, Shaanxi, China; Key Laboratory of Trace Elements and Endemic Diseases in Ministry of Health, Xi'an, Shaanxi, China; Key Laboratory of Environment and Genes Related to Diseases (Xi'an Jiaotong University), Ministry of Education, Xi'an, China.
| |
Collapse
|
6
|
Cao L, Diao R, Shi X, Cao L, Gong Z, Zhang X, Yan X, Wang T, Mao H. Effects of Air Pollution Exposure during Preconception and Pregnancy on Gestational Diabetes Mellitus. TOXICS 2023; 11:728. [PMID: 37755739 PMCID: PMC10534707 DOI: 10.3390/toxics11090728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 09/28/2023]
Abstract
This study aimed to investigate the association between air pollution and gestational diabetes mellitus (GDM) in small- and medium-sized cities, identify sensitive periods and major pollutants, and explore the effects of air pollution on different populations. A total of 9820 women who delivered in Handan Maternal and Child Health Hospital in the Hebei Province from February 2018 to July 2020 were included in the study. Logistic regression and principal component logistic regression models were used to assess the effects of air pollution exposure during preconception and pregnancy on GDM risk and the differences in the effects across populations. The results suggested that each 20 μg/m3 increase in PM2.5 and PM10 exposure during preconception and pregnancy significantly increased the risk of GDM, and a 10 μg/m3 increase in NO2 exposure during pregnancy was also associated with the risk of GDM. In a subgroup analysis, pregnant women aged 30-35 years, nulliparous women, and those with less than a bachelor's education were the most sensitive groups. This study provides evidence for an association between air pollution and the prevalence of GDM, with PM2.5, PM10, and NO2 as risk factors for GDM.
Collapse
Affiliation(s)
- Lei Cao
- China Institute for Radiation Protection, Taiyuan 030006, China
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Ruiping Diao
- Handan Maternal and Children Health Hospital, Handan 056001, China
| | - Xuefeng Shi
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Lu Cao
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Zerui Gong
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Xupeng Zhang
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Xiaohan Yan
- China Institute for Radiation Protection, Taiyuan 030006, China
| | - Ting Wang
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| | - Hongjun Mao
- Tianjin Key Laboratory of Urban Transport Emission Research & State Environmental Protection Key, Laboratory of Urban Ambient Air Particulate Matter Pollution Prevention and Control, College of Environmental Science and Engineering, Nankai University, Tianjin 300071, China
| |
Collapse
|
7
|
Alvarado-Jiménez D, Donzelli G, Morales-Suárez-Varela M. A systematic review on the association between exposure to air particulate matter during pregnancy and the development of hypertensive disorders of pregnancy and gestational diabetes mellitus. REVIEWS ON ENVIRONMENTAL HEALTH 2023; 0:reveh-2022-0258. [PMID: 37141623 DOI: 10.1515/reveh-2022-0258] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
Particulate matter (PM) is considered an intrauterine toxin that can cross the blood-placental barrier and circulate in fetal blood, affecting fetal development, and implicating placental and intrauterine inflammation, and oxidative damage. However, the relationship between PM exposure and adverse pregnancy outcomes is still unclear and our aim was to systematically review toxicological evidence on the link between PM exposure during pregnancy and the development of gestational diabetes mellitus or hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. PubMed and Science Direct were searched until January 2022. Of the 204 studies identified, 168 were excluded. The remaining articles were assessed in full-text, and after evaluation, 27 were included in the review. Most of the studies showed an association between PM exposure and gestational hypertension, systolic and diastolic blood pressure, pre-eclampsia, and gestational diabetes mellitus. These results should be interpreted with caution due to the heterogeneity of baseline concentrations, which ranged from 3.3 μg/m3 to 85.9 μg/m3 and from 21.8 μg/m3 to 92.2 μg/m3, respectively for PM2.5 and PM10. Moreover, critical exposure periods were not consistent among studies, with five out of ten observational studies reporting the second trimester as the critical period for hypertensive disorders of pregnancy, and ten out of twelve observational studies reporting the first or second trimester as the critical period for gestational diabetes mellitus. Overall, the findings support an association between PM exposure during pregnancy and adverse pregnancy outcomes, highlighting the need for further research to identify the critical exposure periods and underlying mechanisms.
Collapse
Affiliation(s)
| | - Gabriele Donzelli
- Department of Health Sciences, University of Florence, 50134 Florence, Italy
| | - María Morales-Suárez-Varela
- Department of Preventive Medicine and Public Health, Food Sciences, Toxicology, and Legal Medicine, School of Pharmacy, University of Valencia, Burjassot, Valencia, Spain
- CIBER of Epidemiology and Public Health (CIBERESP), Madrid, Spain
| |
Collapse
|
8
|
Shen Y, Yu G, Liu C, Wang W, Kan H, Zhang J, Cai J. Prenatal Exposure to PM 2.5 and Its Specific Components and Risk of Hypertensive Disorders in Pregnancy: A Nationwide Cohort Study in China. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2022; 56:11473-11481. [PMID: 35914180 DOI: 10.1021/acs.est.2c01103] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Hypertensive disorders in pregnancy (HDP) are a leading cause of maternal mortality and adverse birth outcomes. Fine particulate matter (PM2.5) has been linked to HDP risk; however, limited studies have explored the relationships between specific chemical constituents of PM2.5 and HDP risk. Based on maternal data from the China Labor and Delivery Survey (CLDS), this study included a total of 67,659 participants from 95 participant hospitals in 25 provinces of China between March 1, 2015, and December 31, 2016. Maternal exposure to total PM2.5 mass and six main components during pregestation and pregnancy were estimated using the Combined Geoscience-Statistical Method. Multilevel logistic regression models were applied to quantify the associations, controlling for sociodemographic characteristics. We found that an interquartile range (IQR) increase in PM2.5 exposure during the second trimester was associated with a 14% increase in HDP risk (95% CI: 2%, 29%). We observed that black carbon (BC) and SO42- had larger or comparable estimates of the effect than total PM2.5 mass. The association estimates were greater in the gestational hypertension group than in the group of pre-eclampsia and eclampsia. Our findings suggest that PM2.5 exposure and specific chemical components (particularly BC and SO42-) were associated with an increased HDP risk in China.
Collapse
Affiliation(s)
- Yanling Shen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Guoqi Yu
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
| | - Cong Liu
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Weidong Wang
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Haidong Kan
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| | - Jun Zhang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao-Tong University School of Medicine, Shanghai 200092, China
- School of Public Health, Shanghai Jiao-Tong University School of Medicine, Shanghai 200025, China
| | - Jing Cai
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai 200032, China
| |
Collapse
|
9
|
Yan M, Liu N, Fan Y, Ma L, Guan T. Associations of pregnancy complications with ambient air pollution in China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 241:113727. [PMID: 35679731 DOI: 10.1016/j.ecoenv.2022.113727] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/22/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Gestational hypertension (GH), preeclampsia (PE), and gestational diabetes mellitus (GDM) are common pregnancy complications and can result in maternal and prenatal morbidity and mortality. Air pollution exposure could adversely impact pregnancy complications; however, evidence remains limited in China, where ambient air pollution is relatively severe. OBJECTIVE This study aims to examine the associations of GH, PE, and GDM with exposure to six air pollutants (PM2.5, PM10, SO2, NO2, O3, and CO) during pregnancy. METHODS Leveraging a multicenter birth cohort study among pregnant women in 24 hospitals from 15 provinces in China, we obtained data for maternal characteristics and pregnancy outcomes. We generated ambient concentrations of the six air pollutants using a combination of chemical transport model simulations with monitoring data. We used multivariable logistic regression models to estimate the effects on pregnancy complications from exposure to six air pollutants in each trimester and the entire pregnancy. RESULTS Among the total 3754 pregnant women in this study, the prevalences of GH, GDM, and PE were 2.6 %, 11.2 %, and 0.7 %, respectively. GH risk increased 11.9 % (95 % CI, -8.5 %, 36.8 %) and 13.8 % (1.4 %, 27.8 %) per 10 μg/m3 increases in PM2.5 and PM10 in the entire pregnancy, respectively. PM2.5 and PM10 exposures in the first trimester were significantly associated with an increased risk of GDM. Exposure to O3, SO2, NO2, and CO in early pregnancy could be associated with GDM risk. Geographic region and season of conception may influence the associations of GH and PE with air pollution. CONCLUSIONS Ambient particulate matter pollution adversely affects GH, GDM, and PE among Chinese pregnant women. Since most regions of China still suffer from hazardous levels of air pollution, our findings indicate importance of better protecting pregnant women from the risk of air pollution.
Collapse
Affiliation(s)
- Meilin Yan
- School of Ecology and Environment, Beijing Technology and Business University, Beijing, China
| | - Nana Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China
| | - Yunfei Fan
- China National Environmental Monitoring Centre, Beijing 100012, China
| | - Liangkun Ma
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Science, Beijing 100730, China.
| | - Tianjia Guan
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 10073, China.
| |
Collapse
|
10
|
Gogna P, Villeneuve PJ, Borghese MM, King WD. An exposure-response meta-analysis of ambient PM 2.5 during pregnancy and preeclampsia. ENVIRONMENTAL RESEARCH 2022; 210:112934. [PMID: 35150719 DOI: 10.1016/j.envres.2022.112934] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Relationships between PM2.5 exposure and preeclampsia have been the focus of four recent systematic reviews and meta-analyses. We expand on knowledge gaps in these reviews by characterizing the shape of the exposure-outcome relationship, and by assessing the heterogeneity in these associations by study characteristics. Studies of PM2.5 and preeclampsia were identified from reviews, and confounder-adjusted estimates were extracted. Estimates were derived using a random-effects model. Potential non-linearity was evaluated using a one-stage dose-response meta-analysis. Contrary to previous meta-analyses reporting stronger relationships, the overall adjusted relative risk (RR) for a 10 μg/m3 average increase in PM2.5 during pregnancy and preeclampsia was modest and not statistically significant (RR: 1.07, 95% CI: 0.99-1.15). This was mainly attributable to inclusion/exclusion decisions for studies made during this review. In addition, there was no evidence of non-linearity, and no important sub-group differences by characteristics such as region, exposure assessment, participant exclusions, and early versus late-onset preeclampsia. Overall, our analysis suggests a modest relationship between ambient PM2.5 and preeclampsia. We provide details on inclusion and exclusion decisions that were lacking in previous studies, and report novel investigations of non-linearity and heterogeneity.
Collapse
Affiliation(s)
- Priyanka Gogna
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Michael M Borghese
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
| |
Collapse
|
11
|
Daniel S, Kloog I, Factor-Litvak P, Levy A, Lunenfeld E, Kioumourtzoglou MA. Risk for preeclampsia following exposure to PM 2.5 during pregnancy. ENVIRONMENT INTERNATIONAL 2021; 156:106636. [PMID: 34030074 DOI: 10.1016/j.envint.2021.106636] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 05/03/2021] [Accepted: 05/07/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Previous findings concerning the risk for preeclampsia following exposure to particulate matter are inconclusive. METHODS We used data from all singleton pregnancies of women insured by the "Clalit health services" (CHS) maintenance organization in southern Israel that resulted in delivery or perinatal mortality at Soroka Medical Center (SMC). Daily PM2.5 concentrations were estimated by a hybrid satellite-based model at one-squared kilometer spatial resolution. We used Cox proportional hazard models coupled with distributed lag models to examine the association between the mean exposure to PM2.5 in every gestational week and the diagnosis of preeclampsia, adjusting for maternal age, parity, year of birth, season of birth and socio-economic status. Hazard Ratios (HR) and 95% Confidence Intervals (CI) were calculated for individual gestational weeks and for cumulative exposure until the 25th gestational week. RESULTS A total of 133,197 pregnancies ended at SMC during the study period, of which 68,126 (51.1%) were Jewish and 65,071 (48.9%) were Bedouin. For pregnancies of Jewish women, exposure to PM2.5 from the 7th until the 14st gestational week was significantly associated with preeclampsia (maximal HR = 1.06; 95%CI: 1.01 - 1.11 during the 10th gestational week per 10 μg/m3 increase in PM2.5). Cumulative exposure to PM2.5 during the first 25th gestational weeks was also significantly associated with preeclampsia (HR = 2.08; 95%CI: 1.10 - 3.94 per 10 μg/m3 increase in PM2.5). We observed no association for pregnancies of Bedouin women. CONCLUSIONS Exposure to PM2.5 between the 7th and the 14st gestational weeks was associated with preeclampsia among Jewish women but not among Bedouin women.
Collapse
Affiliation(s)
- Sharon Daniel
- Department of Public Health, Beer-Sheva, Israel; Pediatrics and Obstetrics and Gynecology, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel; Clalit Health Services, Southern District, Beer-Sheva, Israel.
| | - Itai Kloog
- Department of Geography & Human Environment, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Pam Factor-Litvak
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Amalia Levy
- Department of Public Health, Beer-Sheva, Israel
| | - Eitan Lunenfeld
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Soroka University Medical Center, Beer-Sheva, Israel
| | - Marianthi-Anna Kioumourtzoglou
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, USA
| |
Collapse
|
12
|
Particulate matter and hypertensive disorders in pregnancy: systematic review and meta-analysis. Public Health 2021; 200:22-32. [PMID: 34653738 DOI: 10.1016/j.puhe.2021.08.013] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2021] [Revised: 08/18/2021] [Accepted: 08/18/2021] [Indexed: 01/14/2023]
Abstract
OBJECTIVES We aimed to quantitatively synthesize the association between maternal exposure to particulate matter (PM; including PM <2.5 μm and PM <10 μm) and hypertensive disorders in pregnancy (HDP; including gestational hypertension [GH] and pre-eclampsia) and to explore the influence of certain factors on the outcome. STUDY DESIGN Meta-analysis was used to quantitatively synthesize the results of similar independent studies. METHODS Original documents were identified by searching six electronic bibliographic databases from their inceptions to August 17, 2021. Then we performed meta-analysis to combine the effect estimates if at least three estimates reported the same exposure and outcome and used stratified analysis to evaluate the impact of exposure assessment method, data source, and study area on heterogeneity. In addition, we used the 95% prediction interval to evaluate the potential effects of exposure in random effects meta-analysis. RESULTS The overall meta-analysis showed that the risk of HDP was significantly associated with per 5 μg/m3 increase in PM2.5 exposure during T1 and PM10 exposure during T, with odds ratios [ORs] 1.06 (95% confidence interval [CI]: 1.01-1.12) and 1.04 (95% CI: 1.02-1.07), respectively. The results also showed that PM2.5 exposure during T1 and T2 and PM10 exposure during T1 increased the incidence of GH; the summary ORs were 1.11 (95% CI: 1.01-1.23), 1.16 (95% CI: 1.05-1.29), and 1.04 (95% CI: 1.02-1.07), respectively. Subgroup analyses showed that the pooled effects were generally significant or more apparent in studies using models to assess exposure, studies whose data derived from birth registers, and studies in Europe. CONCLUSIONS This meta-analysis showed that PM exposure was associated with increased HDP risks, and the association varied by study area, data source, and exposure assessment method. With the continuous improvement of research design and exposure assessment, future research may find higher risks.
Collapse
|
13
|
de Ferreyro Monticelli D, Santos JM, Goulart EV, Mill JG, Kumar P, Reis NC. A review on the role of dispersion and receptor models in asthma research. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 287:117529. [PMID: 34186501 DOI: 10.1016/j.envpol.2021.117529] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 05/17/2021] [Accepted: 06/01/2021] [Indexed: 06/13/2023]
Abstract
There is substantial evidence that air pollution exposure is associated with asthma prevalence that affects millions of people worldwide. Air pollutant exposure can be determined using dispersion models and refined with receptor models. Dispersion models offer the advantage of giving spatially distributed outdoor pollutants concentration while the receptor models offer the source apportionment of specific chemical species. However, the use of dispersion and/or receptor models in asthma research requires a multidisciplinary approach, involving experts on air quality and respiratory diseases. Here, we provide a literature review on the role of dispersion and receptor models in air pollution and asthma research, their limitations, gaps and the way forward. We found that the methodologies used to incorporate atmospheric dispersion and receptor models in human health studies may vary considerably, and several of the studies overlook features such as indoor air pollution, model validation and subject pathway between indoor spaces. Studies also show contrasting results of relative risk or odds ratio for a health outcome, even using similar methodologies. Dispersion models are mostly used to estimate air pollution levels outside the subject's home, school or workplace; however, very few studies addressed the subject's routines or indoor/outdoor relationships. Conversely, receptor models are employed in regions where asthma incidence/prevalence is high or where a dispersion model has been previously used for this assessment. Road traffic (vehicle exhaust) and NOx are found to be the most targeted source and pollutant, respectively. Other key findings were the absence of a standard indicator, shortage of studies addressing VOC and UFP, and the shift toward chemical speciation of exposure.
Collapse
Affiliation(s)
- Davi de Ferreyro Monticelli
- Department of Environmental Engineering, Federal University of Espirito Santo (UFES), Vitória, Espirito Santo, Brazil
| | - Jane Meri Santos
- Department of Environmental Engineering, Federal University of Espirito Santo (UFES), Vitória, Espirito Santo, Brazil.
| | - Elisa Valentim Goulart
- Department of Environmental Engineering, Federal University of Espirito Santo (UFES), Vitória, Espirito Santo, Brazil
| | - José Geraldo Mill
- Department of Physiological Sciences, Federal University of Espirito Santo (UFES), Vitória, Espirito Santo, Brazil
| | - Prashant Kumar
- Global Centre for Clean Air Research (GCARE), Department of Civil and Environmental Engineering, Faculty of Engineering and Physical Sciences, University of Surrey, Guildford, GU2 7XH, United Kingdom
| | - Neyval Costa Reis
- Department of Environmental Engineering, Federal University of Espirito Santo (UFES), Vitória, Espirito Santo, Brazil
| |
Collapse
|
14
|
Stanhope KK, Adeyemi DI, Li T, Johnson T, Boulet SL. The relationship between the neighborhood built and social environment and hypertensive disorders of pregnancy: A scoping review. Ann Epidemiol 2021; 64:67-75. [PMID: 34547447 DOI: 10.1016/j.annepidem.2021.09.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/03/2021] [Accepted: 09/12/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Theory and limited empirical research suggest that the neighborhood environment influences maternal health outcomes. The goal of this scoping review is to summarize extant research considering the impact of the built and social environment of resident neighborhood on hypertensive disorders of pregnancy (HDP) globally. METHODS We performed a systematic search of the literature using four databases, PubMed, Web of Science, CINAHL, and Embase on July 15, 2020. We excluded articles not in English, that did not consider one or more HDP as a primary or secondary outcome, and that did not include an element of the neighborhood built or social environment as an exposure. We applied a modified version of the Effective Public Health Practice Project Quality Assessment Tool for Quantitative Studies to evaluate quality of included studies. RESULTS Our search identified 11,385 unique abstracts for screening. Following exclusions, we included 64 articles in the final review. The majority of articles measured an element of the built environment (70.3% (44)), most commonly traffic-related air pollution (42.2% (27)). A third of articles (31.3% (20)) considered an element of the neighborhood social environment, most commonly neighborhood deprivation (10.9% (7)). Global quality ratings were mostly moderate (29.7% (19)) or weak (68.8% (44)), primarily due to inattention to neighborhood-level confounding. CONCLUSION Critical gaps remain in understanding how the resident neighborhood may impact HDP. Future research should focus on designing high-quality studies incorporating elements of both the built and social environment to holistically understand how context may impact maternal health.
Collapse
Affiliation(s)
- Kaitlyn K Stanhope
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA,.
| | - Deborah I Adeyemi
- Department of Epidemiology, Rollin School of Public Health, Emory University, Atlanta, GA
| | - Tanya Li
- Emory College of Arts and Sciences, Emory University, Atlanta, GA
| | | | - Sheree L Boulet
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA
| |
Collapse
|
15
|
Williams AD, Kanner J, Grantz KL, Ouidir M, Sheehy S, Sherman S, Robledo C, Mendola P. Air pollution exposure and risk of adverse obstetric and neonatal outcomes among women with type 1 diabetes. ENVIRONMENTAL RESEARCH 2021; 197:111152. [PMID: 33844969 PMCID: PMC8190832 DOI: 10.1016/j.envres.2021.111152] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 02/13/2021] [Accepted: 04/07/2021] [Indexed: 05/30/2023]
Abstract
AIMS/HYPOTHESIS Women with type 1 diabetes have increased risk for poor obstetric outcomes. Prenatal air pollution exposure is also associated with adverse outcomes for women and infants. We examined whether women with type 1 diabetes are more vulnerable than other women to pollution-associated risks during pregnancy. METHODS In singleton deliveries from the Consortium on Safe Labor (2002-2008), obstetric and neonatal outcomes were compared for women with type 1 diabetes (n = 507) and women without autoimmune disease (n = 204,384). Preconception, trimester, and whole pregnancy average air pollutant exposure (ozone (O3), carbon monoxide (CO), particulate matter >10 μm (PM10), PM > 2.5 μm (PM2.5), sulfur dioxide (SO2), nitrogen oxides (NOx)) were estimated using modified Community Multiscale Air Quality models. Poisson regression models with diabetes*pollutant interaction terms estimated relative risks and 95% confidence intervals for adverse outcomes, adjusted for maternal characteristics and geographic region. RESULTS For whole pregnancy exposure to SO2, women with type 1 diabetes had 15% increased risk (RR:1.15 95%CI:1.01,1.31) and women without autoimmune disease had 5% increased risk (RR:1.05 95%CI:1.05,1.06) for small for gestational age birth (pinteraction = 0.09). Additionally, whole pregnancy O3 exposure was associated with 10% increased risk (RR:1.10 95%CI:1.02,1.17) among women with type 1 diabetes and 2% increased risk (RR:1.02 95%CI:1.00,1.04) among women without autoimmune disease for perinatal mortality (pinteraction = 0.08). Similar patterns were observed between PM2.5 exposure and spontaneous preterm birth. CONCLUSIONS Pregnant women with type 1 diabetes may be at greater risk for adverse outcomes when exposed to air pollution than women without autoimmune disease.
Collapse
Affiliation(s)
- Andrew D Williams
- Public Health Program, Department of Population Health, School of Medicine and Health Sciences, University of North Dakota, Room E162, 1301 North Columbia Road Stop 9037, Grand Forks, ND, 58202, USA.
| | - Jenna Kanner
- School of Medicine, University of Maryland, Baltimore, 655 W. Baltimore Stree, Baltimore, MD, 21201, USA
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20892, USA
| | - Marion Ouidir
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20892, USA
| | - Shanshan Sheehy
- Slone Epidemiology Center, Boston University School of Medicine, 72 E Concord Street, Boston, MA, 02118, USA
| | - Seth Sherman
- The Emmes Company, 401 North Washington Street #700, Rockville, MD, 20850, USA
| | - Candace Robledo
- Department of Population Health and Biostatistics, University of Texas Rio Grande Valley School of Medicine, 2102 Treasure Hill Blvd, Harlingen, TX, 78550, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, Bethesda, MD, 20892, USA; Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, 401 Kimball Tower, Buffalo, NY, 14214, USA
| |
Collapse
|
16
|
Stoup T, Chenivesse C. [Management of asthma during pregnancy]. Rev Mal Respir 2021; 38:626-637. [PMID: 34052060 DOI: 10.1016/j.rmr.2021.04.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2020] [Accepted: 02/04/2021] [Indexed: 10/21/2022]
Abstract
Asthma is the most common chronic condition in pregnant women. The risks of complications associated with asthma for the mother, the foetus and the pregnancy are mainly due to uncontrolled asthma and the occurrence of exacerbations. These events are promoted by the patient's difficulty in complying with treatment or by prescription insufficiency for an unjustified fear of teratogenicity. The challenge of the management of asthma during pregnancy is to ensure optimal maternal asthma control in order to prevent foetal hypoxia and thus, reduce the risk of complications. Preventing the occurrence of asthma symptoms and exacerbations, ensuring optimal lung function and managing the risk factors of poor asthma outcomes and comorbidities are the principles necessary to achieve this goal. Because of the low or non-existent risks of the main treatments of asthma for the foetus and the mother, it is widely recommended that all therapies initiated before conception are continued, in particular inhaled corticosteroids, and to adjust the dosage to the minimum effective dose. During the preconception period and throughout pregnancy, coordination of the different healthcare professionals (general practitioner, respiratory specialist and gynecologist) is essential, with the mother-to-be playing a central role in the management of her asthma.
Collapse
Affiliation(s)
- T Stoup
- CHU Lille, université Lille, service de pneumologie et immuno-allergologie, centre de référence constitutif pour les maladies pulmonaires rares, 59000 Lille, France
| | - C Chenivesse
- CHU Lille, université Lille, CNRS, Inserm, institut Pasteur de Lille, service de pneumologie et immuno-allergologie, centre de référence constitutif pour les maladies pulmonaires rares, U1019, UMR 9017, Center for Infection and Immunity of Lille (CIIL), CRISALIS, F-CRIN Inserm network, 59000 Lille, France.
| |
Collapse
|
17
|
Padmanabhan V, Moeller J, Puttabyatappa M. Impact of gestational exposure to endocrine disrupting chemicals on pregnancy and birth outcomes. ADVANCES IN PHARMACOLOGY (SAN DIEGO, CALIF.) 2021; 92:279-346. [PMID: 34452689 DOI: 10.1016/bs.apha.2021.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
With the advent of industrialization, humans are exposed to a wide range of environmental chemicals, many with endocrine disrupting potential. As successful maintenance of pregnancy and fetal development are under tight hormonal control, the gestational exposure to environmental endocrine disrupting chemicals (EDC) have the potential to adversely affect the maternal milieu and support to the fetus, fetal developmental trajectory and birth outcomes. This chapter summarizes the impact of exposure to EDCs both individually and as mixtures during pregnancy, the immediate and long-term consequences of such exposures on the mother and fetus, the direct and indirect mechanisms through which they elicit their effects, factors that modify their action, and the research directions to focus future investigations.
Collapse
Affiliation(s)
| | - Jacob Moeller
- Department of Pediatrics, University of Michigan, Ann Arbor, MI, United States
| | | |
Collapse
|
18
|
Lin SY, Yang YC, Su JW, Wang JS, Jiang CC, Hsu CY, Kao CH. Association Between Preeclampsia Risk and Fine Air Pollutants and Acidic Gases: A Cohort Analysis in Taiwan. Front Public Health 2021; 9:617521. [PMID: 33869125 PMCID: PMC8044398 DOI: 10.3389/fpubh.2021.617521] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/09/2021] [Indexed: 11/16/2022] Open
Abstract
Background: Fine air pollutant particles have been reported to be associated with risk of preeclampsia. The association between air pollutant exposure and preeclampsia risk in heavily air polluted Taiwan warrants investigation. Methods: We combined data from Taiwan National Health Insurance (NHI) Research Database (NHIRD) and Taiwan Air Quality Monitoring Database. Women aged 16–55 years were followed from January 1, 2000, until appearance of ICD-9 coding of preeclampsia withdrawal from the NHI program, or December 31, 2013. Daily concentration of NOx, NO, NO2, and CO was calculated by Kriging method. The Cox proportional hazard regression model was used for risk assessment. Results: For NOx, Relative to Quartile [Q] 1 concentrations, the Q2 (adjusted hazard ratio adjusted = 2.20, 95% CI = 1.50–3.22), Q3 (aHR = 7.28, 95% CI = 4.78–11.0), and Q4 (aHR = 23.7, 95% CI = 13.7–41.1) concentrations were associated with a significantly higher preeclampsia or eclampsia risk. Similarly, for NO, relative to Q1 concentrations, the Q2 (aHR = 1.82, 95% CI = 1.26–2.63), Q3 (aHR = 7.53, 95% CI = 5.12–11.0), and Q4 (aHR = 11.1, 95% CI = 6.72–18.3) concentrations were correlated with significantly higher preeclampsia or eclampsia risk. Furthermore, for NO2, relative to Q1 concentration, the Q2 (aHR = 1.99, 95% CI = 1.37–2.90), Q3 (aHR = 6.15, 95% CI = 3.95–9.57), and Q4 (aHR = 32.7, 95% CI = 19.7–54.3) concentrations also associated with a significantly higher preeclampsia or eclampsia risk. Conclusion: Women exposed to higher NOX, NO, NO2, and CO concentrations demonstrated higher preeclampsia incidence.
Collapse
Affiliation(s)
- Shih-Yi Lin
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Yu-Cih Yang
- Management Office for Health Data, China Medical University Hospital, Taichung, Taiwan.,College of Medicine, China Medical University, Taichung, Taiwan
| | - Jun-Wei Su
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan.,Department of Gynecology, China Medical University Hospital, Taichung, Taiwan
| | - Jie-Sian Wang
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Chang-Cheng Jiang
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan.,Division of Nephrology and Kidney Institute, China Medical University Hospital, Taichung, Taiwan
| | - Chung-Y Hsu
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan
| | - Chia-Hung Kao
- College of Medicine, Graduate Institute of Biomedical Sciences and School of Medicine, China Medical University, Taichung, Taiwan.,Department of Nuclear Medicine and PET Center, China Medical University Hospital, Taichung, Taiwan.,Department of Bioinformatics and Medical Engineering, Asia University, Taichung, Taiwan.,Center of Augmented Intelligence in Healthcare, China Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
19
|
Bearblock E, Aiken CE, Burton GJ. Air pollution and pre-eclampsia; associations and potential mechanisms. Placenta 2020; 104:188-194. [PMID: 33360680 DOI: 10.1016/j.placenta.2020.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/11/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Air pollution has significant negative health impacts, particularly on the cardiovascular system. The aims of this narrative review were to identify whether there is an association between air pollution and the incidence of pre-eclampsia, and the potential mechanisms by which any effects may be mediated. METHODS We undertook a literature search using Google Scholar, PubMed, the Cochrane Library and NICE Evidence. The primary eligibility criterion was articles correlating exposure to air pollution with incidence of pre-eclampsia. RESULTS Meta-analyses currently show a positive association between pre-eclampsia and exposure to both particulate matter PM2.5 and nitrogen dioxide, but no significant associations with ambient ozone or carbon monoxide exposure. No meta-analysis has been performed for exposure to sulfur dioxide. Variability in terms of quantification of exposure, the exposure period and co-founders among the studies makes comparisons complex. Adverse effects on trophoblast invasion and placental vascularisation, and increases in oxidative stress and anti-angiogenic factors, such as sFlt-1, in response to air pollution provide pathways by which exposure may contribute to the pathophysiology of pre-eclampsia. So far, studies have not discriminated between the early- and late-onset forms of the syndrome. DISCUSSION Future prospective studies using personal air pollution monitors and blood biomarkers of pre-eclampsia would strengthen the associations. Interactions between pollutants are poorly documented, and at present there is minimal informed advice available to women on the need to avoid exposure to air pollutants during pregnancy.
Collapse
Affiliation(s)
- Elizabeth Bearblock
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Catherine E Aiken
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Graham J Burton
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK.
| |
Collapse
|
20
|
Su X, Zhao Y, Yang Y, Hua J. Correlation between exposure to fine particulate matter and hypertensive disorders of pregnancy in Shanghai, China. Environ Health 2020; 19:101. [PMID: 32943053 PMCID: PMC7499904 DOI: 10.1186/s12940-020-00655-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/11/2020] [Indexed: 05/14/2023]
Abstract
BACKGROUND Association between fine particulate matter (PM2.5) and hypertensive disorders of pregnancy (HDP) is inconsistent and appears to change in each trimester. We aim to investigate the association of exposure to ambient PM2.5 in early pregnancy with HDP. METHODS A retrospective cohort study was performed among 8776 women with singleton pregnancy who attended the antenatal clinic before 20 gestational weeks in a tertiary women's hospital during 2014-2015. Land use regression models were used to predict individual levels of PM2.5 exposure. RESULTS The average PM2.5 concentration during the first 20 gestational weeks ranged from 28.6 to 74.8 μg m- 3 [median, 51.4 μg m- 3; interquartile range, 47.3-57.8 μg m- 3]. A total of 440 (5.0%) women was diagnosed with HDP. The restricted cubic spline showed a positive exposure-response relationship between the PM2.5 concentration and risk of HDP. We observed an association between PM2.5 exposure during the first trimester with HDP (RR = 3.89 per 10 μg m- 3, 95% CI: 1.45-10.43), but not during the second trimester (RR = 0.71 per 10 μg m- 3, 95% CI: 0.40-1.27). Compared with their counterparts, nulliparous women who were exposed to high levels of PM2.5 in the index pregnancy had a higher risk of developing HDP [the relative excess risk due to interaction was 0.92 (0.46-1.38)]. CONCLUSION Our findings suggest that PM2.5 exposure during the first trimester is associated with the development of HDP. The effect estimate is more obvious for nulliparous women than multiparous women.
Collapse
Affiliation(s)
- Xiujuan Su
- Department of Women & Children’s Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Shanghai, 200040 China
| | - Yan Zhao
- Department of Women & Children’s Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Shanghai, 200040 China
| | - Yingying Yang
- Department of Women & Children’s Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Shanghai, 200040 China
| | - Jing Hua
- Department of Women & Children’s Health Care, Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, No.2699, West Gaoke Road, Shanghai, 200040 China
| |
Collapse
|
21
|
Abstract
BACKGROUND Metabolic syndrome is associated with increases in both inflammation and aspirin resistance, but effectiveness of aspirin in improving reproductive health among women with metabolic syndrome is unknown. We evaluated the effectiveness of low-dose aspirin in improving reproductive outcomes across metabolic syndrome score. METHODS The EAGeR trial randomly assigned 1228 women with a history of pregnancy loss to receive 81 mg aspirin or placebo for up to six menstrual cycles of attempting pregnancy and, if they became pregnant, throughout pregnancy. We assessed components of metabolic syndrome at enrollment, including: waist circumference ≥88 cm, triglycerides ≥150 mg/dl, high-density lipoprotein ≤50 mg/dl, blood pressure ≥130 mmHg systolic or ≥85 mmHg diastolic, and glucose ≥100 mg/dl. We summed components to calculate metabolic syndrome score. RESULTS A total of 229 participants (20%) met full criteria for metabolic syndrome, 207 (18%) had two components, 366 (31%) one component, and 372 (32%) no components. Among those without any component of metabolic syndrome, aspirin was associated with 10.7 [95% confidence interval (CI) = 1.2, 20.2] more pregnancies and 13.7 (95% CI = 3.3, 24.0) more live births per 100 couples. Effects were attenuated as metabolic syndrome score increased and we observed no clear effect of aspirin on pregnancy or live birth among women with metabolic syndrome. CONCLUSIONS Low-dose aspirin is most effective in increasing pregnancy and live birth among women with no or few components of metabolic syndrome. Reduced effectiveness among women with metabolic syndrome may be due to differences in effective dose or aspirin resistance.
Collapse
|
22
|
Ha S, Nobles C, Kanner J, Sherman S, Cho SH, Perkins N, Williams A, Grobman W, Biggio J, Subramaniam A, Ouidir M, Chen Z, Mendola P. Air Pollution Exposure Monitoring among Pregnant Women with and without Asthma. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17134888. [PMID: 32645870 PMCID: PMC7369909 DOI: 10.3390/ijerph17134888] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/18/2020] [Accepted: 06/30/2020] [Indexed: 11/16/2022]
Abstract
Background: We monitored exposure to fine particulates (PM2.5), ozone, nitrogen dioxide (NO2), and ambient temperature for pregnant women with and without asthma. Methods: Women (n = 40) from the Breathe—Well-Being, Environment, Lifestyle, and Lung Function Study (2015–2018) were enrolled during pregnancy and monitored for 2–4 days. Daily pollutants were measured using personal air monitors, indoor air monitors, and nearest Environmental Protection Agency’s stationary monitors based on GPS tracking and home address. Results: Personal-monitor measurements of PM2.5, ozone, and NO2 did not vary by asthma status but exposure profiles significantly differed by assessment methods. EPA stationary monitor-based methods appeared to underestimate PM2.5 and temperature exposure and overestimate ozone and NO2 exposure. Higher indoor-monitored PM2.5 exposures were associated with smoking and the use of gas appliances. The proportion of waking-time during which personal monitors were worn was ~56%. Lower compliance was associated with exercise, smoking, being around a smoker, and the use of a prescription drug. Conclusions: Exposure did not vary by asthma status but was influenced by daily activities and assessment methods. Personal monitors may better capture exposures but non-compliance merits attention. Meanwhile, larger monitoring studies are warranted to further understand exposure profiles and the health effects of air pollution during pregnancy.
Collapse
Affiliation(s)
- Sandie Ha
- Department of Public Health, Health Sciences Research Institute, College of Social Sciences, Humanities, and Arts, University of California, Merced, CA 95343, USA
- Correspondence: ; Tel.: +1-209-228-3615
| | - Carrie Nobles
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Jenna Kanner
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | | | - Seung-Hyun Cho
- RTI International, Research Triangle Park, NC 27709, USA;
| | - Neil Perkins
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Andrew Williams
- School of Medicine & Health Sciences, University of North Dakota, Grand Forks, ND 58202, USA;
| | - William Grobman
- Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA;
| | | | - Akila Subramaniam
- Department of Obstetrics & Gynecology, University of Alabama at Birmingham, Birmingham, AL 35294, USA;
| | - Marion Ouidir
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA; (C.N.); (J.K.); (N.P.); (M.O.); (Z.C.); (P.M.)
| |
Collapse
|
23
|
Bai W, Li Y, Niu Y, Ding Y, Yu X, Zhu B, Duan R, Duan H, Kou C, Li Y, Sun Z. Association between ambient air pollution and pregnancy complications: A systematic review and meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 185:109471. [PMID: 32276169 DOI: 10.1016/j.envres.2020.109471] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/08/2020] [Accepted: 03/30/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 μg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 μg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 μg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.
Collapse
Affiliation(s)
- Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yuanyuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yaling Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ye Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Bo Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ruixin Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China.
| | - Yanbo Li
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China.
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
| |
Collapse
|
24
|
Yang R, Luo D, Zhang YM, Hu K, Qian ZM, Hu LQ, Shen LJ, Xian H, Iwelunmor J, Mei SR. Adverse Effects of Exposure to Fine Particulate Matters and Ozone on Gestational Hypertension. Curr Med Sci 2019; 39:1019-1028. [PMID: 31845236 DOI: 10.1007/s11596-019-2137-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 09/25/2019] [Indexed: 11/30/2022]
Abstract
Gestational hypertension (GH) is a common complication during pregnancy. GH is regarded as a potential public health challenge for pregnant women and infants. Limited evidence has linked ambient air pollution to an increased GH risk. However, most of the studies were conducted in developed countries, with inconsistent results obtained. The present study was performed to explore whether exposure to particulate matters with an aerodynamic diameter < 2.5 (PM2.5) and ozone (O3) was related to elevated odds of GH in a Chinese population. This population-based cohort study involved 38 115 pregnant women in Wuhan, China. All information was collected from the Wuhan Maternal and Child Health Management Information System, using standardized quality control. The daily air pollutant data for PM2.5 and O3 were obtained from the 20 monitoring stations of the Wuhan Environmental Monitoring Center during 2014. The nearest monitor approach was applied to individual exposure assessment of PM2.5 and O3 for each participant. After adjusting for major confounders and other air pollutants, a 10 µg/m3 increase in PM2.5 and O3 concentrations was found to correlate to a 1.14-fold [95% confidence interval (95% CI): 1.09, 1.20] and a 1.05-fold (95% CI: 1.02, 1.07) increase in GH risk, respectively. Additionally, stronger relationships between GH risk and PM2.5 and O3 exposure were observed in women who conceived in winter and summer, respectively. These findings suggest that air pollutants may contribute to the development of GH.
Collapse
Affiliation(s)
- Rong Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China.
| | - Dan Luo
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Yi-Ming Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430015, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, 430015, China
| | - Zheng-Min Qian
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Li-Qin Hu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Long-Jiao Shen
- Wuhan Environmental Monitoring Center, Wuhan, 430015, China
| | - Hong Xian
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Juliet Iwelunmor
- College for Public Health & Social Justice, Saint Louis University, Saint Louis, MO, 63104, USA
| | - Su-Rong Mei
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environment Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| |
Collapse
|
25
|
Seeni I, Williams A, Nobles C, Chen Z, Sherman S, Mendola P. Acute air pollution exposure and NICU admission: a case-crossover analysis. Ann Epidemiol 2019; 37:64-70.e2. [PMID: 31445753 DOI: 10.1016/j.annepidem.2019.07.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2019] [Revised: 05/23/2019] [Accepted: 07/10/2019] [Indexed: 02/04/2023]
Abstract
PURPOSE Neonatal intensive care unit (NICU) admission rates have increased over time. Air pollution is associated with adverse pregnancy outcomes, but the relationship between prenatal air pollution exposure and NICU admission has not been investigated. METHODS In the Consortium on Safe Labor (2002-2008), 27,189 singletons were admitted to the NICU. Modified Community Multiscale Air Quality models estimated exposures for criteria air pollutants and constituents of particles less than or equal to 2.5 microns (PM2.5). Case-crossover analyses calculated odds ratios and 95% confidence intervals for interquartile range increases in pollutant exposure, comparing exposures during the week of delivery to control periods before and after delivery. RESULTS In models that adjusted for PM2.5, exposure to PM2.5 constituents during the week before delivery was significantly associated with increased odds of NICU admission: elemental carbon (35%), ammonium ions (37%), nitrate compounds (16%), organic compounds (147%), and sulfate compounds (35%). Odds were also significantly increased by day of and day before delivery exposures to carbon monoxide (4%-5%), nitrogen dioxide (13%), nitrogen oxides (4%-8%), particles less than or equal to 10 microns (2%), particles less than or equal to 2.5 microns (2%), and sulfur dioxide (3%-6%). No associations were observed for ozone. CONCLUSIONS Acute exposures to PM2.5 constituents and several traffic-related pollutants during the week before delivery, the day of delivery, and day before delivery appear to increase the odds of NICU admissions. These novel associations suggest infants exposed in utero to common air pollutants may require additional care during the newborn hospital admission.
Collapse
Affiliation(s)
- Indulaxmi Seeni
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Andrew Williams
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Carrie Nobles
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | - Zhen Chen
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD
| | | | - Pauline Mendola
- Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD.
| |
Collapse
|
26
|
Nobles CJ, Williams A, Ouidir M, Sherman S, Mendola P. Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia. Hypertension 2019; 74:384-390. [PMID: 31230552 DOI: 10.1161/hypertensionaha.119.12731] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although ambient air pollution may increase hypertension risk through endothelial damage and oxidative stress, evidence is inconsistent regarding its effect on hypertension in pregnancy. Prior research has evaluated a limited scope of pollution species and often not differentiated preeclampsia, which may have a placental origin, from gestational hypertension. Among 49 607 women with at least 2 singleton deliveries in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Consecutive Pregnancies Study (2002-2010), we estimated criteria pollutant and volatile organic compound levels during pregnancy using Community Multiscale Air Quality models and abstracted gestational hypertension and preeclampsia diagnoses from medical records. Generalized estimating equations accounted for repeat pregnancies and adjusted for ambient temperature and maternal age, race/ethnicity, body mass index, smoking, alcohol, parity, insurance, marital status, and asthma. Air pollution levels were low to moderate (eg, median 41.6 ppb [interquartile range, 38.9-43.7 ppb] for ozone and 35.1 ppb [28.9-40.3 ppb] for nitrogen oxides). Higher levels of most criteria pollutants during preconception and the first trimester were associated with lower preeclampsia risk, while higher second-trimester levels were associated with greater gestational hypertension risk. For example, an interquartile increase in first-trimester carbon monoxide was associated with a relative risk of 0.88 (95% CI, 0.81-0.95) for preeclampsia and second-trimester carbon monoxide a relative risk of 1.14 (95% CI, 1.07-1.22) for gestational hypertension. Volatile organic compounds, conversely, were not associated with gestational hypertension but consistently associated with higher preeclampsia risk. These findings further suggest air pollution may affect the development of hypertension in pregnancy, although differing causes of preeclampsia and gestational hypertension may alter these relationships.
Collapse
Affiliation(s)
- Carrie J Nobles
- From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.)
| | - Andrew Williams
- From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.)
| | - Marion Ouidir
- From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.)
| | | | - Pauline Mendola
- From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.)
| |
Collapse
|
27
|
Comparing Photocatalytic Degradation of Gaseous Ethylbenzene Using N-doped and Pure TiO2 Nano-Catalysts Coated on Glass Beads under Both UV and Visible Light Irradiation. Catalysts 2018. [DOI: 10.3390/catal8100466] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Volatile Organic Compounds (VOCs) are within the main industrial air pollutants whose release into the atmosphere is harmful to the ecosystem and human health. Gas-phase photocatalytic degradation of ethylbenzene, an aromatic VOC emitted from various sources, has been investigated in this study using TiO2 nanoparticle-coated glass beads in an annular photoreactor. To use visible light irradiation, TiO2 nanoparticles were doped by nitrogen using urea. The results showed that nitrogen doping significantly increased the removal efficiency of ethylbenzene under visible light irradiation compared with the pure TiO2, so that the removal efficiencies between 75–100% could be yielded for the initial ethylbenzene concentrations up to 0.13 g/m3 under visible light which could be useful for improving indoor air quality. The UV irradiated reactor needed less residence time and much higher removal efficiencies could be yielded at high initial concentrations. When the residence time under UV irradiation was one third of the same under visible light, the removal efficiency was more than 80% for the inlet concentrations up to 0.6 g/m3, whereas the removal efficiency under visible light was about 25% at this inlet concentration. Langmuir-Hinshelwood kinetic model could be well fitted to the photocatalytic reaction in both irradiation systems.
Collapse
|
28
|
Seeni I, Ha S, Nobles C, Liu D, Sherman S, Mendola P. Air pollution exposure during pregnancy: maternal asthma and neonatal respiratory outcomes. Ann Epidemiol 2018; 28:612-618.e4. [PMID: 30153910 PMCID: PMC6232679 DOI: 10.1016/j.annepidem.2018.06.003] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 06/01/2018] [Accepted: 06/05/2018] [Indexed: 01/24/2023]
Abstract
PURPOSE Maternal asthma increases adverse neonatal respiratory outcomes, and pollution may further increase risk. Air quality in relation to neonatal respiratory health has not been studied. METHODS Transient tachypnea of the newborn (TTN), asphyxia, and respiratory distress syndrome (RDS) were identified using medical records among 223,375 singletons from the Consortium on Safe Labor (2002-2008). Community Multiscale Air Quality models estimated pollutant exposures. Multipollutant Poisson regression models calculated adjusted relative risks of outcomes for interquartile range increases in average exposure. Maternal asthma and preterm delivery were evaluated as effect modifiers. RESULTS TTN risk increased after particulate matter (PM) less than or equal to 10-micron exposure during preconception and trimester one (9-10%), and whole-pregnancy exposure to PM less than or equal to 2.5 microns (PM2.5; 17%) and carbon monoxide (CO; 10%). Asphyxia risk increased after exposure to PM2.5 in trimester one (48%) and whole pregnancy (84%), CO in trimester two and whole pregnancy (28-32%), and consistently for ozone (34%-73%). RDS risk was associated with increased concentrations of nitrogen oxides (33%-42%) and ozone (9%-21%) during all pregnancy windows. Inverse associations were observed with several pollutants, particularly sulfur dioxide. No interaction with maternal asthma was observed. Restriction to term births yielded similar results. CONCLUSIONS Several pollutants appear to increase neonatal respiratory outcome risks.
Collapse
Affiliation(s)
- Indulaxmi Seeni
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD
| | - Sandie Ha
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD; University of California, Merced, Social Sciences and Management Building, Merced, CA
| | - Carrie Nobles
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD
| | - Danping Liu
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Biostatistics Branch, Rockville, MD
| | | | - Pauline Mendola
- Eunice Kennedy Shriver National Institute of Child Health and Human Development, Division of Intramural Population Health Research, Bethesda, MD.
| |
Collapse
|
29
|
Wang Q, Zhang H, Liang Q, Knibbs LD, Ren M, Li C, Bao J, Wang S, He Y, Zhu L, Wang X, Zhao Q, Huang C. Effects of prenatal exposure to air pollution on preeclampsia in Shenzhen, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 237:18-27. [PMID: 29466771 DOI: 10.1016/j.envpol.2018.02.010] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Revised: 02/01/2018] [Accepted: 02/05/2018] [Indexed: 05/05/2023]
Abstract
The impact of ambient air pollution on pregnant women is a concern in China. However, little is known about the association between air pollution and preeclampsia and the potential modifying effects of meteorological conditions have not been assessed. This study aimed to assess the effects of prenatal exposure to air pollution on preeclampsia, and to explore whether temperature and humidity modify the effects. We performed a retrospective cohort study based on 1.21 million singleton births from the birth registration system in Shenzhen, China, between 2005 and 2012. Daily average measurements of particulate matter <10 μm (PM10), sulfur dioxide (SO2), nitrogen dioxide (NO2), air temperature (T), and dew point (Td) were collected. Logistic regression models were performed to estimate associations between air pollution and preeclampsia during the first and second trimesters, and during the entire pregnancy. In each time window, we observed a positive gradient of increasing preeclampsia risk with increasing quartiles of PM10 and SO2 exposure. When stratified by T and Td in three categories (<5th, 5th -95th, and >95th percentile), we found a significant interaction between PM10 and Td on preeclampsia; the adverse effects of PM10 increased with Td. During the entire pregnancy, there was a null association between PM10 and preeclampsia under Td < 5th percentile. Preeclampsia risk increased by 23% (95% CI: 19-26%) when 5th < Td < 95th percentile, and by 34% (16-55%) when Td > 95th percentile. We also found that air pollution effects on preeclampsia in autumn/winter seasons were stronger than those in the spring/summer. This is the first study to address modifying effects of meteorological factors on the association between air pollution and preeclampsia. Findings indicate that prenatal exposure to PM10 and SO2 increase preeclampsia risk in Shenzhen, China, and the effects could be modified by humidity. Pregnant women should limit air pollution exposure, particularly during humid periods.
Collapse
Affiliation(s)
- Qiong Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Huanhuan Zhang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Qianhong Liang
- Department of Ultrasound, Panyu Maternal and Child Care Service Center of Guangzhou, China
| | - Luke D Knibbs
- School of Public Health, The University of Queensland, Herston, Australia
| | - Meng Ren
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Changchang Li
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Junzhe Bao
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Suhan Wang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Yiling He
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Lei Zhu
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China
| | - Xuemei Wang
- Institute of Environmental and Climate Research, Jinan University, China
| | - Qingguo Zhao
- Family Planning Research Institute of Guangdong Province, China; Family Planning Special Hospital of Guangdong Province, China.
| | - Cunrui Huang
- Department of Health Policy and Management, School of Public Health, Sun Yat-sen University, China; Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, School of Public Health, Sun Yat-sen University, China.
| |
Collapse
|
30
|
Schinasi LH, Auchincloss AH, Forrest CB, Diez Roux AV. Using electronic health record data for environmental and place based population health research: a systematic review. Ann Epidemiol 2018; 28:493-502. [PMID: 29628285 DOI: 10.1016/j.annepidem.2018.03.008] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 03/13/2018] [Accepted: 03/16/2018] [Indexed: 12/21/2022]
Abstract
PURPOSE We conducted a systematic review of literature published on January 2000-May 2017 that spatially linked electronic health record (EHR) data with environmental information for population health research. METHODS We abstracted information on the environmental and health outcome variables and the methods and data sources used. RESULTS The automated search yielded 669 articles; 128 articles are included in the full review. The number of articles increased by publication year; the majority (80%) were from the United States, and the mean sample size was approximately 160,000. Most articles used cross-sectional (44%) or longitudinal (40%) designs. Common outcomes were health care utilization (32%), cardiometabolic conditions/obesity (23%), and asthma/respiratory conditions (10%). Common environmental variables were sociodemographic measures (42%), proximity to medical facilities (15%), and built environment and land use (13%). The most common spatial identifiers were administrative units (59%), such as census tracts. Residential addresses were also commonly used to assign point locations, or to calculate distances or buffer areas. CONCLUSIONS Future research should include more detailed descriptions of methods used to geocode addresses, focus on a broader array of health outcomes, and describe linkage methods. Studies should also explore using longitudinal residential address histories to evaluate associations between time-varying environmental variables and health outcomes.
Collapse
Affiliation(s)
- Leah H Schinasi
- Department of Environmental and Occupational Health, Dornsife School of Public Health, Drexel University, Philadelphia, PA; Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
| | - Amy H Auchincloss
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| | | | - Ana V Diez Roux
- Urban Health Collaborative, Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA; Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA
| |
Collapse
|
31
|
Koman PD, Hogan KA, Sampson N, Mandell R, Coombe CM, Tetteh MM, Hill-Ashford YR, Wilkins D, Zlatnik MG, Loch-Caruso R, Schulz AJ, Woodruff TJ. Examining Joint Effects of Air Pollution Exposure and Social Determinants of Health in Defining "At-Risk" Populations Under the Clean Air Act: Susceptibility of Pregnant Women to Hypertensive Disorders of Pregnancy. WORLD MEDICAL & HEALTH POLICY 2018; 10:7-54. [PMID: 30197817 PMCID: PMC6126379 DOI: 10.1002/wmh3.257] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Pregnant women are uniquely susceptible to adverse effects of air pollution exposure due to vulnerabilities and health consequences during pregnancy (e.g., hypertensive disorders of pregnancy [HDP]) compared to the general population. Because the Clean Air Act (CAA) creates a duty to protect at-risk groups, the regulatory assessment of at-risk populations has both policy and scientific foundations. Previously, pregnant women have not been specially protected in establishing the margin of safety for the ozone and particulate matter (PM) standards. Due to physiological changes, pregnant women can be at greater risk of adverse effects of air pollution and should be considered an at-risk population. Women with preexisting conditions, women experiencing poverty, and groups that suffer systematic discrimination may be particularly susceptible to cardiac effects of air pollutants during pregnancy. We rigorously reviewed 11 studies of over 1.3 million pregnant women in the United States to characterize the relationship between ozone or PM exposure and HDP. Findings were generally mixed, with a few studies reporting a joint association between ozone or PM and social determinants or pre-existing chronic health conditions related to HDP. Adequate evidence associates exposure to PM with an adverse effect of HDP among pregnant women not evident among non-gravid populations.
Collapse
Affiliation(s)
- Patricia D Koman
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan
| | - Kelly A Hogan
- University of Michigan School of Public Health, Environmental Health Sciences Department in Ann Arbor, Michigan, and presently a research fellow in the Department of Biochemistry and Molecular Biology and the Robert and Arlene Kogod Center on Aging at Mayo Clinic, Rochester, Minnesota
| | - Natalie Sampson
- University of Michigan-Dearborn, Department of Health & Human Services in Dearborn, Michigan
| | - Rebecca Mandell
- Arbor Research Collaborative for Health in Ann Arbor, Michigan
| | - Chris M Coombe
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | - Myra M Tetteh
- University of Michigan School of Public Health, Department of Health Behavior & Health Education in Ann Arbor, Michigan
| | | | | | - Marya G Zlatnik
- University of California San Francisco, Department of Obstetrics, Gynecology and Reproductive Sciences in San Francisco, California
| | - Rita Loch-Caruso
- University of Michigan School of Public Health, Environmental Health Sciences Department and director of the Michigan Center on Lifestage Environmental Exposures and Disease and director of the Environmental Toxicology and Epidemiology Program in Ann Arbor, Michigan
| | - Amy J Schulz
- Department of Health Behavior and Health Education, associate director for the Center for Research on Ethnicity, Culture and Health, and co-lead for the Community Engagement Core for the Michigan Center on Lifestage Environmental Exposures and Disease at the University of Michigan School of Public Health
| | - Tracey J Woodruff
- University of California, San Francisco in the Department of Obstetrics, Gynecology, and Reproductive Sciences and Philip R. Lee Institute for Health Policy Studies and the director of the Program on Reproductive Health and the Environment in San Francisco, California
| |
Collapse
|
32
|
Rosen EM, Muñoz MI, McElrath T, Cantonwine DE, Ferguson KK. Environmental contaminants and preeclampsia: a systematic literature review. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART B, CRITICAL REVIEWS 2018; 21:291-319. [PMID: 30582407 PMCID: PMC6374047 DOI: 10.1080/10937404.2018.1554515] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
Preeclampsia is a medical condition specific to pregnancy characterized by high blood pressure and protein in the woman's urine, indicating kidney damage. It is one of the most serious reproductive conditions, posing substantial risks to the baby and potentially fatal for the mother. The causes of preeclampsia are largely unknown and environmental contaminants merit further investigation. The aim of this review was to determine the association between environmental chemical exposures and preeclampsia. PubMed was searched for articles examining a priori chemical exposures and preeclampsia through April 2018. Studies were included in our review if they included at least 10 cases, evaluated preeclampsia independent of gestational hypertension, and used either measured or modeled exposure assessments. Our review contained 28 investigations examining persistent organic pollutants (POP) (6 studies), drinking water contaminants (1 study), atmospheric pollutants (11 studies), metals and metalloids (6 studies), and other environmental contaminants (4 studies). There were an insufficient number of investigations on most chemicals to draw definitive conclusions, but strong evidence existed for an association between preeclampsia and cadmium (Cd). There is suggestive evidence for associations between nitrogen dioxide (NO2), particulate matter (PM)2.5, and traffic exposure with preeclampsia. There is evidence for an association between preeclampsia and Cd but insufficient literature to evaluate many other environmental chemicals. Additional studies using repeated measures, appropriate biological matrices, and mixtures methods are needed to expand this area of research and address the limitations of previous studies.
Collapse
Affiliation(s)
- Emma M Rosen
- a Epidemiology Branch , National Institute of Environmental Health Sciences, Research Triangle Park , NC , USA
| | - Mg Isabel Muñoz
- a Epidemiology Branch , National Institute of Environmental Health Sciences, Research Triangle Park , NC , USA
| | - Thomas McElrath
- b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Brigham and Women's Hospital , Boston , MA , USA
| | - David E Cantonwine
- b Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology , Brigham and Women's Hospital , Boston , MA , USA
| | - Kelly K Ferguson
- a Epidemiology Branch , National Institute of Environmental Health Sciences, Research Triangle Park , NC , USA
| |
Collapse
|
33
|
Manzano-Salgado CB, Casas M, Lopez-Espinosa MJ, Ballester F, Iñiguez C, Martinez D, Romaguera D, Fernández-Barrés S, Santa-Marina L, Basterretxea M, Schettgen T, Valvi D, Vioque J, Sunyer J, Vrijheid M. Prenatal Exposure to Perfluoroalkyl Substances and Cardiometabolic Risk in Children from the Spanish INMA Birth Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:097018. [PMID: 28934720 PMCID: PMC5915205 DOI: 10.1289/ehp1330] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 07/13/2017] [Accepted: 07/21/2017] [Indexed: 05/04/2023]
Abstract
BACKGROUND Perfluoroalkyl substances (PFAS) may affect body mass index (BMI) and other components of cardiometabolic (CM) risk during childhood, but evidence is scarce and inconsistent. OBJECTIVES We estimated associations between prenatal PFAS exposures and outcomes relevant to cardiometabolic risk, including a composite CM-risk score. METHODS We measured perfluorohexanesulfonic acid (PFHxS), perfluorooctanesulfonic acid (PFOS), perfluorooctanoic acid (PFOA), and perfluorononanoic acid (PFNA) in maternal plasma (first trimester). We assessed weight gain from birth until 6 mo. At 4 and 7 y, we calculated the age- and sex-specific z-scores for BMI, waist circumference (WC), and blood pressure (BP) (n≈1,000). At age 4, we calculated the age-, sex-, and region-specific z-scores for cholesterol, triglycerides (TGs), high-density (HDL-C), and low-density lipoprotein cholesterol (LDL-C) (n=627). At age 4, we calculated a CM-risk score (n=386) as the sum of the individual age-, sex-, and region-specific z-scores for WC, BP, HDL-C, and TGs. We used the average between the negative of HDL-C z-score and TGs z-score to give similar weight to lipids and the other components in the score. A higher score indicates a higher cardiometabolic risk at age 4. RESULTS PFOS and PFOA were the most abundant PFAS (geometric mean: 5.80 and 2.32 ng/mL, respectively). In general, prenatal PFAS concentrations were not associated with individual outcomes or the combined CM-risk score. Exceptions were positive associations between prenatal PFHxS and TGs z-score [for a doubling of exposure, β=0.11; 95% confidence interval (CI): 0.01, 0.21], and between PFNA and the CM-risk score (β=0.60; 95% CI: 0.04, 1.16). There was not clear or consistent evidence of modification by sex. CONCLUSIONS We observed little or no evidence of associations between low prenatal PFAS exposures and outcomes related to cardiometabolic risk in a cohort of Spanish children followed from birth until 7 y. https://doi.org/10.1289/EHP1330.
Collapse
Affiliation(s)
- Cyntia B Manzano-Salgado
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| | - Maribel Casas
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| | - Maria-Jose Lopez-Espinosa
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València , Valencia, Spain
| | - Ferran Ballester
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València , Valencia, Spain
| | - Carmen Iñiguez
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat Jaume I-Universitat de València , Valencia, Spain
| | - David Martinez
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| | - Dora Romaguera
- Health Research Institute of Palma (IdISPa), University Hospital Son Espases , Palma de Mallorca, Spain
- Spanish Consortium for Research on Obesity and Nutrition (CIBEROBN) , Madrid, Spain
| | - Silvia Fernández-Barrés
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| | - Loreto Santa-Marina
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Public Health Department of Gipuzkoa, San Sebastián, Spain
- Health Research Institute BIODONOSTIA , San Sebastián, Spain
| | - Mikel Basterretxea
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Public Health Department of Gipuzkoa, San Sebastián, Spain
- Health Research Institute BIODONOSTIA , San Sebastián, Spain
| | - Thomas Schettgen
- Institute for Occupational Medicine, RWTH Aachen University , Aachen, Germany
| | - Damaskini Valvi
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jesus Vioque
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Miguel Hernandez University , San Juan de Alicante, Spain
| | - Jordi Sunyer
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| | - Martine Vrijheid
- ISGlobal, Centre for Research in Environmental Epidemiology (CREAL) , Barcelona, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP) , Madrid, Spain
- Universitat Pompeu Fabra , Barcelona, Spain
| |
Collapse
|
34
|
Bonham CA, Patterson KC, Strek ME. Asthma Outcomes and Management During Pregnancy. Chest 2017; 153:515-527. [PMID: 28867295 DOI: 10.1016/j.chest.2017.08.029] [Citation(s) in RCA: 59] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 07/26/2017] [Accepted: 08/21/2017] [Indexed: 01/15/2023] Open
Abstract
Asthma during pregnancy poses a common, increasingly prevalent threat to the health of women and their children. The present article reviews recent insights gained from the epidemiology of asthma during pregnancy, demonstrating the many short- and long-term risks to mother and fetus incurred by poorly controlled maternal asthma. We further discuss emerging evidence that active management of asthma during pregnancy can positively influence and perhaps completely mitigate these poor outcomes. Recent high-quality trials examining best methods for asthma treatment are reviewed and synthesized to offer an evidence-based pathway for comprehensive treatment of asthma in the outpatient setting. Safe and effective medications, as well as nonpharmacologic interventions, for asthma during pregnancy are discussed, and treatment options for related conditions of pregnancy, including depression, rhinitis, and gastroesophageal reflux, are presented. Throughout, we emphasize that an effective treatment strategy relies on a detailed patient evaluation, patient education, objective measurement of asthma control, and frequent and supportive follow-up. The cardiovascular and respiratory physiology of pregnancy is reviewed, as well as its implications for the management of patients with asthma, including patients requiring intubation and mechanical ventilation. For the situation when outpatient asthma management has failed, an approach to the critically ill pregnant patient with status asthmaticus is detailed. Multidisciplinary teams that include pulmonary specialists, obstetricians, primary care providers, nurses, pharmacists, and asthma educators improve the care of pregnant women with asthma.
Collapse
Affiliation(s)
- Catherine A Bonham
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL.
| | - Karen C Patterson
- Division of Pulmonary, Allergy and Critical Care Medicine, University of Pennsylvania, Philadelphia, PA; Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Mary E Strek
- Section of Pulmonary and Critical Care Medicine, University of Chicago, Chicago, IL
| |
Collapse
|
35
|
Zhu Y, Zhang C, Liu D, Ha S, Kim SS, Pollack A, Mendola P. Ambient Air Pollution and Risk of Gestational Hypertension. Am J Epidemiol 2017; 186:334-343. [PMID: 28472208 PMCID: PMC5860464 DOI: 10.1093/aje/kwx097] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/07/2016] [Accepted: 09/08/2016] [Indexed: 12/28/2022] Open
Abstract
Air pollution has been linked to hypertension in the general population, but data on gestational hypertension (GH) are limited. We investigated criteria air pollutants and air toxics during the period before conception and in early gestation in relation to GH risk in the Consortium on Safe Labor/Air Quality and Reproductive Health Study (United States, 2002-2008). Modified Community Multi-scale Air Quality models estimated air pollution exposures for 6,074 singleton pregnancies in which GH was present and 199,980 normotensive pregnancies. Generalized estimating equations estimated relative risks per interquartile-range increment for pollutants and high exposure (≥75th percentile) for air toxics after adjustment for major risk factors. For an interquartile-range increment, GH risk was significantly increased by 18% for sulfur dioxide during the 3 months before conception and, during gestational weeks 1-20, 17% for nitrogen oxides, 10% for particulate matter with an aerodynamic diameter <2.5 μm, 7% for particulate matter with an aerodynamic diameter <10 μm, and 22% for sulfur dioxide. High exposures to several polycyclic aromatic hydrocarbons before conception and during the first trimester were significantly associated with 8%-20% higher risk of GH. Further, preconceptional exposures to several volatile organic compounds were significantly associated with 11%-19% higher risk. Our findings suggest that early exposures to criteria air pollutants, particularly from transport emissions, and high exposure to several air toxics before conception may increase GH risk.
Collapse
Affiliation(s)
| | | | | | | | | | | | - Pauline Mendola
- Correspondence to Dr. Pauline Mendola, Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Boulevard, Room 7B03F, Rockville, MD 20852 (e-mail: )
| |
Collapse
|
36
|
Chronic and Acute Ozone Exposure in the Week Prior to Delivery Is Associated with the Risk of Stillbirth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2017; 14:ijerph14070731. [PMID: 28684711 PMCID: PMC5551169 DOI: 10.3390/ijerph14070731] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Revised: 06/26/2017] [Accepted: 06/29/2017] [Indexed: 01/06/2023]
Abstract
Chronic and acute air pollution has been studied in relation to stillbirth with inconsistent findings. We examined stillbirth risk in a retrospective cohort of 223,375 singleton deliveries from 12 clinical sites across the United States. Average criteria air pollutant exposure was calculated using modified Community Multiscale Air Quality models for the day of delivery and each of the seven days prior, whole pregnancy, and first trimester. Poisson regression models using generalized estimating equations estimated the relative risk (RR) of stillbirth and 95% confidence intervals (CI) in relation to an interquartile range increase in pollutant with adjustment for temperature, clinical, and demographic factors. Ozone (O3) was associated with a 13–22% increased risk of stillbirth on days 2, 3, and 5–7 prior to delivery in single pollutant models, and these findings persisted in multi-pollutant models for days 5 (RR = 1.22, CI = 1.07–1.38) and 6 (RR = 1.18, CI = 1.04–1.33). Whole pregnancy and first trimester O3 increased risk 18–39% in single pollutant models. Maternal asthma increased stillbirth risk associated with chronic PM2.5 and carbon monoxide exposures. Both chronic and acute O3 exposure consistently increased stillbirth risk, while the role of other pollutants varied. Approximately 8000 stillbirths per year in the US may be attributable to O3 exposure.
Collapse
|
37
|
Westergaard N, Gehring U, Slama R, Pedersen M. Ambient air pollution and low birth weight - are some women more vulnerable than others? ENVIRONMENT INTERNATIONAL 2017; 104:146-154. [PMID: 28390661 DOI: 10.1016/j.envint.2017.03.026] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2017] [Revised: 03/21/2017] [Accepted: 03/31/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND AND OBJECTIVES Ambient air pollution is controllable, and it is one of the greatest environmental threats to human health. Studies conducted worldwide have provided evidence that maternal exposure to ambient air pollution during pregnancy enhances the risk of low birth weight at term (TLBW, <2500g among infants born ≥37 completed weeks of gestation), a maker of intrauterine growth restriction (IUGR), and suggest that some subgroups of pregnant women who are smoking, of low or high body-mass index (BMI), low socioeconomic status (SES) or asthma are more vulnerable towards the effect of ambient air pollution. The aim of this commentary is to review the published literature on the association between ambient air pollution and TLBW regarding increased vulnerability for the above-mentioned subgroups. RESULTS Although more than fifty epidemiological studies have examined the associations between ambient air pollution and TLBW to date, we only identified six studies that examined the potential effect modification of the association between ambient air pollution and TLBW by the above listed maternal risk factors. Two studies assessed effect modification caused by smoking on the association between ambient air pollution and TLBW. The adjusted odds ratio (OR) for TLBW associated with exposure to ambient air pollution were in one study higher among women who smoked during pregnancy, as compared to the OR of non-smoking women, while in the other study the association was in the opposite direction. The association of ambient air pollution and TLBW were higher among women characterized by extreme BMI (two studies) and low SES compared to non-obese women or women of higher SES (four studies), respectively. Only one study reported the estimated effects among asthmatic and non-asthmatic women and no statistically significant effect modification was evident for the risk of TLBW associated with ambient air pollution. CONCLUSION AND RECOMMENDATIONS The current epidemiologic evidence is scarce, but suggests that pregnant women who are smoking, being underweight, overweight/obese or having lower SES are a vulnerable subpopulation when exposed to ambient air pollution, with and increased risk of having a child with TLBW. The limited evidence precludes for definitive conclusions and further studies are recommended.
Collapse
Affiliation(s)
- Nadja Westergaard
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Ulrike Gehring
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, The Netherlands
| | - Rémy Slama
- INSERM/Centre National de la Recherche Scientifique (CNRS), Université Grenoble Alpes Joint Research Center, Grenoble, France
| | - Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Copenhagen, Denmark; Danish Cancer Society Research Center, Copenhagen, Denmark.
| |
Collapse
|
38
|
Ferguson KK, McElrath TF, Pace GG, Weller D, Zeng L, Pennathur S, Cantonwine DE, Meeker JD. Urinary Polycyclic Aromatic Hydrocarbon Metabolite Associations with Biomarkers of Inflammation, Angiogenesis, and Oxidative Stress in Pregnant Women. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2017; 51:4652-4660. [PMID: 28306249 PMCID: PMC5771235 DOI: 10.1021/acs.est.7b01252] [Citation(s) in RCA: 70] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Environmental exposure to polycyclic aromatic hydrocarbons (PAHs) is prevalent and may adversely impact pregnancy and development of the fetus. The purpose of this exploratory study was to examine urinary PAH metabolites in potential association with mediators of these outcomes. To do so, we measured a panel of 12 inflammatory, angiogenic, and oxidative stress biomarkers in plasma or urine from women in their third trimester of pregnancy (n = 200). Urinary PAH metabolites were highly detectable (>88%) in the study population, and most were higher in women who had lower education levels, higher body mass index, and who were African-American. Some PAH metabolites showed consistent positive associations with the plasma inflammation marker C-reactive protein (CRP) and the urinary oxidative stress markers 8-hydroxydeoxyguanosine (8-OHdG) and 8-isoprostane. For example, an interquartile range increase in 2-hydroxynapthalene was associated with a 35% increase in CRP (95% confidence interval = -0.13, 83.2), a 14% increase in 8-OHdG (95% confidence interval =0.59, 30.1), and a 48% increase in 8-isoprostane (95% confidence interval =16.7, 87.0). These data suggest that exposure to PAHs may cause systemic changes during pregnancy that could lead to adverse pregnancy or developmental outcomes; however, these results should be corroborated in a larger study population.
Collapse
Affiliation(s)
- Kelly K. Ferguson
- Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, 27709, USA
| | - Thomas F. McElrath
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | | | - David Weller
- NSF International, Ann Arbor, Michigan, 48105, USA
| | - Lixia Zeng
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - Subramaniam Pennathur
- Division of Nephrology, Department of Medicine, University of Michigan, Ann Arbor, Michigan, 48109, USA
| | - David E. Cantonwine
- Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, 02115, USA
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, Michigan, 48109, USA
| |
Collapse
|