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Okui T, Nakashima N. Effects of ambient air pollution on the risk of small- and large-for-gestational-age births: an analysis using national birth data in Japan. Int Arch Occup Environ Health 2024; 97:545-555. [PMID: 38602525 DOI: 10.1007/s00420-024-02063-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/28/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Small-for-gestational-age (SGA) and large-for-gestational-age (LGA) births are major adverse birth outcomes related to newborn health. In contrast, the association between ambient air pollution levels and SGA or LGA births has not been investigated in Japan; hence, the purpose of our study is to investigate this association. METHODS We used birth data from Vital Statistics in Japan from 2017 to 2021 and municipality-level data on air pollutants, including nitrogen dioxide (NO2), sulfur dioxide (SO2), photochemical oxidants, and particulate matter 2.5 (PM2.5). Ambient air pollution levels throughout the first, second, and third trimesters, as well as the whole pregnancy, were calculated for each birth. The association between SGA/LGA and ambient levels of the air pollutants was investigated using crude and adjusted log-binomial regression models. In addition, a regression model with spline functions was also used to detect the non-linear association. RESULTS We analyzed data from 2,434,217 births. Adjusted regression analyses revealed statistically significant and positive associations between SGA birth and SO2 level, regardless of the exposure period. Specifically, the risk ratio for average SO2 values throughout the whole pregnancy was 1.014 (95% confidence interval [CI] 1.009, 1.019) per 1 ppb increase. In addition, regression analysis with spline functions indicated that an increase in risk ratio for SGA birth depending on SO2 level was linear. Furthermore, statistically significant and negative associations were observed between LGA birth and SO2 except for the third trimester. CONCLUSIONS It was suggested that ambient level of SO2 during the pregnancy term is a risk factor for SGA birth in Japan.
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Affiliation(s)
- Tasuku Okui
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan.
| | - Naoki Nakashima
- Medical Information Center, Kyushu University Hospital, Maidashi 3-1-1 Higashi-ku, Fukuoka City , Fukuoka prefecture, 812-8582, Japan
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2
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Niu Z, Habre R, Yang T, Chen X, Vigil M, Barragan K, Lurmann F, Pavlovic NR, Grubbs BH, Toledo-Corral CM, Johnston J, Dunton GF, Lerner D, Lurvey N, Al-Marayati L, Eckel SP, Breton CV, Bastain TM, Farzan SF. Increased Risk of Gestational Hypertension by Periconceptional Exposure to Ambient Air Pollution and Effect Modification by Prenatal Depression. Hypertension 2024; 81:1285-1295. [PMID: 38533642 PMCID: PMC11096032 DOI: 10.1161/hypertensionaha.123.22272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 03/17/2024] [Indexed: 03/28/2024]
Abstract
BACKGROUND Air pollution has been associated with gestational hypertension (GH) and preeclampsia, but susceptible windows of exposure and potential vulnerability by comorbidities, such as prenatal depression, remain unclear. METHODS We ascertained GH and preeclampsia cases in a prospective pregnancy cohort in Los Angeles, CA. Daily levels of ambient particulate matters (with a diameter of ≤10 μm [PM10] or ≤2.5 μm [PM2.5]), nitrogen dioxide, and ozone were averaged for each week from 12 weeks preconception to 20 gestational weeks. We used distributed lag models to identify susceptible exposure windows, adjusting for potential confounders. Analyses were additionally stratified by probable prenatal depression to explore population vulnerability. RESULTS Among 619 participants, 60 developed preeclampsia and 42 developed GH. We identified a susceptible window for exposure to PM2.5 from 1 week preconception to 11 weeks postconception: higher exposure (5 µg/m3) within this window was associated with an average of 8% (95% CI, 1%-15%) higher risk of GH. Among participants with probable prenatal depression (n=179; 32%), overlapping sensitive windows were observed for all pollutants from 8 weeks before to 10 weeks postconception with increased risk of GH (PM2.5, 16% [95% CI, 3%-31%]; PM10, 39% [95% CI, 13%-72%]; nitrogen dioxide, 65% [95% CI, 17%-134%]; and ozone, 45% [95% CI, 9%-93%]), while the associations were close to null among those without prenatal depression. Air pollutants were not associated with preeclampsia in any analyses. CONCLUSIONS We identified periconception through early pregnancy as a susceptible window of air pollution exposure with an increased risk of GH. Prenatal depression increases vulnerability to air pollution exposure and GH.
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Affiliation(s)
- Zhongzheng Niu
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Xinci Chen
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Mario Vigil
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Karina Barragan
- Department of Health Sciences, California State University, Northridge (K.B., C.M.T.-C.)
| | - Fred Lurmann
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
- Sonoma Technology, Inc, Petaluma, CA (F.L., N.R.P.)
| | | | - Brendan H Grubbs
- Department of Obstetrics and Gynecology (B.H.G., L.A.-M.), University of Southern California, Los Angeles
| | - Claudia M Toledo-Corral
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
- Department of Health Sciences, California State University, Northridge (K.B., C.M.T.-C.)
| | - Jill Johnston
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Genevieve F Dunton
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | | | | | - Laila Al-Marayati
- Department of Obstetrics and Gynecology (B.H.G., L.A.-M.), University of Southern California, Los Angeles
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles
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3
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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.
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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
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4
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He XB, Zhou K, Hussain J, Akhtar R. Public perceptions of air pollution and its impacts on fertility desire: a nationwide study in China. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024; 68:445-459. [PMID: 38127126 DOI: 10.1007/s00484-023-02603-3] [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: 05/18/2023] [Revised: 08/02/2023] [Accepted: 12/11/2023] [Indexed: 12/23/2023]
Abstract
Over the past few years, there has been a significant focus on air pollution due to its various detrimental effects on human health. However, its influence on people's tendency to have children remains uncertain, as only a few studies have examined the correlation between public perception of air pollution and the desire to start a family. This article introduces a theoretical framework utilizing a two-stage interval iteration model to explore the connection between children's relative utility and the perception of air pollution. Data for this study were gathered from the "Chinese General Social Survey" (CGSS 2013). The CGSS 2013 project employed a four-stage stratified random sampling technique and conducted household interviews using questionnaires. The sample covered 28 provincial-level cities across China. The hypothesis was tested using a Probit regression model. The findings indicate that individuals considering air pollution a significant issue are 8.62% less likely to have more than one child. The variation in fertility desire sensitivity to air pollution points to heterogeneity among residents, such as registered residents and those living in various residential areas, as well as individuals with different characteristics like education levels. The study concludes that air quality significantly influences human fertility desire, highlighting the urgent necessity to raise awareness of environmental protection issues among both the public and authorities. In particular, there are two key steps to address this issue. Firstly, the government should establish clear air pollution control objectives and refine policies to enhance governance efficiency. Secondly, there is a need to encourage environmentally friendly behaviours among the public, promote more significant involvement in public environmental matters, and ensure effective oversight of the government's responsibilities in managing air pollution.
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Affiliation(s)
- Xing Bang He
- Southwest Petroleum University, No. 8, Xindu Road, Xindu District, Chengdu, 610500, China
| | - Kui Zhou
- School of Economics, Southwestern University of Finance and Economics, 55, Guanghuacun Street, Chengdu, 611130, China.
| | - Jamal Hussain
- School of Economics, Southwestern University of Finance and Economics, 55, Guanghuacun Street, Chengdu, 611130, China.
- Department of Economics, University of Religions and Denominations, Qom, Iran.
- Department of Economics, Karakoram International University, Gilgit, Pakistan.
| | - Rizwan Akhtar
- Department of Economics, Karakoram International University, Gilgit, Pakistan
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5
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Kumari U, Sharma RK, Keshari JR, Sinha A. Environmental Exposure: Effect on Maternal Morbidity and Mortality and Neonatal Health. Cureus 2023; 15:e38548. [PMID: 37273345 PMCID: PMC10239284 DOI: 10.7759/cureus.38548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/27/2023] [Indexed: 06/06/2023] Open
Abstract
Environmental factors are important causes that impair global pregnancy outcomes and are, importantly, responsible for maternal morbidity and mortality. However, apart from the direct reasons for maternal deaths, mainly obstetric and neonatal complications, such factors are ignored or given less importance. The recent surge in research on the impact of various environmental factors on pregnancy outcomes suggests the need for immediate attention to such factors and device-specific policies to counter the situation. Moreover, the recent coronavirus disease of 2019 (COVID-19) pandemic, global warming, and climate change showed a lack of preparedness to counter the impact of such events on maternal survival and safe and successful pregnancy outcomes. In the present review, we have emphasized the specific factors responsible for increased maternal and neonatal deaths and their association with specific environmental factors. Increased attention on maternal healthcare, preparedness to counter sudden environmental challenges and improvement of the conventional requirement for better maternal healthcare access and nutrition at a global level may improve the scenario.
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Affiliation(s)
- Usha Kumari
- Biochemistry, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | | | - J R Keshari
- Biochemistery, Indira Gandhi Institute of Medical Sciences, Patna, IND
| | - Archana Sinha
- Obstetrics and Gynaecology, Indira Gandhi Institute of Medical Sciences, Patna, IND
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6
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Yuan Z, Li Q, Su T, Yang J, Chen J, Peng Y, Zhou S, Bao H, Luo S, Wang H, Liu J, Han N, Guo Y, Ji Y, Wang HJ. Effects of fine ambient particulate matters on de novo hypertensive disorders of pregnancy and blood pressure before 20 weeks. ENVIRONMENTAL RESEARCH 2023; 218:115023. [PMID: 36502896 DOI: 10.1016/j.envres.2022.115023] [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: 10/08/2022] [Revised: 11/13/2022] [Accepted: 12/07/2022] [Indexed: 06/17/2023]
Abstract
The effects of fine particulate matter (PM) on de novo hypertensive disorders of pregnancy (HDP) were inconsistent during the first and second trimesters. This study aimed to assess the trimester-specific effects of PM2.5 and PM1 prior to diagnosis of de novo HDP. The exposure of fine PM was predicted by satellite remote sensing data according to maternal residential addresses. De novo HDP was defined as gestational hypertension and preeclampsia during the current pregnancy. A logistic regression model was performed to assess the association of PM2.5 and PM1 with HDP during the first and early second trimesters (0-13 weeks and 14-20 weeks). The generalized estimating equation model was conducted to assess the effect of PM2.5 and PM1 on blood pressure. The present study included 22,821 pregnant women (mean age, 29.1 years) from 2013 to 2017. PM2.5 and PM1 were significantly associated with an increased risk of de novo HDP during the first trimester (OR = 1.070, 95% CI: 1.013-1.130; OR = 1.264, 95% CI: 1.058-1.511 for per 10 μg/m3) and early second trimester (OR = 1.045, 95% CI: 1.003-1.088; OR = 1.170, 95% CI: 1.002-1.366 for per 10 μg/m3). Significant trends of increased de novo HDP risk was also observed with the increment of PM (all P for trend <0.05). The stratified analyses demonstrated that the associations between exposure to fine PM and the risk of HDP were more pronounced among the pregnant women with maternal age above 35 and low maternal education level (all OR >1.047). Each 10 μg/m3 increase of PM1 and PM2.5 before diagnosis of de novo HDP elevated 0.204 (95% CI: 0.098-0.310) and 0.058 (95%CI: 0.033-0.083) mmHg of systolic blood pressure. Exposure to PM2.5 and PM1 during the first and early second trimester were positively associated with the risk of de novo HDP. The fine PM before diagnosis of de novo HDP elevated the systolic blood pressure.
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Affiliation(s)
- Zhichao Yuan
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Tao Su
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Jie Yang
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Junjun Chen
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China; Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, 21218, United States
| | - Yuanzhou Peng
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Heling Bao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, 100191, China
| | - Na Han
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, 101101, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China.
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, 100191, China; National Health Commission Key Laboratory of Reproductive Health, Beijing, 100191, China.
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7
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Yuan Z, Wang HJ, Li Q, Su T, Yang J, Chen J, Peng Y, Zhou S, Bao H, Luo S, Wang H, Liu J, Han N, Guo Y, Ji Y. Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study. JMIR Public Health Surveill 2023; 9:e41442. [PMID: 36689262 PMCID: PMC9903185 DOI: 10.2196/41442] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 09/20/2022] [Accepted: 11/30/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Particulate matter (PM) is detrimental to the respiratory and circulatory systems. However, no study has evaluated the lag effects of weekly exposure to fine PM during the period from preconception to delivery on the risk of hypertensive disorders of pregnancy (HDPs). OBJECTIVE We set out to investigate the lag effect windows of PM on the risk of HDPs on a weekly scale. METHODS Data from women with de novo HDPs and normotensive pregnant women who were part of the Peking University Retrospective Birth Cohort, based on the hospital information system of Tongzhou district, were obtained for this study. Meteorological data and data on exposure to fine PM were predicted by satellite remote sensing data based on maternal residential address. The de novo HDP group consisted of pregnant women who were diagnosed with gestational hypertension or preeclampsia. Fine PM was defined as PM2.5 and PM1. The gestational stage of participants was from preconception (starting 12 weeks before gestation) to delivery (before the 42nd gestational week). A distributed-lag nonlinear model (DLNM) was nested in a Cox regression model to evaluate the lag effects of weekly PM exposure on de novo HDP hazard by controlling the nonlinear relationship of exposure-reaction. Stratified analyses by employment status (employed or unemployed), education level (higher or lower), and parity (primiparity or multiparity) were performed. RESULTS A total of 22,570 pregnant women (mean age 29.1 years) for whom data were available between 2013 and 2017 were included in this study. The prevalence of de novo HDPs was 6.7% (1520/22,570). Our findings showed that PM1 and PM2.5 were significantly associated with an elevated hazard of HDPs. Exposure to PM1 during the 5th week before gestation to the 6th gestational week increased the hazard of HDPs. A significant lag effect of PM2.5 was observed from the 1st week before gestation to the 6th gestational week. The strongest lag effects of PM1 and PM2.5 on de novo HDPs were observed at week 2 and week 6 (hazard ratio [HR] 1.024, 95% CI 1.007-1.042; HR 1.007, 95% CI 1.000-1.015, respectively, per 10 μg/m3 increase). The stratified analyses indicated that pregnant women who were employed, had low education, and were primiparous were more vulnerable to PM exposure for de novo HDPs. CONCLUSIONS Exposure to PM1 and PM2.5 was associated with the risk of de novo HDPs. There were significant lag windows between the preconception period and the first trimester. Women who were employed, had low education, and were primiparous were more vulnerable to the effects of PM exposure; more attention should be paid to these groups for early prevention of de novo HDPs.
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Affiliation(s)
- Zhichao Yuan
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Hai-Jun Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
- National Health Commission Key Laboratory of Reproductive Health, Beijing, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Tao Su
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China
| | - Jie Yang
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China
| | - Junjun Chen
- Department of Electrical and Computer Engineering, Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Yuanzhou Peng
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Shuang Zhou
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Heling Bao
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Shusheng Luo
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Hui Wang
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
| | - Jue Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Na Han
- Tongzhou Maternal and Child Health Care Hospital of Beijing, Beijing, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Yuelong Ji
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China
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Zheng S, Zhang X, Zhang L, Shi G, Liu Y, Lv K, Zhang D, Yin C, Bai Y, Zhang Y, Wang M. Effects of short-term exposure to gaseous pollutants on metabolic health indicators of patients with metabolic syndrome in Northwest China. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 249:114438. [PMID: 38321659 DOI: 10.1016/j.ecoenv.2022.114438] [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: 06/29/2022] [Revised: 12/11/2022] [Accepted: 12/12/2022] [Indexed: 02/08/2024]
Abstract
Currently few studies have explored the relationship between exposure to gaseous pollutants and metabolic health indicators in patients, especially in patients with metabolic syndrome (Mets). This study collected 15,520 patients with Mets in a prospective cohort of nearly 50,000 people with 7 years of follow-up from 2011 to 2017, and matched air pollutants and meteorological data during the same period. The mixed effects model was used to analyze the relationship between different short exposure windows (1-week, 1-month, 2-month, and 3-month) of gaseous pollutants (SO2, NO2, and O3) and the metabolic health indicators of patients after controlled the confounding factors. Stratified analysis was performed by demographic characteristics and behavioral factors. The effects of gaseous pollutants on patients with different Met components were also analyzed. The results showed that the short-term exposure to SO2, NO2, and O3 had a certain effect on the metabolic health indicators of patients with Mets in different exposure windows, and with the extension of the exposure window period, the effects increased. The stratified analysis showed that gender, age, and life behaviors might modify these detrimental effects. In addition, the effects of gaseous pollutants on metabolic health indicators in G4 and G7 were more obvious than other Met components, and the effects of gaseous pollutants on the level of LDL-C were found to be statistically significant in most components. Therefore, patients with Mets should pay more attention to the influence of gaseous pollutants to take appropriate protection to reduce potential health risk.
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Affiliation(s)
- Shan Zheng
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Xiaofei Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Li Zhang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Guoxiu Shi
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Yanli Liu
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Kang Lv
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Desheng Zhang
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang 737103, China
| | - Chun Yin
- Workers' Hospital of Jinchuan Group Co., Ltd., Jinchang 737103, China
| | - Yana Bai
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China
| | - Yaqun Zhang
- Gansu Academy of Eco-environmental Sciences, Lanzhou 730020, China.
| | - Minzhen Wang
- Institute of Epidemiology and Statistics, School of Public Health, Lanzhou University, Lanzhou 73000, China.
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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.
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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
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10
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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.
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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.
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11
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Gao J, Luo M, Zhao S, Wang H, Li X, Xu P, Ma W, Liu C. Effect of PM2.5 exposure on gestational hypertension, fetal size in preeclampsia-like rats. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:45808-45820. [PMID: 35152352 DOI: 10.1007/s11356-021-18233-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 12/16/2021] [Indexed: 06/14/2023]
Abstract
Studies have shown intriguing associations between gestational PM2.5 exposure and preeclampsia (PE), as well as fetal growth restriction (FGR). This study investigated the impact of PM2.5 exposure on gestational hypertension and fetal outcome in a preeclampsia-like rat model. Pregnant Sprague Dawley rats were exposed to either filtered (FA) or PM2.5-contaminated air during the whole pregnancy period. A PE-like rat model was established by intraperitoneal injection of L-NAME (300 mg/kg) from gestational day (GD) 12 to until GD20. Systolic blood pressure (SBP), weight gain, pup weight and placental weight were measured. The percentages of rat Treg/Th17 cells and Th17-related cytokines were examined by flow cytometry. Gene expression profiles were analyzed by microarray, and the expression of differentially expressed genes was validated by qRT-PCR. The results showed that maternal PM2.5 exposure had no effect on SBP but was associated with low birth weight (LBW) and a higher labyrinth/basal zone ratio. The percentages of splenic Th17 cells from the PM2.5 group of PE-like rats were higher than those from the FA or PM2.5 groups of healthy controls. A significantly decreased Treg/Th17 cell ratio was found in the PM2.5 group of PE-like rats. The mRNA expression of Foxp3 was downregulated, while the mRNA expression of RORα and RORγτ was upregulated after PM2.5 exposure. Furthermore, we observed that both the mRNA and protein levels of TNF-a, CCL2, CCL3 and CCR1 increased in the PM2.5 groups. Our study suggested that systemic inflammation may contribute to the development of FGR associated with PM2.5 exposure throughout pregnancy.
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Affiliation(s)
- Jie Gao
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Mei Luo
- Central Laboratory, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Shuo Zhao
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Hailing Wang
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Xuan Li
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Pili Xu
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Wei Ma
- Department of Obstetrics and Gynecology, Beijing Luhe Hospital, Capital Medical University, Beijing, China
| | - Chongdong Liu
- Department of Obstetrics and Gynecology, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
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12
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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.
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13
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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.
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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
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14
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Garcia M, Salazar R, Wilson T, Lucas S, Herbert G, Young T, Begay J, Denson JL, Zychowski K, Ashley R, Byrum S, Mackintosh S, Bleske BE, Ottens AK, Campen MJ. Early Gestational Exposure to Inhaled Ozone Impairs Maternal Uterine Artery and Cardiac Function. Toxicol Sci 2021; 179:121-134. [PMID: 33146391 DOI: 10.1093/toxsci/kfaa164] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Exposure to air pollutants such as ozone (O3) is associated with adverse pregnancy outcomes, including higher incidence of gestational hypertension, preeclampsia, and peripartum cardiomyopathy; however, the underlying mechanisms of this association remain unclear. We hypothesized that O3 exposures during early placental formation would lead to more adverse cardiovascular effects at term for exposed dams, as compared with late-term exposures. Pregnant Sprague Dawley rats were exposed (4 h) to either filtered air (FA) or O3 (0.3 or 1.0 ppm) at either gestational day (GD)10 or GD20, with longitudinal functional assessments and molecular endpoints conducted at term. Exposure at GD10 led to placental transcriptional changes at term that were consistent with markers in human preeclampsia, including reduced mmp10 and increased cd36, fzd1, and col1a1. O3 exposure, at both early and late gestation, induced a significant increase in maternal circulating soluble FMS-like tyrosine kinase-1 (sFlt-1), a known driver of preeclampsia. Otherwise, exposure to 0.3 ppm O3 at GD10 led to several late-stage cardiovascular outcomes in dams that were not evident in GD20-exposed dams, including elevated uterine artery resistance index and reduced cardiac output and stroke volume. GD10 O3 exposure proteomic profile in maternal hearts characterized by a reduction in proteins with essential roles in metabolism and mitochondrial function, whereas phosphoproteomic changes were consistent with pathways involved in cardiomyopathic responses. Thus, the developing placenta is an indirect target of inhaled O3 and systemic maternal cardiovascular abnormalities may be induced by O3 exposure at a specific window of gestation.
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Affiliation(s)
- Marcus Garcia
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Raul Salazar
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Thomas Wilson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Selita Lucas
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Guy Herbert
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Tamara Young
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jessica Begay
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jesse L Denson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Katherine Zychowski
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Ryan Ashley
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, New Mexico 88003
| | - Stephanie Byrum
- Arkansas Children's Research Institute, Little Rock, Arkansas 72202
| | - Samuel Mackintosh
- Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Barry E Bleske
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Andrew K Ottens
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia 23298-0709
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
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15
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Kim JH, Choi YY, Yoo SI, Kang DR. Association between ambient air pollution and high-risk pregnancy: A 2015-2018 national population-based cohort study in Korea. ENVIRONMENTAL RESEARCH 2021; 197:110965. [PMID: 33722528 DOI: 10.1016/j.envres.2021.110965] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 02/26/2021] [Accepted: 02/27/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Several studies have indicated that prenatal exposure to ambient air pollution is associated with an increased risk of gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth. However, no previous study has focused on the association between the number of pregnancy complications and exposure to ambient air pollution. OBJECTIVES To investigate the association between prenatal exposure to ambient air pollutants and the number of pregnancy complications in high-risk pregnancies. METHODS We collected data on gestational diabetes mellitus, hypertensive disorder during pregnancy, preterm birth, and stillbirth from the National Health Information Databases, provided by the Korean National Health Insurance Service.R To assess individual-level exposure to air pollutants, a spatial prediction model and area-averaging approach were used. RESULTS From 2015 to 2018, data of 789,595 high-risk pregnancies were analyzed. The ratio of gestational diabetes mellitus in the country was the highest, followed by preterm birth, hypertensive disorder during pregnancy, and stillbirth. Approximately 71.7% of pregnant women (566,143) presented with one pregnancy complication in identical pregnancies, 27.5% (216,714) presented with two, and 0.9% (6738) presented with three or more. Multiple logistic regression models with adjustments for age, residence, and income variables indicated that the risk of having two or more pregnancy complications was positively associated with the exposure to higher levels of PM10 (odds ratio [OR], 1.11; 95% confidence interval [CI], 1.09-1.12) and PM2.5 (OR, 1.14; 95% CI, 1.12-1.15). The highest quartile presented higher odds of two or more pregnancy complications compared with the lower three quartiles of PM10, PM2.5, CO, NO2, and SO2 exposures (p < 0.001). CONCLUSION The results indicate that the risk of pregnancy complications is positively associated with the exposure to the high concentrations of PM10, PM2.5, CO, NO2, and SO2.
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Affiliation(s)
- Ju Hee Kim
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea.
| | - Yoon Young Choi
- Artificial Intelligence Big Data Medical Center, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea
| | - Soo-In Yoo
- Department of Nursing, College of Nursing Science, Kyung Hee University, Seoul, 02447, Republic of Korea
| | - Dae Ryong Kang
- Department of Precision Medicine, Wonju College of Medicine, Yonsei University, Wonju, 26426, Republic of Korea.
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da Silveira D, Rabelo NN, de Sena Barbosa MG, Frigeri G, Vellosa JCR. Intracranial pressure and laboratory parameters in high- and low-risk pregnant women. Surg Neurol Int 2021; 12:250. [PMID: 34221581 PMCID: PMC8247669 DOI: 10.25259/sni_109_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/08/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Pregnancy can trigger several pathological changes, thus representing a great challenge for gynecology and obstetrics. The objective is to evaluate high- and low-risk pregnant women through Intracranial pressure (ICP) and laboratory parameters. Methods: Volunteers clinical and laboratory data were collected from medical records and ICP was monitored through noninvasive method. Results: Statistically significant differences were observed between the group of high-risk and low-risk pregnant women for serum levels of alkaline phosphatase (ALP) and US-C-reactive protein (CRP) and a statistically positive association between blood pressure (BP) levels and plasma glucose. About 12.77% of the volunteers presented altered ICP. Higher BP values were encountered with the higher plasma glucose values. All ICP altered volunteers presented altered BP. ALP is among the most effective biochemical markers for assessing the risk of premature birth before 32 weeks of gestation. Conclusion: We have observed important changes on BP, serum glucose, US-CRP, and ALP thus indicating higher risk of complications during pregnancy. Even more, some of the volunteers presented altered ICP what could indicate cerebral compliance changes.
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Affiliation(s)
- Daniel da Silveira
- Graduate Program of Biomedical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, , Brazil
| | - Nícollas Nunes Rabelo
- Department of Neurosurgery, Atenas School of Medicine, Passos, Minas Gerais, Paraná, Brazil
| | | | - Gustavo Frigeri
- Braincare Technological Development and Innovation LTDA, São Carlos-SP, Paraná, Brazil
| | - José Carlos Rebuglio Vellosa
- Graduate Program of Biomedical Sciences, State University of Ponta Grossa, Ponta Grossa, Paraná, , Brazil.,Braincare Technological Development and Innovation LTDA, São Carlos-SP, Paraná, Brazil
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17
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Padula AM, Ma C, Huang H, Morello-Frosch R, Woodruff TJ, Carmichael SL. Drinking water contaminants in California and hypertensive disorders in pregnancy. Environ Epidemiol 2021; 5:e149. [PMID: 33870020 PMCID: PMC8043732 DOI: 10.1097/ee9.0000000000000149] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/04/2021] [Indexed: 12/07/2022] Open
Abstract
Environmental pollutants have been associated with hypertensive disorders in pregnancy including gestational hypertension, preeclampsia, and eclampsia, though few have focused on drinking water contamination. Water pollution can be an important source of exposures that may contribute to adverse pregnancy outcomes. METHODS We linked water quality data on 13 contaminants and two violations from the California Communities Environmental Health Screening Tool to birth records from vital statistics and hospital discharge records (2007-2012) to examine the relationship between drinking water contamination and hypertensive disorders in pregnancy. We examined contaminants in single- and multipollutant models. Additionally, we examined if the relationship between water contamination and hypertensive disorders in pregnancy differed by neighborhood poverty, individual socioeconomic status, and race/ethnicity. RESULTS Arsenic, nitrate, trihalomethane, hexavalent chromium, and uranium were detected in a majority of water systems. Increased risk of hypertensive disorders in pregnancy was modestly associated with exposure to cadmium, lead, trihalomethane, and hexavalent chromium in drinking water after adjusting for covariates in single pollutant models with odds ratios ranging from 1.01 to 1.08. In multipollutant models, cadmium was consistent, lead and trihalomethane were stronger, and additional contaminants were associated with hypertensive disorders in pregnancy including trichloroethylene, 1,2-Dibromo-3-chloropropane, nitrate, and tetrachloroethylene. Other contaminants either showed null results or modest inverse associations. The relationship between water contaminants and hypertensive disorders in pregnancy did not differ by neighborhood poverty. CONCLUSIONS We found increased risk of hypertensive disorders in pregnancy associated with exposure to several contaminants in drinking water in California. Results for cadmium, lead, trihalomethane, and hexavalent chromium were robust in multipollutant models.
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Affiliation(s)
- Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Chen Ma
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Hongtai Huang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management & School of Public Health, University of California, Berkeley, Berkeley, California
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Suzan L. Carmichael
- Department of Environmental Science, Policy and Management & School of Public Health, University of California, Berkeley, Berkeley, California
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18
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Zhang Y, Li J, Liao J, Hu C, Cao Z, Xia W, Xu S, Li Y. Impacts of Ambient Fine Particulate Matter on Blood Pressure Pattern and Hypertensive Disorders of Pregnancy: Evidence From the Wuhan Cohort Study. Hypertension 2021; 77:1133-1140. [PMID: 33611939 DOI: 10.1161/hypertensionaha.120.15608] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
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Affiliation(s)
- Yu Zhang
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Juxiao Li
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Jiaqiang Liao
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Chen Hu
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Zhongqiang Cao
- Wuhan Medical and Healthcare Center for Women and Children, Hubei, People's Republic of China (Z.C.)
| | - Wei Xia
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Shunqing Xu
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
| | - Yuanyuan Li
- From the Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, People's Republic of China (Y.Z., J. Li, J. Liao, C.H., W.X., S.X., Y.L.)
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19
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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.
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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
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20
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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
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21
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Cao W, Dong M, Sun X, Liu X, Xiao J, Feng B, Zeng W, Hu J, Li X, Guo L, Wan D, Sun J, Ning D, Wang J, Chen D, Zhang Y, Du Q, Ma W, Liu T. Associations of maternal ozone exposures during pregnancy with maternal blood pressure and risk of hypertensive disorders of pregnancy: A birth cohort study in Guangzhou, China. ENVIRONMENTAL RESEARCH 2020; 183:109207. [PMID: 32050130 DOI: 10.1016/j.envres.2020.109207] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Revised: 01/14/2020] [Accepted: 01/30/2020] [Indexed: 06/10/2023]
Abstract
Although studies have assessed the associations of maternal exposure to ozone (O3) during pregnancy with blood pressure and the risk of hypertensive disorders of pregnancy (HDP), the results were inconsistent. Furthermore, no studies have been conducted in China where the ambient O3 concentration continuedly increased. The present study aimed to estimate the effects of maternal exposure to O3 during pregnancy on the HDP risk, systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse pressure (PP). All participants of pregnant women were selected from the prospective birth cohort study on Prenatal Environments and Offspring Health conducted in Guangzhou, China. A spatiotemporal land-use-regression model was used to estimate individual monthly air pollution exposure from three months before pregnancy to childbirth date. Information on HDP, SBP, DBP and PP was obtained from maternal medical records. A Logistic regression model and a mixed linear model were used to estimate the associations of maternal exposure to O3 with the risk of HDP and blood pressure (SBP, DBP and PP), respectively. We found significant associations of maternal exposure to O3 during the third (OR = 1.31, 95%CI: 1.07, 1.60) and the second month (OR = 1.25, 95%CI: 1.02, 1.51) before pregnancy with the risk of HDP. Observed significantly positive associations of O3 exposures with SBP, DBP and PP during the two months before pregnancy and during the early pregnancy. The peak effects of O3 exposure on SBP, DBP and PP were respectively observed during the second month of pregnancy (β = 1.07 mmHg, 95%CI: 0.84, 1.31 mmHg), the first month before pregnancy (β = 0.40 mmHg, 95%CI: 0.21, 0.50 mmHg) and the second month of pregnancy (β = 0.78 mmHg, 95%CI: 0.59, 0.97 mmHg). Our results suggest that maternal exposure to O3 were positively associated with blood pressure and the risk of HDP, and the period from three months before pregnancy to the first trimester might be the critical exposure window.
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Affiliation(s)
- Wenjun Cao
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Moran Dong
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xiaoli Sun
- Gynecology Department, Guangdong Women and Children Hospital, Guangzhou, 511442, China
| | - Xin Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianpeng Xiao
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Baixiang Feng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Weilin Zeng
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jianxiong Hu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Xing Li
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Lingchuan Guo
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Donghua Wan
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Jiufeng Sun
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Dan Ning
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Jiaqi Wang
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Dengzhou Chen
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Yonghui Zhang
- Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China
| | - Qingfeng Du
- General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Wenjun Ma
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China; General Practice Center, Nanhai Hospital, Southern Medical University, Foshan, 528200, China
| | - Tao Liu
- Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou, 511430, China.
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22
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Sun M, Yan W, Fang K, Chen D, Liu J, Chen Y, Duan J, Chen R, Sun Z, Wang X, Xia Y. The correlation between PM 2.5 exposure and hypertensive disorders in pregnancy: A Meta-analysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 703:134985. [PMID: 31731170 DOI: 10.1016/j.scitotenv.2019.134985] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Revised: 10/01/2019] [Accepted: 10/13/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE To find the correlation between exposure to PM2.5 (fine particulate matter) and hypertensive disorders in pregnancy (HDP), and provide medical evidence for decreasing the incidence of hypertensive disorders in pregnancy. METHOD A combination of computer and manual retrieval was used to search for keywords in PubMed (385 records), Cochrane Library (20 records), Web of Science (419 records) and Embase (325 records). Finally, ten epidemiological articles were considered in this meta-analysis. Stata 13.0 was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, odds ratio) by selecting the corresponding models. Sensitivity analysis and publication bias test were also performed. RESULTS Meta-analysis indicated that there was an association between PM2.5 exposure (per 10 µg/m3 increase) and hypertensive disorders in pregnancy (OR = 1.52, 95% CI: 1.24-1.87). Exposure to PM2.5 (per 10 µg/m3 increase) enhanced the risk of pre-eclampsia (OR = 1.31, 95% CI: 1.07-1.61), but there was no evidence relating exposure to PM2.5 to gestational hypertension (OR = 1.35, 95% CI: 0.98-1.87). CONCLUSION There is a significant link between exposure to PM2.5 and hypertensive disorders in pregnancy. The first and the third trimester were more susceptible to PM2.5 exposure. It is recommended to further strengthen protective measures against PM2.5 during pregnancy.
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Affiliation(s)
- Mengqi Sun
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Wu Yan
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Kacey Fang
- Department of Cognitive Science, Yale University, New Haven, CT, USA.
| | - Danrong Chen
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Jiani Liu
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Yi Chen
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, China
| | - Junchao Duan
- School of Public Health, Capital Medical University, China.
| | - Rui Chen
- School of Public Health, Capital Medical University, China.
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, China.
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing 211166, China; Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China.
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23
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Assibey-Mensah V, Glantz JC, Hopke PK, Jusko TA, Thevenet-Morrison K, Chalupa D, Rich DQ. Wintertime Wood Smoke, Traffic Particle Pollution, and Preeclampsia. Hypertension 2020; 75:851-858. [PMID: 31902253 PMCID: PMC7035201 DOI: 10.1161/hypertensionaha.119.13139] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Supplemental Digital Content is available in the text. Previous studies have reported associations between ambient fine particle concentrations and preeclampsia; however, the impact of particulate pollution on early- and late-onset preeclampsia is understudied. Furthermore, few studies have examined the association between source-specific particles such as markers of traffic pollution or wood combustion on adverse pregnancy outcomes. Electronic medical records and birth certificate data were linked with land-use regression models in Monroe County, New York for 2009 to 2013 to predict monthly pollutant concentrations for each pregnancy until the date of clinical diagnosis during winter (November–April) for 16 116 births. Up to 30% of ambient wintertime fine particle concentrations in Monroe County, New York is from wood combustion. Multivariable logistic regression was used to separately estimate the odds of preeclampsia (all, early-, and late-onset) associated with each interquartile range increase in fine particles, traffic pollution, and woodsmoke concentrations during each gestational month, adjusting for maternal characteristics, birth hospital, temperature, and relative humidity. Each 3.64 µg/m3 increase in fine particle concentration was associated with an increased odds of early-onset preeclampsia during the first (odds ratio, 1.35 [95% CI, 1.08–1.68]), second (odds ratio, 1.51 [95% CI, 1.23–1.86]), and third (odds ratio, 1.25 [95% CI, 1.06–1.46]) gestational months. Increases in traffic pollution and woodsmoke during the first gestational month were also associated with increased odds of early-onset preeclampsia. Increased odds of late-onset preeclampsia were not observed. Our findings suggest that exposure to wintertime particulate pollution may have the greatest effect on maternal cardiovascular health during early pregnancy.
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Affiliation(s)
- Vanessa Assibey-Mensah
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.).,Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, PA (V.A.-M.).,Magee-Womens Research Institute, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh, PA (V.A.-M.)
| | - J Christopher Glantz
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.).,Department of Obstetrics and Gynecology (J.C.G.), University of Rochester Medical Center, NY
| | - Philip K Hopke
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.)
| | - Todd A Jusko
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.).,Department of Environmental Medicine (T.A.J., D.C., D.Q.R.), University of Rochester Medical Center, NY
| | - Kelly Thevenet-Morrison
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.)
| | - David Chalupa
- Department of Environmental Medicine (T.A.J., D.C., D.Q.R.), University of Rochester Medical Center, NY
| | - David Q Rich
- From the Department of Public Health Sciences (V.A.-M., J.C.G., P.K.H., T.A.J., K.T.-M., D.Q.R.).,Department of Environmental Medicine (T.A.J., D.C., D.Q.R.), University of Rochester Medical Center, NY.,Department of Medicine (D.Q.R.), University of Rochester Medical Center, NY
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24
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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.
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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
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25
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Nabizadeh R, Yousefian F, Moghadam VK, Hadei M. Characteristics of cohort studies of long-term exposure to PM 2.5: a systematic review. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2019; 26:30755-30771. [PMID: 31494855 DOI: 10.1007/s11356-019-06382-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Accepted: 08/29/2019] [Indexed: 06/10/2023]
Abstract
This study systematically reviewed all the cohort studies investigating the relationship between long-term exposure to PM2.5 and any health outcome until February 2018. We searched ISI Web of Knowledge, Pubmed, and Scopus databases for peer-reviewed journal research articles published in English. We only extracted the results of the single-pollutant main analysis of each study, excluding the effect modifications and sensitivity analyses. Out of the initial 9523 articles, 203 articles were ultimately included for analysis. Based on the different characteristics of studies such as study design, outcome, exposure assessment method, and statistical model, we calculated the number and relative frequency of analyses with statistically significant and insignificant results. Most of the studies were prospective (84.8%), assessed both genders (66.5%), and focused on a specific age range (86.8%). Most of the articles (78.1%) had used modeling techniques for exposure assessment of cohorts' participants. Among the total of 317 health outcomes, the most investigated outcomes include mortality due to cardiovascular disease (6.19%), all causes (5.48%), lung cancer (4.00%), ischemic heart disease (3.50%), and non-accidental causes (3.50%). The percentage of analyses with statistically significant results were higher among studies that used prospective design, mortality as the outcome, fixed stations as exposure assessment method, hazard ratio as risk measure, and no covariate adjustment. We can somehow conclude that the choice of right characteristics for cohort studies can make a difference in their results.
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Affiliation(s)
- Ramin Nabizadeh
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
- Center for Air Pollution Research (CAPR), Institute for Environmental Research (IER), Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Yousefian
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Vahid Kazemi Moghadam
- Department of Environmental Health Engineering, Neyshabur University of Medical Sciences, Neyshabur, Iran
| | - Mostafa Hadei
- Department of Environmental Health Engineering, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
- Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran.
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Qiu J, Dong M, Zhou F, Li P, Kong L, Tan J. Associations between ambient air pollution and pregnancy rate in women who underwent in vitro fertilization in Shenyang, China. Reprod Toxicol 2019; 89:130-135. [PMID: 31306769 DOI: 10.1016/j.reprotox.2019.07.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/17/2019] [Accepted: 07/08/2019] [Indexed: 01/02/2023]
Abstract
To assess the associations between air pollution and the pregnancy rate of IVF, we performed a retrospective cohort study on 1455 women who underwent the first fresh IVF cycle at a fertility center from January 2014 to April 2018 and lived in Shenyang during treatment. Binary logistic regression models were used to evaluate the effect of an interquartile range increase in each pollutant on the intrauterine pregnancy rate. Both average chronic and daily acute exposure to air pollution were considered. Increased O3 (adjusted OR = 0.87, 95% CI: 0.81, 0.98) during the period from gonadotropins starting to oocyte retrieval was associated with decreased probability of intrauterine pregnancy, especially the day before oocyte retrieval (adjusted OR = 0.86, 95% CI: 0.78, 0.95). Our results suggest that exposure to O3 before oocyte retrieval has an adverse effect on intrauterine pregnancy. Future studies should be performed in order to confirm our findings.
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Affiliation(s)
- Jiahui Qiu
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Meng Dong
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Feifei Zhou
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Pingping Li
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Lin Kong
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China
| | - Jichun Tan
- Shengjing Hospital of China Medical University, No. 39, Huaxiang Road, Tiexi District, Shenyang, Liaoning, 110022, China; Key Laboratory of Reproductive Dysfunction Diseases and Fertility Remodeling of Liaoning Province, Shenyang, Liaoning, 110022, China.
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Xia B, Zhou Y, Zhu Q, Zhao Y, Wang Y, Ge W, Yang Q, Zhao Y, Wang P, Si J, Luo R, Li J, Shi H, Zhang Y. Personal exposure to PM 2.5 constituents associated with gestational blood pressure and endothelial dysfunction. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 250:346-356. [PMID: 31004887 DOI: 10.1016/j.envpol.2019.04.024] [Citation(s) in RCA: 47] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Revised: 04/05/2019] [Accepted: 04/05/2019] [Indexed: 06/09/2023]
Abstract
Ambient fine particulate matter (PM2.5) pollution has been implicated in the development of hypertensive disorders of pregnancy. However, evidence on the effects of PM2.5-derived chemical constituents on gestational blood pressure (BP) is limited, and the potential mechanisms underlying the association remain unclear. In this study, we repeated three consecutive 72-h personal air sampling and BP measurements in 215 pregnant women for 590 visits during pregnancy. Individual PM2.5 exposure level was assessed by gravimetric method and 28 PM2.5 chemical constituents were analyzed by ED-XRF method. Plasma biomarkers of endothelial function and inflammation were measured using multiplexed immunoassays. Robust multiple linear regression models were used to estimate the associations among personal PM2.5 exposure and chemical constituents, BP changes (compared with pre-pregnancy BP) and plasma biomarkers. Mediation analyses were performed to evaluate underlying potential pathways. Result showed that exposure to PM2.5 was significantly associated with increases in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in the early second trimester. Meanwhile, elevated concentration of lead (Pb) constituent in PM2.5 was significant associated with increases in DBP and MAP after adjusting for PM2.5 total mass. PM2.5 and Pb constituent also presented positive associations with plasma biomarkers of endothelial function (ET-1, E-selectin, ICAM-1) and inflammation (IL-1β, IL-6, TNFα) significantly. After multiple adjustment, elevated ET-1 and IL-6 were significantly correlated with increased gestational BP, and respectively mediated 1.24%-25.06% and 7.01%-10.69% of the increased BP due to PM2.5 and Pb constituent exposure. In conclusion, our results suggested that personal exposure to PM2.5 and Pb constituent were significantly associated with increased BP during pregnancy, and the early second trimester might be the sensitive window of PM2.5 exposure. The endothelial dysfunction and elevated inflammation partially mediated the effect of PM2.5 and Pb constituent on BP during pregnancy.
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Affiliation(s)
- Bin Xia
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Qingyang Zhu
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yingya Zhao
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ying Wang
- The Maternal and Child Healthcare Hospital of Songjiang District, Shanghai, China
| | - Wenzhen Ge
- Regeneron Pharmaceuticals Inc., New York, NY, USA
| | - Qing Yang
- The Maternal and Child Healthcare Institute of Songjiang District, Shanghai, China
| | - Yan Zhao
- Shanghai First Maternity and Infant Hospital, Tongji University School of Medicine, Shanghai, China
| | - Pengpeng Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Jingyi Si
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Ranran Luo
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Jialin Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Huijing Shi
- Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China.
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Zhuang C, Gao J, Liu J, Wang X, He J, Sun J, Liu X, Liao S. Risk factors and potential protective factors of pregnancy-induced hypertension in China: A cross-sectional study. J Clin Hypertens (Greenwich) 2019; 21:618-623. [PMID: 30990249 DOI: 10.1111/jch.13541] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 01/18/2019] [Accepted: 01/28/2019] [Indexed: 02/06/2023]
Abstract
A cross-sectional study was conducted to the reported factors and assesses possible protective factors for pregnancy-induced hypertension (PIH) in China. The data of pregnant women who delivered between October 2016 and September 2017 were collected from a birth registry. The primary outcome was the occurrence of PIH. Secondary outcomes were delivery before 34 gestational weeks and other adverse obstetric outcomes of PIH. Among the 99 535 women enrolled, 5731 women (5.8%) developed PIH. BMI had a positive correlation with the primary and two secondary outcomes (adjusted OR = 2.05, 2.56, 1.87, respectively, for overweight; adjusted OR = 4.44, 3.90, and 2.63, respectively, for obesity). Otherwise, calcium supplementation during pregnancy was a potential protective factor for those outcomes (adjusted OR = 0.87, 0.14, and 0.44, respectively). These results provide a basis for PIH prevention strategy in the Chinese public health sector. Calcium supplementation and lowering the BMI might have the potential benefit on reducing the prevalence of PIH in selected women.
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Affiliation(s)
- Caixia Zhuang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Jinsong Gao
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Juntao Liu
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China
| | - Xietong Wang
- Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong University, Shandong, China
| | - Jing He
- Department of Obstetrics and Gynecology, Women's Hospital School of Medicine Zhejiang University, Zhejiang, China
| | - Jingxia Sun
- Department of Obstetrics and Gynecology, The First Clinical Hospital affiliated to Harbin Medical University, Harbin, China
| | - Xiaowei Liu
- Department of Obstetrics and Gynecology, Beijing Obstetrics and Gynecology Hospital capital Medical University, Beijing, China
| | - Shixiu Liao
- Department of Obstetrics and Gynecology, Henan Provincial People's Hospital, Henan, China
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Madsen C, Håberg SE, Aamodt G, Stigum H, Magnus P, London SJ, Nystad W, Nafstad P. Preeclampsia and Hypertension During Pregnancy in Areas with Relatively Low Levels of Traffic Air Pollution. Matern Child Health J 2019; 22:512-519. [PMID: 29285630 DOI: 10.1007/s10995-017-2417-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Objectives Air pollution exposure may contribute to the development of preeclampsia and hypertension during pregnancy. However, the evidence for such a relation is still limited. We investigated the associations between exposure for moderate to low levels of air pollution during pregnancy and preeclampsia and gestational hypertension in selected urban and county areas of Norway. Methods This study used a sub-group of 17,533 women in the Norwegian Mother and Child Cohort Study. Air pollution levels at residential addresses were estimated using land use regression models and back-extrapolated to the period of each pregnancy. Information on preeclampsia and gestational hypertension were obtained from the Medical Birth Registry of Norway and information on lifestyle factors was collected from questionnaires completed by the women during pregnancy. Results Moderate mean levels of NO2 (13.6 ± 6.9 µg/m3) at residential address during pregnancy were not associated with preeclampsia and pregnancy hypertension. We found no statistically significant associations per 10 µg/m3 change in NO2 exposure and preeclampsia (adjusted OR 0.89, 95% CI 0.74, 1.08) or hypertension during pregnancy (adjusted OR 0.91, 95% CI 0.78, 1.06). Conclusions for Practice In this large Norwegian pregnancy cohort, we found no statistically significant associations for moderate to low levels of pregnancy NO2 exposure and preeclampsia or hypertension during pregnancy.
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Affiliation(s)
- Christian Madsen
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway. .,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway. .,Department of Health and Inequality, Domain for Mental and Physical Health, Norwegian Institute of Public Health, Nydalen, P.O. Box 4404, 0403, Oslo, Norway.
| | - Siri Eldevik Håberg
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Geir Aamodt
- Department of Landscape Architecture and Spatial Planning, Norwegian University of Life Sciences, Ås, Norway
| | - Hein Stigum
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway
| | - Per Magnus
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Stephanie J London
- Department of Health and Human Services, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, NC, USA
| | - Wenche Nystad
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway
| | - Per Nafstad
- Domain for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.,Department of Community Medicine and Global Health, Medical Faculty, University of Oslo, Oslo, Norway
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Assibey-Mensah V, Glantz JC, Hopke PK, Jusko TA, Thevenet-Morrison K, Chalupa D, Rich DQ. Ambient wintertime particulate air pollution and hypertensive disorders of pregnancy in Monroe County, New York. ENVIRONMENTAL RESEARCH 2019; 168:25-31. [PMID: 30253313 PMCID: PMC7085918 DOI: 10.1016/j.envres.2018.09.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 08/27/2018] [Accepted: 09/05/2018] [Indexed: 05/31/2023]
Abstract
BACKGROUND Previous studies have reported associations between ambient fine particle (PM2.5) concentrations and hypertensive disorders of pregnancy (HDP). However, none have examined whether ultrafine particles (UFP; < 100 nm), accumulation mode particles (AMP; 100-500 nm), markers of traffic pollution (black carbon; BC), or wood burning (Delta-C; (30% of ambient wintertime PM2.5 in Monroe County, NY is from wood burning)) are associated with an increased odds of HDP. We estimated the odds of HDP associated with increased concentrations of PM2.5, UFP, AMP, BC, and Delta-C in each gestational month during winter months. METHODS Electronic medical records and birth certificate data were linked with land-use regression models in Monroe County, New York in 2009-2013 to predict monthly pollutant concentrations during winter (November-April) based on maternal residential address for 16,637 births. Using multivariable logistic regression, we estimated the odds of HDP associated with each interquartile range (IQR) increase in PM2.5, UFP, AMP, BC, and Delta-C concentrations during each gestational month, adjusting for maternal characteristics, birth hospital, temperature, and relative humidity. RESULTS Each 0.52 µg/m3 increase in Delta-C concentration during the 7th gestational month was associated with an increased odds of HDP (odds ratio (OR) = 1.21; 95% confidence interval (CI) = 1.01, 1.45), with a similar sized estimate in month 8 (OR = 1.18; 95%CI = 0.98, 1.43). Non-statistically significant increased odds of HDP associated with IQR increases in BC concentrations during months 3 (OR = 1.12; 95%CI = 0.98, 1.28) and 7 (OR = 1.12; 95%CI = 0.96, 1.29) were observed. Increased odds of HDP were not observed for PM2.5, UFP, or AMP. CONCLUSIONS Our findings suggest that maternal exposure to wood smoke in Monroe County during winter is associated with an increased odds of HDP during late gestation. Additional studies are needed to evaluate the effect of wood smoke on HDP and to explore effects on other pregnancy outcomes.
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Affiliation(s)
- Vanessa Assibey-Mensah
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Obstetrics, Gynecology, and Reproductive Sciences, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA; Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA, USA.
| | - J Christopher Glantz
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Obstetrics and Gynecology, University of Rochester Medical Center, Rochester, NY, USA.
| | - Philip K Hopke
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
| | - Todd A Jusko
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - Kelly Thevenet-Morrison
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA.
| | - David Chalupa
- Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA.
| | - David Q Rich
- Department of Public Health Sciences, University of Rochester Medical Center, Rochester, NY, USA; Department of Environmental Medicine, University of Rochester Medical Center, Rochester, NY, USA; Department of Medicine, University of Rochester Medical Center, Rochester, NY, USA.
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31
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Choe SA, Jun YB, Kim SY. Exposure to air pollution during preconceptional and prenatal periods and risk of hypertensive disorders of pregnancy: a retrospective cohort study in Seoul, Korea. BMC Pregnancy Childbirth 2018; 18:340. [PMID: 30134853 PMCID: PMC6106837 DOI: 10.1186/s12884-018-1982-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 08/15/2018] [Indexed: 01/06/2023] Open
Abstract
Background Previous studies suggested associations between prenatal exposure to air pollution and hypertensive disorders of pregnancy. We explored the associations between ambient concentrations of five major air pollutants during preconceptional and prenatal periods and three hypertensive disorders of pregnancy in Seoul, Korea, using a population-representative cohort. Methods We obtained heath and demographic data of pregnant women residing in Seoul for 2002–2013 from the Korean National Health Insurance Service–National Sample Cohort. For mother’s individual exposures to air pollution, we computed concentrations of particulate matter ≤10 μm in diameter (PM10), nitrogen dioxide (NO2), carbon monoxide (CO), sulfur dioxide (SO2), and ozone (O3) during 1, 3, 6, and 12 months to birth using regulatory monitoring data in Seoul. The associations between air pollution and hypertensive disorders were explored by using logistic regression models after adjusting for individual confounders. Results Among 18,835 pregnant women in Seoul, 0.6, 0.5, and 0.4% of women developed gestational hypertension, preeclampsia, and preeclampsia requiring magnesium sulfate (Mg-preeclampsia), respectively. Although most odds ratios (ORs) were not statistically significant, we found increasing risk gradients with disease severity depending on the pollutant. There was the association between PM10 during 6 months to birth and gestational hypertension (OR for an interquartile range increase = 1.68 [95% confidence interval = 1.09–2.58]). NO2 and ozone during 12 and 1 month, respectively, before birth were associated with Mg-preeclampsia (1.43 [1.01–2.03], 1.53 [1.03–2.27]). Conclusions We observed positive associations of exposure to some air pollutants before and during pregnancy with hypertensive disorders of pregnancy among the Korean general population. Future studies with refined exposure metrics should confirm our findings. Electronic supplementary material The online version of this article (10.1186/s12884-018-1982-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Seung-Ah Choe
- Department of Obstetrics and Gynecology, School of Medicine, CHA University, Gyeonggi-do, Seongnam, 13488, South Korea.,Department of Epidemiology, Brown University School of Public Health, Providence, 02903, RI, USA
| | - Yoon-Bae Jun
- Department of Statistics, Seoul National University, Seoul, 08826, South Korea
| | - Sun-Young Kim
- Department of Cancer Control and Population Health, Graduate School of Cancer Science and Policy, National Cancer Center, Gyeonggi-do, Goyang, 10408, South Korea.
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Xue T, Zhu T, Lin W, Talbott EO. Association Between Hypertensive Disorders in Pregnancy and Particulate Matter in the Contiguous United States, 1999-2004. Hypertension 2018; 72:77-84. [PMID: 29785958 DOI: 10.1161/hypertensionaha.118.11080] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/21/2018] [Accepted: 04/26/2018] [Indexed: 12/26/2022]
Abstract
Hypertensive disorders in pregnancy harm both maternal and infant health and have been linked to ambient particulate matter. However, existing studies are restricted to a local scale and remain inconsistent. A large-scale study is required to enrich the epidemiological evidence and explore the potential sources of the inconsistency. Making use of US birth certificates (1999-2004), and monitoring data from the environmental protection agency air quality networks, we associated hypertensive disorders in pregnancy with maternal exposure to fine particles or coarse particles using logistic regression analysis after adjusting for many covariates among >5 million subjects in the contiguous United States. Additional analyses were conducted to examine variations in the associations according to (1) census divisions; (2) individual-level factors; (3) a socioeconomic indicator, county-level poverty; and (4) the concentration of ambient particles. The results indicated that hypertensive disorders in pregnancy were robustly linked to maternal exposure to fine particles with an adjusted odds ratio of 1.10 (95% confidence intervals, 1.08-1.12) per 5 μg/m3 increment in terms of the entire pregnancy mean. Stronger associations were found among white mothers. There were also considerable variations in the association by census division or poverty level among counties. Nonlinear analysis indicated a sublinear dose-response function with a threshold concentration of 9 μg/m3 Based on the national study, we calculated the population attributable fractions and found that 8.1% (6.8%-9.4%) of hypertensive disorder cases were attributable to an entire pregnancy exposure of fine particles. These findings can help policymakers to plan related interventions.
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Affiliation(s)
- Tao Xue
- From the Beijing Innovation Center for Engineering Science and Advanced Technology (BIC-ESAT) and State Key Joint Laboratory for Environmental Simulation and Pollution Control (SKL-ESPC), College of Environmental Science and Engineering, Peking University, China (T.X., T.Z.)
| | - Tong Zhu
- From the Beijing Innovation Center for Engineering Science and Advanced Technology (BIC-ESAT) and State Key Joint Laboratory for Environmental Simulation and Pollution Control (SKL-ESPC), College of Environmental Science and Engineering, Peking University, China (T.X., T.Z.)
| | - Weiwei Lin
- Guangzhou Key Laboratory of Environmental Pollution and Risk Assessment, Faculty of Preventive Medicine, School of Public Health, Sun Yat-Sen University, China (W.L.)
| | - Evelyn O Talbott
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (E.O.T.)
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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.
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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
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Meta-Prediction of MTHFR Gene Polymorphisms and Air Pollution on the Risk of Hypertensive Disorders in Pregnancy Worldwide. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15020326. [PMID: 29438331 PMCID: PMC5858395 DOI: 10.3390/ijerph15020326] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 01/24/2018] [Accepted: 02/05/2018] [Indexed: 11/16/2022]
Abstract
Hypertensive disorders in pregnancy (HDP) are devastating health hazards for both women and children. Both methylenetetrahydrofolate reductase (MTHFR) gene polymorphisms and air pollution can affect health status and result in increased risk of HDP for women. The major objective of this study was to investigate the effect of MTHFR polymorphisms, air pollution, and their interaction on the risk of HDP by using meta-predictive analytics. We searched various databases comprehensively to access all available studies conducted for various ethnic populations from countries worldwide, from 1997 to 2017. Seventy-one studies with 8064 cases and 13,232 controls for MTHFR C677T and 11 studies with 1425 cases and 1859 controls for MTHFR A1298C were included. MTHFR C677T homozygous TT (risk ratio (RR) = 1.28, p < 0.0001) and CT plus TT (RR = 1.07, p = 0.0002) were the risk genotypes, while wild-type CC played a protective role (RR = 0.94, p = 0.0017) for HDP. The meta-predictive analysis found that the percentage of MTHFR C677T TT plus CT (p = 0.044) and CT (p = 0.043) genotypes in the HDP case group were significantly increased with elevated levels of air pollution worldwide. Additionally, in countries with higher air pollution levels, the pregnant women with wild-type CC MTHFR 677 had a protection effect against HDP (p = 0.014), whereas, the homozygous TT of MTHFR C677T polymorphism was a risk genotype for developing HDP. Air pollution level is an environmental factor interacting with increased MTHFR C677T polymorphisms, impacting the susceptibility of HDP for women.
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Hu H, Ha S, Xu X. Ozone and hypertensive disorders of pregnancy in Florida: Identifying critical windows of exposure. ENVIRONMENTAL RESEARCH 2017; 153:120-125. [PMID: 27940104 PMCID: PMC5222744 DOI: 10.1016/j.envres.2016.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Revised: 11/30/2016] [Accepted: 12/01/2016] [Indexed: 05/05/2023]
Abstract
INTRODUCTION Ozone (O3) has been linked to hypertensive disorders of pregnancy (HDP). However, inconsistent results have been reported, and no study has examined the critical exposure windows during pregnancy. MATERIALS AND METHODS We used Florida birth vital statistics records to investigate the association between HDP and O3 exposure among 655,529 pregnancies with conception dates between 2005 and 2007. Individual O3 exposure was assessed at mothers' home address at the time of delivery using the Hierarchical Bayesian space-time statistical model. We examined the association during three predefined exposure windows including trimester 1, trimester 2, and trimesters 1&2, as well as in each week of the first two trimesters using distributed lag models. RESULTS Pregnancies with HDP had a higher mean exposure to O3 (39.07 in trimester 1, 39.02 in trimester 2, and 39.06 in trimesters 1&2, unit: ppb) than those without HDP (38.65 in trimester 1, 38.57 in trimester 2, and 38.61 in trimesters 1&2, unit: ppb). In the adjusted logistic regression model, increased odds of HDP were observed for each 5 ppb increase in O3 (ORTrimester1=1.04, 95% CI: 1.03, 1.06; ORTrimester2=1.03, 95% CI: 1.02, 1.04; ORTrimester1&2=1.07, 95% CI: 1.05, 1.08). In the distributed lag models, elevated odds of HDP were observed with increased O3 exposure during the 1st to 24th weeks of gestation, with higher odds during early pregnancy. CONCLUSIONS O3 exposure during pregnancy is related to increased odds of HDP, and early pregnancy appears to be a potentially critical window of exposure.
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Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL, USA.
| | - Sandie Ha
- Epidemiology Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD, 20892 USA
| | - Xiaohui Xu
- Department of Epidemiology & Biostatistics, School of Public Health, Texas A&M University, College Station, TX, USA.
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Assibey-Mensah V, Liu K, Thurston SW, Stevens TP, Zhang J, Zhang J, Kane C, Pan Y, Weinberger B, Ohman-Strickland P, Woodruff T, Rich DQ. Impact of the 2008 Beijing Olympics on the risk of pregnancy complications. ARCHIVES OF ENVIRONMENTAL & OCCUPATIONAL HEALTH 2016; 71:208-15. [PMID: 26066998 PMCID: PMC4676735 DOI: 10.1080/19338244.2015.1058236] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Taking advantage of the natural experiment of the 2008 Beijing Olympics (August 8 to September 24), when air pollution levels decreased by 13% to 60%, the authors assessed whether having ≥1 pregnancy month during the Olympics was associated with decreased risks of hypertensive disorders (HDs) and/or fetal-placental conditions (FPCs). Singleton births to mothers with ≥1 pregnancy month in 2008 or 2009 (N = 56,155) were included. Using generalized additive models, the authors estimated the risk of HDs and FPCs associated with (1) the 2008 Olympics compared with the same dates in 2009, and (2) increased mean ambient PM10 (particulate matter with an aerodynamic diameter <10 μm), NO2 (nitrogen dioxide), and SO2 (sulfur dioxide) concentrations during each trimester. However, no association between HDs or FPCs and having any trimester during the 2008 Olympic period was found. This may, in part, be due to a small number of pregnancy complications in this population.
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Affiliation(s)
| | - Kaibo Liu
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Sally W. Thurston
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Timothy P. Stevens
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | | | - Jinliang Zhang
- Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Cathleen Kane
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
| | - Ying Pan
- Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing, China
| | - Barry Weinberger
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | | | - Tracey Woodruff
- University of California San Francisco, Program on Reproductive Health and the Environment, San Francisco, CA, USA
| | - David Q. Rich
- University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Savitz DA, Elston B, Bobb JF, Clougherty JE, Dominici F, Ito K, Johnson S, McAlexander T, Ross Z, Shmool JLC, Matte TD, Wellenius GA. Ambient Fine Particulate Matter, Nitrogen Dioxide, and Hypertensive Disorders of Pregnancy in New York City. Epidemiology 2016; 26:748-57. [PMID: 26237745 DOI: 10.1097/ede.0000000000000349] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
BACKGROUND Previous studies suggested a possible association between fine particulate matter air pollution (PM2.5) and nitrogen dioxide (NO2) and the development of hypertensive disorders of pregnancy, but effect sizes have been small and methodologic weaknesses preclude firm conclusions. METHODS We linked birth certificates in New York City in 2008-2010 to hospital discharge diagnoses and estimated air pollution exposure based on maternal address. The New York City Community Air Survey provided refined estimates of PM2.5 and NO2 at the maternal residence. We estimated the association between exposures to PM2.5 and NO2 in the first and second trimester and risk of gestational hypertension, mild preeclampsia, and severe preeclampsia among 268,601 births. RESULTS In unadjusted analyses, we found evidence of a positive association between both pollutants and gestational hypertension. However, after adjustment for individual covariates, socioeconomic deprivation, and delivery hospital, we did not find evidence of an association between PM2.5 or NO2 in the first or second trimester and any of the outcomes. CONCLUSIONS Our data did not provide clear evidence of an effect of ambient air pollution on hypertensive disorders of pregnancy. Results need to be interpreted with caution considering the quality of the available exposure and health outcome measures and the uncertain impact of adjusting for hospital. Relative to previous studies, which have tended to identify positive associations with PM2.5 and NO2, our large study size, refined air pollution exposure estimates, hospital-based disease ascertainment, and little risk of confounding by socioeconomic deprivation, does not provide evidence for an association.
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Affiliation(s)
- David A Savitz
- From the aDepartments of Epidemiology and Obstetrics and Gynecology, Brown University, Providence, RI; bDepartment of Epidemiology, Brown University, Providence, RI; cDepartment of Biostatistics, Harvard School of Public Health, Boston, MA; dDepartment of Occupational and Environmental Health, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA; eNew York City Department of Health and Mental Hygiene, New York, NY; and f ZevRoss Spatial Analysis, Ithaca, NY
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Wu J, Laurent O, Li L, Hu J, Kleeman M. Adverse Reproductive Health Outcomes and Exposure to Gaseous and Particulate-Matter Air Pollution in Pregnant Women. Res Rep Health Eff Inst 2016; 2016:1-58. [PMID: 29659239 PMCID: PMC7266373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023] Open
Abstract
Introduction There is growing epidemiologic evidence of associations between maternal exposure to ambient air pollution and adverse birth outcomes, such as preterm birth (PTB). Recently, a few studies have also reported that exposure to ambient air pollution may also increase the risk of some common pregnancy complications, such as preeclampsia and gestational diabetes mellitus (GDM). Research findings, however, have been mixed. These inconsistent results could reflect genuine differences in the study populations, the study locations, the specific pollutants considered, the designs of the study, its methods of analysis, or random variation. Dr. Jun Wu of the University of California– Irvine, a recipient of HEI’s Walter A. Rosenblith New Investigator Award, and colleagues have examined the association between air pollution and adverse birth and pregnancy outcomes in California women. In addition, they examined the effect modification by socioeconomic status (SES) and other factors. Approach A retrospective nested case–control study was conducted using birth certificate data from about 4.4 million birth records in California from 2001 to 2008. Wu and colleagues analyzed data on low birth weight (LBW) at term (infants born between 37 and 43 weeks of gestation and weighing less than 2500 g), PTB (infants born before 37 weeks of gestation), and preeclampsia (including eclampsia) of the mother during the pregnancy. In addition, they obtained data on GDM for the years 2006– 2008. In the analyses, all outcomes were included as binary variables. Maternal residential addresses at the time of delivery were geocoded, and a large suite of air pollution exposure metrics was considered, such as (1) regulatory monitoring data on concentrations of criteria pollutants NO2, PM2.5 (particulate matter ≤ 2.5 μm in aerodynamic diameter), and ozone (O3) estimated by empirical Bayesian kriging; (2) concentrations of primary and secondary PM2.5 and PM0.1 components and sources estimated by the University of California–Davis Chemical Transport Model; (3) traffic-related ultrafine particles and concentrations of carbon monoxide (CO) and nitrogen oxides (NOx) estimated by a modified CALINE4 air pollution dispersion model; and (4) proximity to busy roads, road length, and traffic density calculated for different buffer sizes using geographic information system tools. In total, 50 different exposure metrics were available for the analyses. The exposure of primary interest was the mean of the entire pregnancy period for each mother. For the health analyses, controls were randomly selected from the source population. PTB controls were matched on conception year. Term LBW, preeclampsia, and GDM were analyzed using generalized additive mixed models with inclusion of a random effect per hospital. PTB analyses were conducted using conditional logistic regression, with no adjustment for hospital. The main results— adjusted for race and education as categorical variables and adjusted for maternal age and median household income at the census-block level—were derived from single-pollutant models. Main results and interpretation In its independent review of the study, the HEI Health Review Committee concluded that Wu and colleagues had conducted a comprehensive nested case–control study of air pollution and adverse birth and pregnancy outcomes. The very large data set and the extensive exposure assessment were strengths of the study. The study documented associations between increases in various air pollution metrics and increased risks of PTB, whereas the evidence was weaker overall for term LBW; in addition, decreases in many air pollution metrics were associated with an increased risk of preeclampsia and GDM, an unexpected result. The investigators suggested that underreporting in the registry data, especially in lower-SES groups, might have caused the many negative associations found for preeclampsia and GDM. In addition, poor geocoding was listed as a potential explanation, affecting in particular the results that were based on measures of proximity to busy roads and traffic density in the smallest buffer size (50 m). However, those issues were not fully explored. In general, the Committee thought that the analysis of road traffic indicators in the 50 m buffer was hampered by the lack of contrast and that the results are therefore difficult to interpret. Some other issues with the analytical approaches should be considered when interpreting the results. Only a subset of controls was used, to reduce computational demands. Hence, some models did not converge, especially in the subgroup analyses. Most of the results in the report were based on analyses using single-pollutant models, which is a reasonable approach but ignores that people are exposed to complex mixtures of pollutants. The Committee believed that the few two-pollutant models that were run provided important insights: these models showed the strongest association for PM2.5 mass, whereas components and source-specific positive associations largely disappeared after adjusting for PM2.5 mass. This study adds to the ongoing debate about whether some particle components and sources are of greater public health concern than others.
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Abstract
Environmental exposure is an important but underappreciated risk factor contributing to the development and severity of cardiovascular disease (CVD). The heart and vascular system are highly vulnerable to a number of environmental agents--ambient air pollution and the metals arsenic, cadmium, and lead are widespread and the most-extensively studied. Like traditional risk factors, such as smoking and diabetes mellitus, these exposures advance disease and mortality via augmentation or initiation of pathophysiological processes associated with CVD, including blood-pressure control, carbohydrate and lipid metabolism, vascular function, and atherogenesis. Although residence in highly polluted areas is associated with high levels of cardiovascular risk, adverse effects on cardiovascular health also occur at exposure levels below current regulatory standards. Considering the widespread prevalence of exposure, even modest contributions to CVD risk can have a substantial effect on population health. Evidence-based clinical and public-health strategies aimed at reducing environmental exposures from current levels could substantially lower the burden of CVD-related death and disability worldwide.
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Michikawa T, Morokuma S, Fukushima K, Ueda K, Takeuchi A, Kato K, Nitta H. A register-based study of the association between air pollutants and hypertensive disorders in pregnancy among the Japanese population. ENVIRONMENTAL RESEARCH 2015; 142:644-50. [PMID: 26340650 DOI: 10.1016/j.envres.2015.08.024] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Revised: 08/09/2015] [Accepted: 08/25/2015] [Indexed: 05/15/2023]
Abstract
BACKGROUND Ambient air pollution is hypothesized to be a risk factor for hypertensive disorders in pregnancy, one of the major pregnancy complications. Past studies have reported the supporting evidence, however this mainly referred to the Western population, and results from trimester-specific analysis have been varied. In this study, we focused on exposure during the first trimester of pregnancy (placental development stage), and tested the hypothesis among the Japanese population. METHODS We drew on data from the Japan Perinatal Registry Network database, and studied 36,620 singleton pregnant women without medical complications, in western Japan (Kyushu and Okinawa districts) between 2005 and 2010. In addition, data on ozone, suspended particulate matter (SPM), nitrogen dioxide (NO2), and sulfur dioxide (SO2) concentrations were obtained. The nearest monitoring station to the respective birthing hospital was used as a reference point for assigning average concentrations of each pollutant during the first trimester of pregnancy for each woman. The logistic regression model was applied to assess the association between quintiles of each pollutant and hypertensive disorders in pregnancy. RESULTS Mean concentrations during the first trimester were 41.3 ppb for ozone, 27.4 μg/m(3) for SPM, 11.8 ppb for NO2, and 3.2 ppb for SO2. High exposure to ozone was associated with an increased risk of hypertensive disorders in pregnancy (for highest quintile vs. lowest: odds ratio=1.20, 95% confidence interval=1.01-1.42). With regard to SPM, NO2 and SO2, we did not obtain the results with constant directionality. CONCLUSIONS Ozone exposure during early pregnancy may be a risk factor for hypertensive disorders in pregnancy.
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Affiliation(s)
- Takehiro Michikawa
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki 305-8506, Japan.
| | - Seiichi Morokuma
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Kotaro Fukushima
- Department of Obstetrics, Fukuoka Children's Hospital, 5-1-1 Kashiiteriha, Higashi-ku, Fukuoka 813-0017, Japan
| | - Kayo Ueda
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki 305-8506, Japan; Graduate School of Engineering, Kyoto University, Katsura, Sakyo-ku, Kyoto 615-8530, Japan
| | - Ayano Takeuchi
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki 305-8506, Japan; Preventive Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan
| | - Kiyoko Kato
- Department of Obstetrics and Gynecology, Kyushu University Hospital, Kyushu University, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-8582, Japan
| | - Hiroshi Nitta
- Environmental Epidemiology Section, Center for Environmental Health Sciences, National Institute for Environmental Studies, Onogawa 16-2, Tsukuba, Ibaraki 305-8506, Japan
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Hu H, Ha S, Henderson BH, Warner TD, Roth J, Kan H, Xu X. Association of Atmospheric Particulate Matter and Ozone with Gestational Diabetes Mellitus. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:853-9. [PMID: 25794412 PMCID: PMC4559952 DOI: 10.1289/ehp.1408456] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2014] [Accepted: 03/17/2015] [Indexed: 05/20/2023]
Abstract
BACKGROUND Ambient air pollution has been linked to the development of gestational diabetes mellitus (GDM). However, evidence of the association is very limited, and no study has estimated the effects of ozone. OBJECTIVE Our aim was to determine the association of prenatal exposures to particulate matter ≤ 2.5 μm (PM2.5) and ozone (O3) with GDM. METHODS We used Florida birth vital statistics records to investigate the association between the risk of GDM and two air pollutants (PM2.5 and O3) among 410,267 women who gave birth in Florida between 2004 and 2005. Individual air pollution exposure was assessed at the woman's home address at time of delivery using the hierarchical Bayesian space-time statistical model. We further estimated associations between air pollution exposures during different trimesters and GDM. RESULTS After controlling for nine covariates, we observed increased odds of GDM with per 5-μg/m3 increase in PM2.5 (ORTrimester1 = 1.16; 95% CI: 1.11, 1.21; ORTrimester2 = 1.15; 95% CI: 1.10, 1.20; ORPregnancy = 1.20; 95% CI: 1.13, 1.26) and per 5-ppb increase in O3 (ORTrimester1 = 1.09; 95% CI: 1.07, 1.11; ORTrimester2 = 1.12; 95% CI: 1.10, 1.14; ORPregnancy = 1.18; 95% CI: 1.15, 1.21) during both the first trimester and second trimester as well as the full pregnancy in single-pollutant models. Compared with the single-pollutant model, the ORs for O3 were almost identical in the co-pollutant model. However, the ORs for PM2.5 during the first trimester and the full pregnancy were attenuated, and no association was observed for PM2.5 during the second trimester in the co-pollutant model (OR = 1.02; 95% CI: 0.98, 1.07). CONCLUSION This population-based study suggests that exposure to air pollution during pregnancy is associated with increased risk of GDM in Florida, USA. CITATION Hu H, Ha S, Henderson BH, Warner TD, Roth J, Kan H, Xu X. 2015. Association of atmospheric particulate matter and ozone with gestational diabetes mellitus. Environ Health Perspect 123:853-859; http://dx.doi.org/10.1289/ehp.1408456.
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Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions and College of Medicine
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42
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Gestational Hypertension and Organophosphorus Pesticide Exposure: A Cross-Sectional Study. BIOMED RESEARCH INTERNATIONAL 2015; 2015:280891. [PMID: 26339602 PMCID: PMC4538315 DOI: 10.1155/2015/280891] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Revised: 01/22/2015] [Accepted: 05/27/2015] [Indexed: 11/17/2022]
Abstract
Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. High blood pressure (BP) with diastolic BP ≥ 90 mm Hg and/or systolic BP ≥ 140 mm Hg arising after week 22 of pregnancy and resolving after delivery is defined as gestational hypertension (GHY). The aim of this cross-sectional study was to investigate whether occupational and/or environmental exposure to organophosphorus (OP) pesticide affects GHY. Women at approximately 22 weeks of gestation were recruited. OP pesticide exposure in the first trimester of pregnancy was classified into four categories: no exposure, indirect exposure, domestic exposure, and occupational exposure. Application of the exclusion criteria left 2203 participants (mean age 30.4 ± 11.6 years). Data analysis showed that in women with indirect OP pesticide exposure the incidence of GHY was slightly higher than that in the world population, whereas domestic exposure involved a 7% increase and occupational exposure a 12% increase. Analysis of the pesticides used by participants highlighted a possible role for malathion and diazinon (adjusted OR 1.09 and 1.14, resp.). Further investigation of exposed workers and the general population is clearly warranted given the broad diffusion of OP pesticides and their possible public health impact, maybe by including a wider range of health outcomes.
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43
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Ha S, Hu H, Roth J, Kan H, Xu X. Associations Between Residential Proximity to Power Plants and Adverse Birth Outcomes. Am J Epidemiol 2015; 182:215-24. [PMID: 26121989 DOI: 10.1093/aje/kwv042] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2014] [Accepted: 02/06/2015] [Indexed: 01/13/2023] Open
Abstract
Few studies have assessed the associations between residential proximity to power plants and adverse birth outcomes including preterm delivery (PTD), very preterm delivery (VPTD), and term low birth weight (LBW). We geocoded 423,719 singleton Florida births born from 2004 to 2005 and all active power plants and determined residential proximity to the nearest power plant for each birth. Prenatal exposure to particulate matter less than 2.5 µm in diameter for women living near different types of power plants was also determined by using National Environmental Public Health Tracking Network data. Logistic regression models were used to test the hypothesized associations. Women who lived closer to coal and solid waste power plants were exposed to higher levels of particulate matter less than 2.5 µm in diameter compared with other types. We observed a 1.8% (95% confidence interval (CI): 1.3, 2.3) increased odds for PTD, 2.2% (95% CI: 1.0, 3.4) for VPTD, and 1.1% (95% CI: 0.2, 2.0) for term LBW for each 5 km closer to any power plant. When stratifying by different fuel type, we found that only solid waste had an association with term LBW, whereas oil, gas, and solid waste all had an association with PTD and VPTD. Results were consistent when exposure was categorized by number of power plants. Our study found evidence of increasing odds of adverse birth outcomes among infants born to pregnant women living closer to power plants. More research is warranted to better understand the causal relationship.
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Wylie BJ, Singh MP, Coull BA, Quinn A, Yeboah-Antwi K, Sabin L, Hamer DH, Singh N, MacLeod WB. Association between wood cooking fuel and maternal hypertension at delivery in central East India. Hypertens Pregnancy 2015; 34:355-68. [PMID: 26153626 DOI: 10.3109/10641955.2015.1046604] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Smoke from burning of biomass fuels has been linked with adverse pregnancy outcomes and hypertension among nonpregnant subjects; association with hypertension during pregnancy has not been well studied. We evaluated whether the use of wood cooking fuel increases the risk of maternal hypertension at delivery compared to gas which burns with less smoke. METHODS Information on fuel use and blood pressure was available for analysis from a cross-sectional survey of 1369 pregnant women recruited at delivery in India. RESULTS Compared to gas users, women using wood as fuel had on average lower mean arterial pressure (adjusted effect size - 2.0 mmHg; 95% CI: -3.77, -0.31) and diastolic blood pressure (adjusted effect size -1.96 mmHg; 95% CI: -3.60, -0.30) at delivery. Risk of hypertension (systolic >139 mmHg or diastolic >89 mmHg) was 14.6% for wood users compared to 19.6% for gas users although this did not reach significance after adjustment, using propensity score techniques, for factors that make wood and gas users distinct (adjusted prevalence ratio 0.76; 95% CI: 0.49, 1.17). CONCLUSIONS Combustion products from the burning of biomass fuels are similar to those released with tobacco smoking, which has been linked with a reduced risk for preeclampsia. The direction of our findings suggests the possibility of a similar effect for biomass cook smoke. Whether clean cooking interventions being promoted by international advocacy organizations will impact hypertension in pregnancy warrants further analysis as hypertension remains a leading cause of maternal death worldwide and cooking with biomass fuels is widespread.
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Affiliation(s)
- Blair J Wylie
- Division of Maternal-Fetal Medicine, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital, Harvard Medical School , Boston, MA , USA
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Hu H, Ha S, Roth J, Kearney G, Talbott EO, Xu X. Ambient Air Pollution and Hypertensive Disorders of Pregnancy: A Systematic Review and Meta-analysis. ATMOSPHERIC ENVIRONMENT (OXFORD, ENGLAND : 1994) 2014; 97:336-345. [PMID: 25242883 PMCID: PMC4166571 DOI: 10.1016/j.atmosenv.2014.08.027] [Citation(s) in RCA: 68] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Hypertensive disorders of pregnancy (HDP, including gestational hypertension, preeclampsia, and eclampsia) have a substantial public health impact. Maternal exposure to high levels of air pollution may trigger HDP, but this association remains unclear. The objective of our report is to assess and quantify the association between maternal exposures to criteria air pollutants (ozone, carbon monoxide, nitrogen dioxide, sulfur dioxide, and particulate matter ≤ 10, 2.5 μm) on HDP risk. PubMed, EMBASE, MEDLINE, Current Contents, Global Health, and Cochrane were searched (last search: September, 2013). After a detailed screening of 270 studies, 10 studies were extracted. We conducted meta-analyses if a pollutant in a specific exposure window was reported by at least four studies. Using fixed- and random-effects models, odds ratios (ORs) and 95% CIs were calculated for each pollutant with specific increment of concentration. Increases in risks of HDP (OR per 10 ppb = 1.16; 95% CI, 1.03-1.30) and preeclampsia (OR per 10 ppb = 1.10; 95% CI, 1.03-1.17) were observed to be associated with exposure to NO2 during the entire pregnancy, and significant associations between HDP and exposure to CO (OR per 1 ppm = 1.79; 95% CI, 1.31-2.45) and O3 (OR per 10 ppb = 1.09; 95% CI, 1.05-1.13) during the first trimester were also observed. Our review suggests an association between ambient air pollution and HDP risk. Although the ORs were relatively low, the population-attributable fractions were not negligible given the ubiquitous nature of air pollution.
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Affiliation(s)
- Hui Hu
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida
| | - Sandie Ha
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida
| | - Jeffrey Roth
- Department of Pediatrics, College of Medicine, University of Florida
| | - Greg Kearney
- Department of Public Health, Brody School of Medicine, East Carolina University
| | - Evelyn O. Talbott
- Department of Epidemiology, School of Public Health, University of Pittsburgh
| | - Xiaohui Xu
- Department of Epidemiology, College of Public Health and Health Professions, University of Florida
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Pedersen M, Stayner L, Slama R, Sørensen M, Figueras F, Nieuwenhuijsen MJ, Raaschou-Nielsen O, Dadvand P. Ambient Air Pollution and Pregnancy-Induced Hypertensive Disorders. Hypertension 2014; 64:494-500. [DOI: 10.1161/hypertensionaha.114.03545] [Citation(s) in RCA: 204] [Impact Index Per Article: 20.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Pregnancy-induced hypertensive disorders can lead to maternal and perinatal morbidity and mortality, but the cause of these conditions is not well understood. We have systematically reviewed and performed a meta-analysis of epidemiological studies investigating the association between exposure to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December 2009 and December 2013. Combined risk estimates were calculated using random-effect models for each exposure that had been examined in ≥4 studies. Heterogeneity and publication bias were evaluated. A total of 17 articles evaluating the impact of nitrogen oxides (NO
2
, NO
X
), particulate matter (PM
10
, PM
2.5
), carbon monoxide (CO), ozone (O
3
), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Meta-analyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta-analysis combined odds ratio associated with a 5-µg/m
3
increase in PM
2.5
was 1.57 (95% confidence interval, 1.26–1.96) for combined pregnancy-induced hypertensive disorders and 1.31 (95% confidence interval, 1.14–1.50) for preeclampsia. Our results suggest that exposure to air pollution increases the risk of pregnancy-induced hypertensive disorders.
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Affiliation(s)
- Marie Pedersen
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Leslie Stayner
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Rémy Slama
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Mette Sørensen
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Francesc Figueras
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Mark J. Nieuwenhuijsen
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Ole Raaschou-Nielsen
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
| | - Payam Dadvand
- From the Centre for Research in Environmental Epidemiology, Barcelona, Spain (M.P., L.S., M.J.N., P.D.); CIBER Epidemiología y Salud Pública, Madrid, Spain (M.P., M.J.N., P.D.); Universitat Pompeu Fabra, Barcelona, Spain (M.P., M.J.N., P.D.); INSERM, U823, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute Albert Bonniot, Grenoble, France (M.P., R.S.); Division of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago (L.S
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Dadvand P, Ostro B, Amato F, Figueras F, Minguillón MC, Martinez D, Basagaña X, Querol X, Nieuwenhuijsen M. Particulate air pollution and preeclampsia: a source-based analysis. Occup Environ Med 2014; 71:570-7. [DOI: 10.1136/oemed-2013-101693] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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