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Ji N, Eckel SP, Foley H, Yang T, Lurmann F, Grubbs BH, Habre R, Bastain TM, Farzan SF, Breton CV. Prenatal air pollution exposure is associated with inflammatory, cardiovascular, and metabolic biomarkers in mothers and newborns. ENVIRONMENTAL RESEARCH 2024; 252:118797. [PMID: 38555084 PMCID: PMC11156540 DOI: 10.1016/j.envres.2024.118797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/20/2024] [Accepted: 03/25/2024] [Indexed: 04/02/2024]
Abstract
BACKGROUND Prenatal air pollution exposure has been associated with individual inflammatory, cardiovascular, and metabolic biomarkers in mothers and neonates. However, studies of air pollution and a comprehensive panel of biomarkers across maternal and cord blood samples remain limited. Few studies used data-driven methods to identify biomarker groupings that converge biomarkers from multiple biological pathways. This study aims to investigate the impacts of prenatal air pollution on groups of biomarkers in maternal and cord blood samples. METHODS In the Maternal And Developmental Risks from Environmental and Social Stressors (MADRES) cohort, 87 biomarkers were quantified from 45 trimester 1 maternal blood and 55 cord blood samples. Pregnancy and trimester 1-averaged concentrations of particulate matter ≤2.5 μm and ≤10 μm in diameter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3) were estimated, using inverse distance squared weighted spatial interpolation from regulatory air monitoring stations. Traffic-related NOx was assessed using California Line Source Dispersion Model: freeway/highway roads, non-freeway major roads, non-freeway minor roads, and their sum as total NOx. Elastic Net (EN) regression within the rexposome R package was used to group biomarkers and assess their associations with air pollution. RESULTS In maternal samples, trimester 1-averaged PM10 was associated with elevated inflammation biomarkers and lowered cardiovascular biomarkers. NO2 exhibited positive associations with cardiovascular and inflammation markers. O3 was inversely associated with inflammation, metabolic, and cardiovascular biomarkers. In cord blood, pregnancy-averaged PM2.5 was associated with higher cardiovascular biomarkers and lower metabolic biomarkers. PM10 was associated with lower inflammation and higher cardiovascular biomarkers. Total and major road NOx was associated with lower cardiovascular biomarkers. CONCLUSION Prenatal air pollution exposure was associated with changes in biomarkers related to inflammation, cardiovascular, metabolic, cancer, and neurological function in both mothers and neonates. This study shed light on mechanisms by which air pollution can influence biological function during pregnancy.
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Affiliation(s)
- Nan Ji
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Sandrah P Eckel
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Helen Foley
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Tingyu Yang
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Fred Lurmann
- Sonoma Technology Inc., Petaluma, CA, 94954, United States
| | - Brendan H Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Rima Habre
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Theresa M Bastain
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Shohreh F Farzan
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States
| | - Carrie V Breton
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, 90089, United States.
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Pedersen M, Nobile F, Stayner LT, de Hoogh K, Brandt J, Stafoggia M. Ambient air pollution and hypertensive disorders of pregnancy in Rome. ENVIRONMENTAL RESEARCH 2024; 251:118630. [PMID: 38452913 DOI: 10.1016/j.envres.2024.118630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Revised: 02/25/2024] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
BACKGROUND Ambient air pollution has been associated with hypertensive disorders of pregnancy (HDP), but few studies rely on assessment of fine-scale variation in air quality, specific subtypes and multi-pollutant exposures. AIM To study the impact of long-term exposure to individual and mixture of air pollutants on all and specific subtypes of HDP. METHODS We obtained data from 130,470 liveborn singleton pregnacies in Rome during 2014-2019. Spatiotemporal land-use random-forest models at 1 km spatial resolution assigned to the maternal residential addresses were used to estimate the exposure to particulate matter (PM2.5 and PM10), nitrogen dioxide (NO2), and ozone (O3). RESULTS For PM2.5, PM10 and NO2, there was suggestive evidence of increased risk of preeclampsia (PE, n = 442), but no evidence of increased risk for all subtypes of HDP (n = 2297) and gestational hypertension (GH, n = 1901). For instance, an interquartile range of 7.0 μg/m3 increase in PM2.5 exposure during the first trimester of pregnancy was associated with an odds ratio (OR) of 1.06 (95% confidence interval: 0.81, 1.39) and 1.04 (0.92, 1.17) after adjustment for NO2 and the corresponding results for a 15.7 μg/m3 increase in NO2 after adjustment for PM2.5 were 1.11 (0.92, 1.34) for PE and 0.83 (0.76, 0.90) for HDP. Increased risks for HDP and GH were suggested for O3 in single-pollutant models and for PM after adjustment for NO2, but all other associations were stable or attenuated in two-pollutant models. CONCLUSIONS The results of our study suggest that PM2.5, PM10 and NO2 increases the risk of PE and that these effects are robust to adjustment for O3 while the increased risks for GH and HDP suggested for O3 attenuated after adjustment for PM or NO2. Additional studies are needed to evaluate the effects of source-specific component of PM on subtypes as well as all types of HDP which would help to target preventive actions.
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Affiliation(s)
- Marie Pedersen
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy.
| | - Federica Nobile
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Kees de Hoogh
- The Swiss Tropical and Public Health Institute, Allschwil, Switzerland; University of Basel, Basel, Switzerland
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Roskilde, Denmark
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Region Health Service/ASL Roma, Rome, Italy; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Hart NR. Paradoxes: Cholesterol and Hypoxia in Preeclampsia. Biomolecules 2024; 14:691. [PMID: 38927094 PMCID: PMC11201883 DOI: 10.3390/biom14060691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Revised: 05/28/2024] [Accepted: 06/06/2024] [Indexed: 06/28/2024] Open
Abstract
Preeclampsia, a hypertensive disease of pregnancy of unknown etiology, is intensely studied as a model of cardiovascular disease (CVD) not only due to multiple shared pathologic elements but also because changes that develop over decades in CVD appear and resolve within days in preeclampsia. Those affected by preeclampsia and their offspring experience increased lifetime risks of CVD. At the systemic level, preeclampsia is characterized by increased cellular, membrane, and blood levels of cholesterol; however, cholesterol-dependent signaling, such as canonical Wnt/βcatenin, Hedgehog, and endothelial nitric oxide synthase, is downregulated indicating a cholesterol deficit with the upregulation of cholesterol synthesis and efflux. Hypoxia-related signaling in preeclampsia also appears to be paradoxical with increased Hypoxia-Inducible Factors in the placenta but measurably increased oxygen in maternal blood in placental villous spaces. This review addresses the molecular mechanisms by which excessive systemic cholesterol and deficient cholesterol-dependent signaling may arise from the effects of dietary lipid variance and environmental membrane modifiers causing the cellular hypoxia that characterizes preeclampsia.
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Affiliation(s)
- Nancy R Hart
- PeaceHealth St. Joseph Medical Center, Bellingham, WA 98225, USA
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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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Zhou Y, Zhang X, Zhang C, Chen B, Gu B. Mitigating air pollution benefits multiple sustainable development goals in China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2024; 349:123992. [PMID: 38631451 DOI: 10.1016/j.envpol.2024.123992] [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: 01/23/2024] [Revised: 03/27/2024] [Accepted: 04/14/2024] [Indexed: 04/19/2024]
Abstract
Achieving the United nations 2030 Sustainable Development Goals (SDGs) remains a significant challenge, necessitating urgent and prioritized strategies. Among the various challenges, air pollution continues to pose one of the most substantial threats to the SDGs due to its widespread adverse effects on human health and ecosystems. However, the connections between air pollution and the SDGs have often been overlooked. This study reveals that out of the 169 SDG targets, 71 are adversely impacted by air pollution, while only 6 show potential positive effects. In China, two major atmospheric nitrogen pollutants, ammonia and nitrogen oxides, resulted in an economic loss of 400 billion United States Dollar (USD) in 2020, which could be reduced by 33% and 34% by 2030, respectively. It would enhance the progress towards SDGs in China by 14%, directly contributing to the achievement of SDGs 1 to 6 and 11 to 15. This improvement is estimated to yield overall benefits totaling 119 billion USD, exceeded the total implementation cost of 82 billion USD with ammonia as the preferential mitigation target. This study underscores the importance of robust scientific evidence in integrated policies aimed at aligning improvements in environmental quality with the priorities of sustainable development.
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Affiliation(s)
- Yi Zhou
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Xiuming Zhang
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China; Policy Simulation Laboratory, Zhejiang University, Hangzhou 310058, China
| | - Chuanzhen Zhang
- School of Agriculture, Food and Ecosystem Sciences, The University of Melbourne, Victoria 3010, Australia
| | - Binhui Chen
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China
| | - Baojing Gu
- College of Environmental and Resource Sciences, Zhejiang University, Hangzhou 310058, China; Zhejiang Provincial Key Laboratory of Agricultural Resources and Environment, Zhejiang University, Hangzhou 310058, China; Ministry of Education Key Laboratory of Environment Remediation and Ecological Health, Zhejiang University, Hangzhou 310058, China.
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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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Liu X, Na J, Liu X, Jia X, Ren M, Chen J, Han B, Xu J, Li N, Li Z, Wang B. Co-exposure to phthalates and polycyclic aromatic hydrocarbons and the risk of gestational hypertension in Chinese women. ENVIRONMENT INTERNATIONAL 2024; 185:108562. [PMID: 38460239 DOI: 10.1016/j.envint.2024.108562] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2023] [Revised: 02/20/2024] [Accepted: 03/04/2024] [Indexed: 03/11/2024]
Abstract
Phthalates (PAEs) and polycyclic aromatic hydrocarbons (PAHs) are frequently detected in females of reproductive age. Many studies have found that environmental PAE and PAH levels are independent risk factors for gestational hypertension. However, exposure to both components is a more realistic scenario. To better assess the health effects of PAEs and PAHs in pregnant women, we explored the associations of exposure to both individual and combined PAEs and PAHs with gestational hypertension. This nested case-control study was a component of a prospective cohort study conducted in Beijing, China. We included 206 women with gestational hypertension and 214 pregnant controls. We used gas chromatography/tandem mass spectrometry (GC-MS/MS) to detect 8 PAEs and 13 PAHs in > 80 % of all collected hair samples. Multiple linear regression models were employed to test the individual associations between each component and gestational hypertension. A quantile-based g-computation (qgcomp) model and a weighted quantile sum (WQS) regression model were used to estimate whether exposure to both PAEs and PAHs increased the risk of gestational hypertension. The individual exposure analyses revealed that diethyl phthalate (DEP), diisobutyl phthalate (DIBP) (both PAEs), benzo(k)fluoranthene (BKF), anthracene, (ANT), and benzo(a)pyrene (BAP) (all PAHs) were positively associated with increased risk of gestational hypertension. In mixed-effect analyses, the qgcomp model indicated that co-exposure to PAEs and PAHs increased the risk of gestational hypertension (odds ratio = 2.01; 95 % confidence interval: 1.02, 3.94); this finding was verified by the WQS regression model. Our findings support earlier evidence that both PAEs and PAHs increase the risk of gestational hypertension, both individually and in combination. This suggests that reductions in exposure to endocrine system-disrupting chemicals such as PAEs and PAHs might reduce the risk of gestational hypertension.
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Affiliation(s)
- Xiaowen Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Jigen Na
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Vanke School of Public Health, Tsinghua University, Beijing 100084, China
| | - Xiaojing Liu
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Xiaoqian Jia
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Mengyuan Ren
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Junxi Chen
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China
| | - Jia Xu
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing 100012, China.
| | - Nan Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China.
| | - Zhiwen Li
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China
| | - Bin Wang
- Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health, Peking University/ Key Laboratory of Reproductive Health, National Health Commission of the People's Republic of China, Beijing 100191, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, China
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Hao H, Yoo SR, Strickland MJ, Darrow LA, D'Souza RR, Warren JL, Moss S, Wang H, Zhang H, Chang HH. Effects of air pollution on adverse birth outcomes and pregnancy complications in the U.S. state of Kansas (2000-2015). Sci Rep 2023; 13:21476. [PMID: 38052850 PMCID: PMC10697947 DOI: 10.1038/s41598-023-48329-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 11/24/2023] [Indexed: 12/07/2023] Open
Abstract
Neonatal mortality and morbidity are often caused by preterm birth and lower birth weight. Gestational diabetes mellitus (GDM) and gestational hypertension (GH) are the most prevalent maternal medical complications during pregnancy. However, evidence on effects of air pollution on adverse birth outcomes and pregnancy complications is mixed. Singleton live births conceived between January 1st, 2000, and December 31st, 2015, and reached at least 27 weeks of pregnancy in Kansas were included in the study. Trimester-specific and total pregnancy exposures to nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5), and ozone (O3) were estimated using spatiotemporal ensemble models and assigned to maternal residential census tracts. Logistic regression, discrete-time survival, and linear models were applied to assess the associations. After adjustment for demographics and socio-economic status (SES) factors, we found increases in the second and third trimesters and total pregnancy O3 exposures were significantly linked to preterm birth. Exposure to the second and third trimesters O3 was significantly associated with lower birth weight, and exposure to NO2 during the first trimester was linked to an increased risk of GDM. O3 exposures in the first trimester were connected to an elevated risk of GH. We didn't observe consistent associations between adverse pregnancy and birth outcomes with PM2.5 exposure. Our findings indicate there is a positive link between increased O3 exposure during pregnancy and a higher risk of preterm birth, GH, and decreased birth weight. Our work supports limiting population exposure to air pollution, which may lower the likelihood of adverse birth and pregnancy outcomes.
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Affiliation(s)
- Hua Hao
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA.
| | - Sodahm R Yoo
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Matthew J Strickland
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Lyndsey A Darrow
- Depatment of Health Analytics and Biostatistics, Epidemiology and Environmental Health, School of Public Health, University of Nevada, Reno, NV, 89557, USA
| | - Rohan R D'Souza
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Joshua L Warren
- Department of Biostatistics, School of Medicine, Yale University, New Haven, CT, 06510, USA
| | - Shannon Moss
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
| | - Huaqing Wang
- Department of Landscape Architecture and Environment Planning, College of Agriculture and Applied Sciences, Utah State University, Logan, UT, 84322, USA
| | - Haisu Zhang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
| | - Howard H Chang
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, 1518 Clifton Rd., NE, Atlanta, GA, 30322, USA
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, 30322, USA
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9
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Hu B, Xu L, Yang X, Qu S, Wu L, Sun Y, Yan J, Zhang Y, Yu Z, Wang Y, Jia R. Association between ambient air pollution exposure in pregnant women with antiphospholipid syndrome in Nanjing, China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:116266-116278. [PMID: 37910359 PMCID: PMC10682106 DOI: 10.1007/s11356-023-29937-0] [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: 06/12/2023] [Accepted: 09/13/2023] [Indexed: 11/03/2023]
Abstract
Antenatal exposure to air pollutants is thought to be associated with a variety of maternal blood markers as well as adverse birth outcomes. However, the dysgenic influence of air pollutants on the antiphospholipid syndrome (APS) in mothers and their pregnancy outcomes remains unclear. In the current study, 371 mother-infant pairs (189 healthy: 182 APS) from Nanjing Maternal and Child Health Hospital as well as air pollutants concentration from their living environment were used to investigate correlations between air pollution with maternal blood indicators and fetal birth weight in the groups of APS and healthy mothers. Generalized linear model was used to evaluate the contributions of air pollutant exposure during pregnancy to the blood indicators variation. The relationships between birth weight with specific air pollutant and blood index were analyzed using ridge regression. Results showed that APS fetal birth weight was significantly impacted by air pollutant exposure during pregnancy, in particular, the birth weight decreased significantly along with increasing fine particulate matter 2.5 (PM2.5) and fine particulate matter 10 (PM10) exposure concentrations throughout pregnancy. In contrast, birth weight increased significantly with sulfur dioxide (SO2) exposure. In addition, APS-related blood indicators comprised of platelet distribution width (PDW), total bilirubin (TBIL), mean platelet volume (MPV), platelet-larger cell ratio (P_LCR), homocysteine (HCY), alkaline phosphatase (ALP), direct bilirubin (DBIL), basophilic granulocyte (BAS), platelet thrombocytocrit (PCT), preprandial glucose levels (OGTT0), monocytes (MON), and monocytes ratio (MON_ratio) were also strongly related with prenatal exposure to PM2.5 and PM10, in which PDW levels showed most strongly negative impaction on fetal birth weight. Together, we showed that prenatal exposure to air pollutant (PM2.5 and PM10) may exacerbate the poor birth outcomes of low birth weight by impacting APS maternal blood indicators especially for PDW.
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Affiliation(s)
- Bimei Hu
- Lianyungang Branch of Traditional Chinese Medicine, Jiangsu Union Technical Institute, Lianyungang, 222000, Jiangsu, China
| | - Linjie Xu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Xu Yang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing, 210000, Jiangsu, China
- Key Laboratory of Modern Toxicology of Ministry of Education, School of Public Health, Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Shiwen Qu
- Lianyungang Branch of Traditional Chinese Medicine, Jiangsu Union Technical Institute, Lianyungang, 222000, Jiangsu, China
| | - Lan Wu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yumei Sun
- Information Center, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Jun Yan
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yexiao Zhang
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Zhaoer Yu
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Yixiao Wang
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China
| | - Ruizhe Jia
- Department of Obstetrics, Women's Hospital of Nanjing Medical University, Nanjing, 210000, Jiangsu, China.
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10
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Zheng Y, McElrath T, Cantonwine D, Hu H. Longitudinal Associations between Ambient Air Pollution and Angiogenic Biomarkers among Pregnant Women in the LIFECODES Study, 2006-2008. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:87005. [PMID: 37556304 PMCID: PMC10411633 DOI: 10.1289/ehp11909] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 06/21/2023] [Accepted: 07/12/2023] [Indexed: 08/11/2023]
Abstract
BACKGROUND Exposures to ambient air pollution during pregnancy have been linked to adverse pregnancy outcomes such as preeclampsia and fetal growth restriction. Although evidence has shown that women with preeclampsia have higher ratio of soluble fms-like tyrosine kinase 1 to placental growth factor (sFlt-1/PlGF ratio), the potential impact of air pollution on markers of placental growth and function has not been well studied. OBJECTIVES We aimed to examine longitudinal associations between ambient air pollution exposure and angiogenic factors among pregnant women in LIFECODES, a prospective birth cohort and biorepository in Massachusetts in the United States. METHODS PlGF and sFlt-1 were measured among pregnant women using plasma samples collected around 10, 18, 26, and 35 wk' gestation. Women's exposures to ozone (O 3 ), fine particulate matter with aerodynamic diameter ≤ 2.5 μ m (PM 2.5 ), and nitrogen dioxide (NO 2 ) within 1, 2, 4, and 8 wk prior to each plasma sample collection were estimated based on geocoded residential addresses, and mixed effect linear regression models were fitted to assess their associations with sFlt-1/PlGF ratio, sFlt-1 (ng/mL), and PlGF (pg/mL). Percent changes in outcomes associated with each interquartile range increase in exposures were reported, along with their 95% confidence intervals. RESULTS A total of 1,066 pregnant women were included. In the multipollutant models, significant associations were observed for increased sFlt-1/PlGF ratio (PM 2.5 3-8 wk' gestation, NO 2 : 35-39 wk' gestation), elevated sFlt-1 (O 3 : 26-34 wk' gestation, PM 2.5 : 3-8 wk' gestation), decreased sFlt-1 (NO 2 : 4-8 wk' gestation), and decreased PlGF (NO 2 : 34-39 wk' gestation) after adjusting for sociodemographic status, smoking, drinking, body mass index, parity, history of chronic hypertension, and conception time. DISCUSSION Exposures to PM 2.5 during early pregnancy and exposures to O 3 and NO 2 during late pregnancy were associated with increased sFlt-1/PlGF ratio, elevated sFlt-1 and with decreased PlGF, which may be a potential mechanism underlying ambient air pollution's impacts on adverse pregnancy and birth outcomes. https://doi.org/10.1289/EHP11909.
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Affiliation(s)
- Yi Zheng
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Thomas McElrath
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - David Cantonwine
- Division of Maternal-Fetal Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
| | - Hui Hu
- Channing Division of Network Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA
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11
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Jiang W, Yu G, Wang C, Yin S, Huang Y, Chen Q, Sun K, Zhang J. Exposure to multiple air pollutant mixtures and the subtypes of hypertensive disorders in pregnancy: A multicenter study. Int J Hyg Environ Health 2023; 253:114238. [PMID: 37531934 DOI: 10.1016/j.ijheh.2023.114238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 07/05/2023] [Accepted: 07/29/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Hypertensive disorders in pregnancy (HDP) have heterogeneous etiologies. Previous studies have linked individual air pollutants to overall HDP with inconsistent results. Moreover, it has not been explored how exposure to a mixture of multiple air pollutants may affect the risks of the subtypes of the disorders. OBJECTIVES To investigate the associations of exposure to air pollutant mixture in the 1st and 2nd trimesters of pregnancy with the risks of HDP and its subtypes. METHODS Pregnancy data were obtained from the China Labor and Delivery Survey, a nationwide cross-sectional survey in 2015 and 2016. Levels of air pollutants [including fine particulate matter (PM2.5), carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and sulfur dioxide (SO2)] in the 1st and 2nd trimesters were estimated based on the model developed by the Institution of Atmospheric Physics, Chinese Academy of Science. Generalized linear mixed models were built to assess the single-exposure effects of air pollutants in early gestation on HDP. The restricted cubic spline function was further applied to assess the potential non-linearity. The weighted quantile sum (WQS) regression was used to investigate the effects of co-exposure to multiple air pollutants. RESULTS A total of 67,512 pregnancies were included, and 2,834 were HDP cases. The single-effect analysis showed that CO, PM2.5, and SO2 exposure in the 2nd trimester was positively associated with the risks of gestational hypertension (GH), with adjusted odds ratios (aORs) and 95% confidence intervals (CI) of 1.16 (1.04, 1.28), 1.19 (1.04, 1.37), and 1.13 (1.04, 1.22), respectively. The first-trimester O3 exposure was also associated with an increased preeclampsia/eclampsia (PE) risk (aOR = 1.17; 95%CI: 1.02, 1.33). WQS regression confirmed positive associations of air pollutant mixture with HDP subtypes, with PM2.5 as the main contributing pollutant to GH, and CO and O3 as the main pollutants to PE. CONCLUSIONS Exposure to multiple air pollutant mixtures in early pregnancy was associated with increased risks of hypertensive disorders in pregnancy.
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Affiliation(s)
- Wen Jiang
- 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
| | - 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; Global Centre for Asian Women's Health, Department of Obstetrics & Gynaecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Cuiping Wang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Shengju Yin
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, 200025, China
| | - Yun Huang
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Qian Chen
- Ministry of Education-Shanghai Key Laboratory of Children's Environmental Health, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, China
| | - Kun Sun
- Department of Pediatric Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, 200092, 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.
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12
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Zhang M, Yang BY, Zhang Y, Sun Y, Liu R, Zhang Y, Su S, Zhang E, Zhao X, Chen G, Wu Q, Hu L, Zhang Y, Wang L, Luo Y, Liu X, Li J, Wu S, Mi X, Zhang W, Dong G, Yin C, Yue W. Association of ambient PM 1 exposure with maternal blood pressure and hypertensive disorders of pregnancy in China. iScience 2023; 26:106863. [PMID: 37255659 PMCID: PMC10225929 DOI: 10.1016/j.isci.2023.106863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 03/30/2023] [Accepted: 05/08/2023] [Indexed: 06/01/2023] Open
Abstract
Evidence concerning PM1 exposure, maternal blood pressure (BP), and hypertensive disorders of pregnancy (HDP) is sparse. We evaluated the associations using 105,063 participants from a nationwide cohort. PM1 concentrations were evaluated using generalized additive model. BP was measured according to the American Heart Association recommendations. Generalized linear mixed models were used to assess the PM1-BP/HDP associations. Each 10 μg/m3 higher first-trimester PM1 was significantly associated with 1.696 mmHg and 1.056 mmHg higher first-trimester SBP and DBP, and with 11.4% higher odds for HDP, respectively. The above associations were stronger among older participants (> 35 years) or those educated longer than 17 years or those with higher household annual income (> 400,000 CNY). To conclude, first-trimester PM1 were positively associated with BP/HDP, which may be modified by maternal age, education level, and household annual income. Further research is warranted to provide more information for both health management of HDP and environmental policies enactment.
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Affiliation(s)
- Man Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Bo-Yi Yang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yuqin Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yongqing Sun
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Ruixia Liu
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Yue Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Shaofei Su
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Enjie Zhang
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Xiaoting Zhao
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Gongbo Chen
- Climate, Air Quality Research Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Qizhen Wu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lixin Hu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yunting Zhang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Lebing Wang
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yana Luo
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xiaoxuan Liu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiaxin Li
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Sihan Wu
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xin Mi
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Wangjian Zhang
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Guanghui Dong
- Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Preventive Medicine, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Chenghong Yin
- Prenatal Diagnosis Center, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
| | - Wentao Yue
- Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China
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13
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Juan-Reyes SS, Gómez-Oliván LM, Juan-Reyes NS, Islas-Flores H, Dublán-García O, Orozco-Hernández JM, Pérez-Álvarez I, Mejía-García A. Women with preeclampsia exposed to air pollution during pregnancy: Relationship between oxidative stress and neonatal disease - Pilot study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 871:161858. [PMID: 36716872 DOI: 10.1016/j.scitotenv.2023.161858] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/09/2023] [Accepted: 01/23/2023] [Indexed: 06/18/2023]
Abstract
Oxidative imbalance as a pathophysiological mechanism has been reported as an adverse outcome in pregnant women who develop preeclampsia and in their newborns. Furthermore, emerging evidence suggests the same mechanism by which air pollutants may exert their toxic effects. Therefore, the objective of the study was to evaluate the biomarkers of oxidative stress and their relationship with neonatal disease in premature newborns from mothers with preeclampsia exposed to air pollution during pregnancy. The data of air pollutants (PM2.5, PM10 and ozone) were collected at fixed monitoring stations. Oxidative and antioxidant status markers were obtained through special techniques in women with preeclampsia and in umbilical cord blood of their premature newborns. The oxidative stress markers were significantly higher in women with preeclampsia and their newborns who were exposed to higher levels of ambient air pollutants in the first and second trimester of pregnancy. Neonatal diseases are associated with preeclampsia in pregnancies, specifically intrauterine growth restriction (IUGR) and necrotizing enterocolitis (NEC). A significant correlation was identified in the levels of prooxidant agents and antioxidant enzyme activity in the presence of neonatal diseases associated with preeclampsia. There is increased oxidative damage in both the maternal and fetal circulation in women who develop preeclampsia exposed to air pollution during pregnancy. Therefore, these pregnancies complicated by preeclampsia have a greater adverse outcome as neonatal disease in the preterm infant.
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Affiliation(s)
- Sindy San Juan-Reyes
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - Leobardo Manuel Gómez-Oliván
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico.
| | - Nely San Juan-Reyes
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - Hariz Islas-Flores
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - Octavio Dublán-García
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - José Manuel Orozco-Hernández
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - Itzayana Pérez-Álvarez
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
| | - Alejandro Mejía-García
- Laboratorio de Toxicología Ambiental, Facultad de Química, Universidad Autónoma del Estado de México, Paseo Colón intersección Paseo Tollocan s/n, Col. Residencial Colón, 50120 Toluca, Estado de México, Mexico
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14
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Li C, Xu JJ, Zhou FY, Ge YZ, Qin KZ, Huang HF, Wu YT. Effects of Particulate Matter on the Risk of Gestational Hypertensive Disorders and Their Progression. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2023; 57:4930-4939. [PMID: 36913485 PMCID: PMC10061918 DOI: 10.1021/acs.est.2c06573] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Associations between particulate matter (PM) and gestational hypertensive disorders (GHDs) are well documented, but there is no evidence on the associations between PM and GHD progression, especially among those with assisted reproductive technology (ART) conceptions. To explore the effects of PM on the risk of GHDs and their progression among pregnant women with natural or ART conception, we enrolled 185,140 pregnant women during 2014-2020 in Shanghai and estimated the associations during different periods using multivariate logistic regression. During the 3 months of preconception, 10 μg/m3 increases in PM concentrations were associated with increased risks of gestational hypertension (GH) (PM2.5: aOR = 1.076, 95% CI: 1.034-1.120; PM10: aOR = 1.042, 95% CI: 1.006-1.079) and preeclampsia (PM2.5: aOR = 1.064, 95% CI: 1.008-1.122; PM10: aOR = 1.048, 95% CI: 1.006-1.092 ) among women with natural conception. Furthermore, for women with ART conceptions who suffered current GHD, 10 μg/m3 increases in PM concentrations in the third trimester elevated the risk of progression (PM2.5: aOR = 1.156, 95% CI: 1.022-1.306 ; PM10: aOR = 1.134, 95% CI: 1.013-1.270). In summary, women with natural conception should avoid preconceptional PM exposure to protect themselves from GH and preeclampsia. For women with ART conceptions suffering from GHD, it is necessary to avoid PM exposure in late pregnancy to prevent the disease from progressing.
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Affiliation(s)
- Cheng Li
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
| | - Jing-Jing Xu
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
| | - Fang-Yue Zhou
- International
Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Ying-Zhou Ge
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
| | - Kai-Zhou Qin
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
| | - He-Feng Huang
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
- Research
Units of Embryo Original Diseases, Chinese
Academy of Medical Sciences, Shanghai 200011, China
- International
Peace Maternity and Child Health Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Yan-Ting Wu
- Obstetrics
and Gynecology Hospital, Institute of Reproduction and Development, Fudan University, Shanghai 200011, China
- Research
Units of Embryo Original Diseases, Chinese
Academy of Medical Sciences, Shanghai 200011, China
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15
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Starling AP, Wood C, Liu C, Kechris K, Yang IV, Friedman C, Thomas DSK, Peel JL, Adgate JL, Magzamen S, Martenies SE, Allshouse WB, Dabelea D. Ambient air pollution during pregnancy and DNA methylation in umbilical cord blood, with potential mediation of associations with infant adiposity: The Healthy Start study. ENVIRONMENTAL RESEARCH 2022; 214:113881. [PMID: 35835166 PMCID: PMC10402394 DOI: 10.1016/j.envres.2022.113881] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Revised: 06/11/2022] [Accepted: 07/06/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Prenatal exposure to ambient air pollution has been associated with adverse offspring health outcomes. Childhood health effects of prenatal exposures may be mediated through changes to DNA methylation detectable at birth. METHODS Among 429 non-smoking women in a cohort study of mother-infant pairs in Colorado, USA, we estimated associations between prenatal exposure to ambient fine particulate matter (PM2.5) and ozone (O3), and epigenome-wide DNA methylation of umbilical cord blood cells at delivery (2010-2014). We calculated average PM2.5 and O3 in each trimester of pregnancy and the full pregnancy using inverse-distance-weighted interpolation. We fit linear regression models adjusted for potential confounders and cell proportions to estimate associations between air pollutants and methylation at each of 432,943 CpGs. Differentially methylated regions (DMRs) were identified using comb-p. Previously in this cohort, we reported positive associations between 3rd trimester O3 exposure and infant adiposity at 5 months of age. Here, we quantified the potential for mediation of that association by changes in DNA methylation in cord blood. RESULTS We identified several DMRs for each pollutant and period of pregnancy. The greatest number of significant DMRs were associated with third trimester PM2.5 (21 DMRs). No single CpGs were associated with air pollutants at a false discovery rate <0.05. We found that up to 8% of the effect of 3rd trimester O3 on 5-month adiposity may be mediated by locus-specific methylation changes, but mediation estimates were not statistically significant. CONCLUSIONS Differentially methylated regions in cord blood were identified in association with maternal exposure to PM2.5 and O3. Genes annotated to the significant sites played roles in cardiometabolic disease, immune function and inflammation, and neurologic disorders. We found limited evidence of mediation by DNA methylation of associations between third trimester O3 exposure and 5-month infant adiposity.
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Affiliation(s)
- Anne P Starling
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
| | - Cheyret Wood
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Cuining Liu
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Katerina Kechris
- Department of Biostatistics and Informatics, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Ivana V Yang
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Division of Biomedical Informatics and Personalized Medicine, Department of Medicine, University of Colorado School of Medicine, Aurora, CO, USA; Center for Genes, Environment and Health, National Jewish Health, Denver, CO, USA
| | - Chloe Friedman
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Deborah S K Thomas
- Department of Geography and Earth Sciences, University of North Carolina Charlotte, NC, USA
| | - Jennifer L Peel
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - John L Adgate
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Epidemiology, Colorado School of Public Health, Colorado State University, Fort Collins, CO, USA
| | - Sheena E Martenies
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA; Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign, Urbana, IL, USA
| | - William B Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Dana Dabelea
- Department of Epidemiology, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Lifecourse Epidemiology of Adiposity and Diabetes (LEAD) Center, University of Colorado Anschutz Medical Campus, Aurora, CO, USA; Department of Pediatrics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
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16
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Eriksson A, Abera A, Malmqvist E, Isaxon C. Characterization of fine particulate matter from indoor cooking with solid biomass fuels. INDOOR AIR 2022; 32:e13143. [PMID: 36437670 PMCID: PMC9828024 DOI: 10.1111/ina.13143] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Revised: 10/09/2022] [Accepted: 10/10/2022] [Indexed: 05/06/2023]
Abstract
Household burning of solid biomass fuels emits pollution particles that are a huge health risk factor, especially in low-income countries (LICs) such as those in Sub-Saharan Africa. In epidemiological studies, indoor exposure is often more challenging to assess than outdoor exposure. Laboratory studies of solid biomass fuels, performed under real-life conditions, are an important path toward improved exposure assessments. Using on- and offline measurement techniques, particulate matter (PM) from the most commonly used solid biomass fuels (charcoal, wood, dung, and crops residue) was characterized in laboratory settings using a way of burning the fuels and an air exchange rate that is representative of real-world settings in low-income countries. All the fuels generated emissions that resulted in concentrations which by far exceed both the annual and the 24-hour-average WHO guidelines for healthy air. Fuels with lower energy density, such as dung, emitted orders of magnitude more than, for example, charcoal. The vast majority of the emitted particles were smaller than 300 nm, indicating high deposition in the alveoli tract. The chemical composition of the indoor pollution changes over time, with organic particle emissions often peaking early in the stove operation. The chemical composition of the emitted PM is different for different biomass fuels, which is important to consider both in toxicological studies and in source apportionment efforts. For example, dung and wood yield higher organic aerosol emissions, and for dung, nitrogen content in the organic PM fraction is higher than for the other fuels. We show that aerosol mass spectrometry can be used to differentiate stove-related emissions from fuel, accelerant, and incense. We argue that further emission studies, targeting, for example, vehicles relevant for LICs and trash burning, coupled with field observations of chemical composition, would advance our understanding of air pollution in LIC. We believe this to be a necessary step for improved air quality policy.
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Affiliation(s)
- Axel Eriksson
- Division of Ergonomics and Aerosol TechnologyLund UniversityLundSweden
| | - Asmamaw Abera
- Ethiopia Institute of Water ResourcesAddis Ababa UniversityAddis AbabaEthiopia
| | - Ebba Malmqvist
- Division of Occupational and Environmental MedicineLund UniversityLundSweden
| | - Christina Isaxon
- Division of Ergonomics and Aerosol TechnologyLund UniversityLundSweden
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17
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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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18
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Gogna P, Villeneuve PJ, Borghese MM, King WD. An exposure-response meta-analysis of ambient PM 2.5 during pregnancy and preeclampsia. ENVIRONMENTAL RESEARCH 2022; 210:112934. [PMID: 35150719 DOI: 10.1016/j.envres.2022.112934] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/07/2022] [Accepted: 02/07/2022] [Indexed: 06/14/2023]
Abstract
Relationships between PM2.5 exposure and preeclampsia have been the focus of four recent systematic reviews and meta-analyses. We expand on knowledge gaps in these reviews by characterizing the shape of the exposure-outcome relationship, and by assessing the heterogeneity in these associations by study characteristics. Studies of PM2.5 and preeclampsia were identified from reviews, and confounder-adjusted estimates were extracted. Estimates were derived using a random-effects model. Potential non-linearity was evaluated using a one-stage dose-response meta-analysis. Contrary to previous meta-analyses reporting stronger relationships, the overall adjusted relative risk (RR) for a 10 μg/m3 average increase in PM2.5 during pregnancy and preeclampsia was modest and not statistically significant (RR: 1.07, 95% CI: 0.99-1.15). This was mainly attributable to inclusion/exclusion decisions for studies made during this review. In addition, there was no evidence of non-linearity, and no important sub-group differences by characteristics such as region, exposure assessment, participant exclusions, and early versus late-onset preeclampsia. Overall, our analysis suggests a modest relationship between ambient PM2.5 and preeclampsia. We provide details on inclusion and exclusion decisions that were lacking in previous studies, and report novel investigations of non-linearity and heterogeneity.
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Affiliation(s)
- Priyanka Gogna
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada.
| | - Paul J Villeneuve
- School of Mathematics and Statistics, Carleton University, Ottawa, Ontario, Canada
| | - Michael M Borghese
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada; Environmental Health Science and Research Bureau, Health Canada, Ottawa, Ontario, Canada
| | - Will D King
- Department of Public Health Sciences, Queen's University, Kingston, Ontario, Canada
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19
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Yang W, Braun JM, Vuong AM, Percy Z, Xu Y, Xie C, Deka R, Calafat AM, Ospina M, Werner E, Yolton K, Cecil KM, Lanphear BP, Chen A. Maternal urinary OPE metabolite concentrations and blood pressure during pregnancy: The HOME study. ENVIRONMENTAL RESEARCH 2022; 207:112220. [PMID: 34656632 PMCID: PMC8810616 DOI: 10.1016/j.envres.2021.112220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 05/03/2023]
Abstract
BACKGROUND Few studies have examined the association between maternal exposure to organophosphate esters (OPEs) and systolic/diastolic blood pressure (SBP/DBP) during pregnancy. METHODS We analyzed data from 346 women with a singleton live birth in the HOME Study, a prospective birth cohort in Cincinnati, Ohio, USA. We quantified four OPE metabolites in maternal spot urine samples collected at 16 and 26 weeks pregnancy, standardized by specific gravity. We calculated intraclass correlation coefficients (ICCs). We extracted the first two recorded BP measurements (<20 weeks), the two highest recorded BP measurements (≥20 weeks), and diagnoses of hypertensive disorders of pregnancy (HDP) via chart review. Women with two BP measurements ≥140/90 mmHg or HDP noted in the chart at ≥20 weeks pregnancy were defined as HDP cases. We used linear mixed models and modified Poisson regression with covariate adjustment to estimate associations between OPE concentrations as continuous variables or in tertiles with maternal BP and HDP. RESULTS ICCs of OPEs were 0.17-0.45. Diphenyl phosphate (DPHP) had the highest geometric mean concentration among OPE metabolites. Increasing the average bis(2-chloroethyl) phosphate (BCEP) concentrations were positively associated with two highest recorded DBP ≥20 weeks pregnancy. Compared with women in the 1st DPHP tertile, women in the 3rd tertile at 16 weeks pregnancy had 1.72 mmHg (95% CI: -0.01, 3.46) higher DBP <20 weeks pregnancy, and women in the 3rd tertile of the average DPHP concentrations had 2.25 mmHg (95% CI: 0.25, 4.25) higher DBP ≥20 weeks pregnancy. 33 women (9.5%) were identified with HDP. Di-n-butyl phosphate (DNBP) concentrations at 16 weeks were positively associated with HDP, with borderline significance (RR = 2.98, 95% CI 0.97-9.15). Other OPE metabolites were not significantly associated with HDP. CONCLUSION Maternal urinary BCEP and DPHP concentrations were associated with increased BP during pregnancy. Maternal urinary DNBP concentrations were associated with HDP, with borderline significance.
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Affiliation(s)
- Weili Yang
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Joseph M Braun
- Department of Epidemiology, Brown University, Providence, RI, USA
| | - Ann M Vuong
- Department of Epidemiology and Biostatistics, University of Nevada Las Vegas, Las Vegas, NV, USA
| | - Zana Percy
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Yingying Xu
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Changchun Xie
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Ranjan Deka
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Antonia M Calafat
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Maria Ospina
- National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Erika Werner
- Department of Epidemiology, Brown University, Providence, RI, USA; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Women and Infants Hospital, The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Kimberly Yolton
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Kim M Cecil
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Pediatrics, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA; Department of Radiology, Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Bruce P Lanphear
- Child and Family Research Institute, BC Children's Hospital, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Aimin Chen
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA.
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20
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Li G, Zhang H, Hu M, He J, Yang W, Zhao H, Zhu Z, Zhu J, Huang F. Associations of combined exposures to ambient temperature, air pollution, and green space with hypertension in rural areas of Anhui Province, China: A cross-sectional study. ENVIRONMENTAL RESEARCH 2022; 204:112370. [PMID: 34780789 DOI: 10.1016/j.envres.2021.112370] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 10/08/2021] [Accepted: 11/08/2021] [Indexed: 06/13/2023]
Abstract
Hypertension (HTN) was a major preventable cause of cardiovascular disease (CVD), contributing to a huge disease burden. Ambient temperature, air pollution and green space were important influencing factors of HTN, and few studies have assessed the effects and interactions of ambient temperature, air pollution and green space on HTN in rural areas. In this study, we selected 8400 individuals randomly in rural areas of Anhui Province by a multi-stage stratified cluster sampling. A total of 8383 individuals were included in the final analysis. We collected particulate pollutants and meteorological data from the local air quality monitoring stations and National Center for Meteorological Science from January 1 to December 31, 2020, respectively. The normalized differential vegetation index (NDVI) of Anhui Province in 2020 was produced and processed by remote sensing inversion on the basis of medium resolution satellite images. The average annual mean exposure concentrations of air pollution, meteorological factors, and NDVI were calculated for each individual based on the geocoded residential address. HTN was defined according the Chinese Guidelines for Prevention and Treatment of HTN. The effects and interactions of ambient temperature, air pollution and green space on HTN were evaluated by generalized linear model and interaction model, respectively. In this study, the prevalence of HTN was 24.14%. The adjusted odd ratio of HTN for each 1 μg/m3 increasing in PM2.5 and PM10, 1 °C of ambient temperature, and 0.1 of NDVI were:1.276 (1.013, 1.043), 1.012 (1.006, 1.018), 0.862 (0.862, 0.981) and 0.669 (0.611, 0.733), respectively. The results showed that air pollutants were positively correlated with HTN, while ambient temperature and green space were negatively correlated with HTN. Meanwhile, the negative associations of green space on HTN could decrease with the increasing concentrations of air pollution, but increase with the rising of ambient temperature.
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Affiliation(s)
- Guoao Li
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Hanshuang Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Mingjun Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jialiu He
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Wanjun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Huanhuan Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Zhenyu Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Jinliang Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China
| | - Fen Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, China.
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21
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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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22
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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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23
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Ouidir M, Seyve E, Rivière E, Bernard J, Cheminat M, Cortinovis J, Ducroz F, Dugay F, Hulin A, Kloog I, Laborie A, Launay L, Malherbe L, Robic PY, Schwartz J, Siroux V, Virga J, Zaros C, Charles MA, Slama R, Lepeule J. Maternal Ambient Exposure to Atmospheric Pollutants during Pregnancy and Offspring Term Birth Weight in the Nationwide ELFE Cohort. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18115806. [PMID: 34071637 PMCID: PMC8198942 DOI: 10.3390/ijerph18115806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 05/18/2021] [Accepted: 05/20/2021] [Indexed: 12/26/2022]
Abstract
Background: Studies have reported associations between maternal exposure to atmospheric pollution and lower birth weight. However, the evidence is not consistent and uncertainties remain. We used advanced statistical approaches to robustly estimate the association of atmospheric pollutant exposure during specific pregnancy time windows with term birth weight (TBW) in a nationwide study. Methods: Among 13,334 women from the French Longitudinal Study of Children (ELFE) cohort, exposures to PM2.5, PM10 (particles < 2.5 µm and <10 µm) and NO2 (nitrogen dioxide) were estimated using a fine spatio-temporal exposure model. We used inverse probability scores and doubly robust methods in generalized additive models accounting for spatial autocorrelation to study the association of such exposures with TBW. Results: First trimester exposures were associated with an increased TBW. Second trimester exposures were associated with a decreased TBW by 17.1 g (95% CI, −26.8, −7.3) and by 18.0 g (−26.6, −9.4) for each 5 µg/m3 increase in PM2.5 and PM10, respectively, and by 15.9 g (−27.6, −4.2) for each 10 µg/m3 increase in NO2. Third trimester exposures (truncated at 37 gestational weeks) were associated with a decreased TBW by 48.1 g (−58.1, −38.0) for PM2.5, 38.1 g (−46.7, −29.6) for PM10 and 14.7 g (−25.3, −4.0) for NO2. Effects of pollutants on TBW were larger in rural areas. Conclusions: Our results support an adverse effect of air pollutant exposure on TBW. We highlighted a larger effect of air pollutants on TBW among women living in rural areas compared to women living in urban areas.
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Affiliation(s)
- Marion Ouidir
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France; (E.S.); (V.S.); (R.S.); (J.L.)
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
- Correspondence:
| | - Emie Seyve
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France; (E.S.); (V.S.); (R.S.); (J.L.)
| | - Emmanuel Rivière
- ASPA, ATMO Grand Est, 67300 Schiltigheim, France; (E.R.); (J.B.)
| | - Julien Bernard
- ASPA, ATMO Grand Est, 67300 Schiltigheim, France; (E.R.); (J.B.)
| | - Marie Cheminat
- Ined-Inserm-EFS Joint Unit ELFE, 75020 Paris, France; (M.C.); (C.Z.); (M.-A.C.)
| | | | | | | | - Agnès Hulin
- ATMO Nouvelle-Aquitaine, 33000 Bordeaux, France;
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva P.O. Box 653, Israel;
| | | | | | - Laure Malherbe
- National Institute for Industrial Environment and Risks (INERIS), 60550 Verneuil en Halatte, France;
| | | | - Joel Schwartz
- Exposure, Epidemiology, and Risk Program, Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA;
| | - Valérie Siroux
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France; (E.S.); (V.S.); (R.S.); (J.L.)
| | | | - Cécile Zaros
- Ined-Inserm-EFS Joint Unit ELFE, 75020 Paris, France; (M.C.); (C.Z.); (M.-A.C.)
| | - Marie-Aline Charles
- Ined-Inserm-EFS Joint Unit ELFE, 75020 Paris, France; (M.C.); (C.Z.); (M.-A.C.)
- Inserm Univ. Paris Descartes, U1153 CRESS, 75004 Paris, France
| | - Rémy Slama
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France; (E.S.); (V.S.); (R.S.); (J.L.)
| | - Johanna Lepeule
- Univ. Grenoble Alpes, Inserm, CNRS, IAB, 38000 Grenoble, France; (E.S.); (V.S.); (R.S.); (J.L.)
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Huang M, Chen J, Yang Y, Yuan H, Huang Z, Lu Y. Effects of Ambient Air Pollution on Blood Pressure Among Children and Adolescents: A Systematic Review and Meta-Analysis. J Am Heart Assoc 2021; 10:e017734. [PMID: 33942625 PMCID: PMC8200690 DOI: 10.1161/jaha.120.017734] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background Previous studies have investigated the association of ambient air pollution with blood pressure (BP) in children and adolescents, however, the results are not consistent. We conducted a systematic review and meta‐analysis to assess the relationship between short‐term and long‐term ambient air pollutant exposure with BP values among children and adolescents. Methods and Results We searched PubMed, Web of Science, and Embase before September 6, 2020. Two reviewers independently searched and selected studies, extracted data, and assessed study quality. The studies were divided into groups by composition of air pollutants (NO2, particulate matter (PM) with diameter ≤10 μm or ≤2.5 μm) and length of exposure. The beta regression coefficients (β) and their 95% CIs were calculated to evaluate the strength of the effect with each 10 μg/m3 increase in air pollutants. Out of 36 650 articles, 14 articles were included in this meta‐analysis. The meta‐analysis showed short‐term exposure to PM with diameter ≤10 μm (β=0.267; 95% CI, 0.033‒0.501) was significantly associated with elevated systolic BP values. In addition, long‐term exposure to PM with diameter ≤2.5 μm (β=1.809; 95% CI, 0.962‒2.655), PM with diameter ≤10 μm (β=0.526; 95% CI, 0.095‒0.958), and NO2 (β=0.754; 95% CI, 0.541‒0.968) were associated with systolic BP values and long‐term exposure to PM with diameter ≤2.5 μm (β=0.931; 95% CI, 0.157‒1.705), and PM with diameter ≤10 μm (β=0.378; 95% CI, 0.022‒0.735) was associated with diastolic BP. Conclusions Our study indicates that both short‐term and long‐term exposure to some ambient air pollutants may increase BP values among children and adolescents.
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Affiliation(s)
- Miao Huang
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China
| | - Jingyuan Chen
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China
| | - Yiping Yang
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China
| | - Hong Yuan
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China.,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology Changsha China
| | - Zhijun Huang
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China.,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology Changsha China
| | - Yao Lu
- Center of Clinical Pharmacology The Third Xiangya Hospital, Central South University Changsha China.,National-Local Joint Engineering Laboratory of Drug Clinical Evaluation Technology Changsha China.,Department of Life Science and Medicine King's College London London United Kingdom
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Measurements of NOx and Development of Land Use Regression Models in an East-African City. ATMOSPHERE 2021. [DOI: 10.3390/atmos12040519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Air pollution causes premature mortality and morbidity globally, but these adverse health effects occur over proportionately in low- and middle-income countries. Lack of both air pollution data and knowledge of its spatial distribution in African countries have been suggested to lead to an underestimation of health effects from air pollution. This study aims to measure nitrogen oxides (NOx), as well as nitrogen dioxide (NO2), to develop Land Use Regression (LUR) models in the city of Adama, Ethiopia. NOx and NO2 was measured at over 40 sites during six days in both the wet and dry seasons. Throughout the city, measured mean levels of NOx and NO2 were 29.0 µg/m3 and 13.1 µg/m3, respectively. The developed LUR models explained 68% of the NOx variances and 75% of the NO2. Both models included similar geographical predictor variables (related to roads, industries, and transportation administration areas) as those included in prior LUR models. The models were validated by using leave-one-out cross-validation and tested for spatial autocorrelation and multicollinearity. The performance of the models was good, and they are feasible to use to predict variance in annual average NOx and NO2 concentrations. The models developed will be used in future epidemiological and health impact assessment studies. Such studies may potentially support mitigation action and improve public health.
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Bearblock E, Aiken CE, Burton GJ. Air pollution and pre-eclampsia; associations and potential mechanisms. Placenta 2020; 104:188-194. [PMID: 33360680 DOI: 10.1016/j.placenta.2020.12.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/11/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Air pollution has significant negative health impacts, particularly on the cardiovascular system. The aims of this narrative review were to identify whether there is an association between air pollution and the incidence of pre-eclampsia, and the potential mechanisms by which any effects may be mediated. METHODS We undertook a literature search using Google Scholar, PubMed, the Cochrane Library and NICE Evidence. The primary eligibility criterion was articles correlating exposure to air pollution with incidence of pre-eclampsia. RESULTS Meta-analyses currently show a positive association between pre-eclampsia and exposure to both particulate matter PM2.5 and nitrogen dioxide, but no significant associations with ambient ozone or carbon monoxide exposure. No meta-analysis has been performed for exposure to sulfur dioxide. Variability in terms of quantification of exposure, the exposure period and co-founders among the studies makes comparisons complex. Adverse effects on trophoblast invasion and placental vascularisation, and increases in oxidative stress and anti-angiogenic factors, such as sFlt-1, in response to air pollution provide pathways by which exposure may contribute to the pathophysiology of pre-eclampsia. So far, studies have not discriminated between the early- and late-onset forms of the syndrome. DISCUSSION Future prospective studies using personal air pollution monitors and blood biomarkers of pre-eclampsia would strengthen the associations. Interactions between pollutants are poorly documented, and at present there is minimal informed advice available to women on the need to avoid exposure to air pollutants during pregnancy.
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Affiliation(s)
- Elizabeth Bearblock
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK
| | - Catherine E Aiken
- Department of Obstetrics and Gynaecology, University of Cambridge, Cambridge, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Graham J Burton
- Department of Physiology, Development and Neuroscience, University of Cambridge, Cambridge, UK; Centre for Trophoblast Research, University of Cambridge, Cambridge, UK.
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Han Y, Wang W, Wang X, Dong T, van Donkelaar A, Martin RV, Chen Y, Kan H, Xia Y. Prenatal exposure to fine particles, premature rupture of membranes and gestational age: A prospective cohort study. ENVIRONMENT INTERNATIONAL 2020; 145:106146. [PMID: 32987218 DOI: 10.1016/j.envint.2020.106146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 09/10/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND The associations between maternal exposure to fine particles with aerodynamic diameter ≤ 2.5 μm (PM2.5) and gestational age as well as premature rupture of membranes (PROM) remain unclear. Few studies have focused on preconception exposure and components of fine particles in China. METHODS A total of 1715 pregnant women were enrolled at hospitals affiliated with Nanjing Medical University from 2014 to 2015. Personal exposure to PM2.5 was estimated from preconception to the first trimester. Gestational age and PROM were investigated to explore their associations with PM2.5 and its components. RESULTS From 12 weeks before conception to the end of the first trimester, the gestational age was reduced by 0.89 days (95% CI: -1.37, -0.40) per 10 μg/m3 increment in PM2.5 exposure. After the exposure period was separated into two groups, PM2.5 exposure reduced the gestational age by 0.35 days (95% CI: -0.59, -0.11) in the 12 weeks before pregnancy. With maternal exposure to PM2.5 early in the first trimester, gestational age was reduced by 0.62 days (95% CI: -1.09, -0.14). After mediation analysis, we found that PROM mediated the association between PM2.5 and gestational age from preconception to the first trimester. Components analysis indicated that exposure to black carbon, organic matter, and nitrate increased the risk of PROM and decreased gestational age. CONCLUSION Exposure to PM2.5 as well as some components of PM2.5 before and during early pregnancy was associated with PROM and gestational age. PROM might be a potential mediator in associations between PM2.5 as well as various components and gestational age.
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Affiliation(s)
- Yingying Han
- Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University, No. 321 Zhongshan Road, Nanjing, Jiangsu Province 210008, China; State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Weidong Wang
- Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xu Wang
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Tianyu Dong
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, N.S., Canada
| | - Randall V Martin
- Harvard-Smithsonian Center for Astrophysics, Cambridge, MA 02138, United States
| | - Ying Chen
- Central Lab, Wuxi Maternal and Child Health Hospital, Nanjing Medical University, 48 Huaishu Lane, Wuxi 214002, China
| | - Haidong Kan
- Key Laboratory of Public Health Safety of the Ministry of Education and Key Laboratory of Health Technology Assessment of the Ministry of Health, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yankai Xia
- State Key Laboratory of Reproductive Medicine, School of Public Health, Nanjing Medical University, Nanjing 211166, China.
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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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Dutheil F, Bourdel N, Comptour A. The Coronavirus Might be Paradoxically Beneficial on the Risk of Autism. J Autism Dev Disord 2020; 51:1805-1807. [PMID: 32748192 PMCID: PMC7397450 DOI: 10.1007/s10803-020-04621-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Frédéric Dutheil
- Physiological and Psychosocial Stress, Université Clermont Auvergne, CNRS, LaPSCo, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Occupational and Environmental Medicine, WittyFit, Santé Travail Environnement, 58 rue Montalembert, 63000, Clermont-Ferrand, France.
| | - Nicolas Bourdel
- Department of Gynecological Surgery, INSERM, CIC 1405 Unité CRECHE, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Aurélie Comptour
- Department of Gynecological Surgery, University Hospital of Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Hypertension
Editors’ Picks. Hypertension 2020; 76:e18-e22. [DOI: 10.1161/hypertensionaha.120.15142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Association between ambient temperature and hypertensive disorders in pregnancy in China. Nat Commun 2020; 11:2925. [PMID: 32522990 PMCID: PMC7286884 DOI: 10.1038/s41467-020-16775-8] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 05/21/2020] [Indexed: 02/05/2023] Open
Abstract
Hypertensive disorders in pregnancy (HDPs) are leading perinatal diseases. Using a national cohort of 2,043,182 pregnant women in China, we evaluated the association between ambient temperatures and HDP subgroups, including preeclampsia or eclampsia, gestational hypertension, and superimposed preeclampsia. Under extreme temperatures, very cold exposure during preconception (12 weeks) increases odds of preeclampsia or eclampsia and gestational hypertension. Compared to preconception, in the first half of pregnancy, the impact of temperature on preeclampsia or eclampsia and gestational hypertension is opposite. Cold exposure decreases the odds, whereas hot exposure increases the odds. Under average temperatures, a temperature increase during preconception decreases the risk of preeclampsia or eclampsia and gestational hypertension. However, in the first half of pregnancy, temperature is positively associated with a higher risk. No significant association is observed between temperature and superimposed preeclampsia. Here we report a close relationship exists between ambient temperature and preeclampsia or eclampsia and gestational hypertension. Hypertensive disorders in pregnancy are prevalent perinatal diseases. Here the authors report an association between ambient temperature before or after conception and risk of preeclampsia or eclampsia and gestational hypertension.
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Bai W, Li Y, Niu Y, Ding Y, Yu X, Zhu B, Duan R, Duan H, Kou C, Li Y, Sun Z. Association between ambient air pollution and pregnancy complications: A systematic review and meta-analysis of cohort studies. ENVIRONMENTAL RESEARCH 2020; 185:109471. [PMID: 32276169 DOI: 10.1016/j.envres.2020.109471] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/08/2020] [Accepted: 03/30/2020] [Indexed: 05/22/2023]
Abstract
BACKGROUND Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 μg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 μg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 μg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.
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Affiliation(s)
- Wei Bai
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yuanyuan Li
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Yaling Niu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ye Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Xiao Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Bo Zhu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Ruixin Duan
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China
| | - Huawei Duan
- Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Changgui Kou
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China.
| | - Yanbo Li
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China.
| | - Zhiwei Sun
- School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China
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Shashar S, Kloog I, Erez O, Shtein A, Yitshak-Sade M, Sarov B, Novack L. Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome. PLoS One 2020; 15:e0232877. [PMID: 32421729 PMCID: PMC7234374 DOI: 10.1371/journal.pone.0232877] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 04/22/2020] [Indexed: 01/09/2023] Open
Abstract
INTRODUCTION This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In "Warm" pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during "warm" pregnancies, an elevation of one IQR of the average temperature in the 1st or the 3rd trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1st trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3rd trimester 1.94(95%CI 1.34;2.81); Bedouins: 1st trimester: RR = 2.91(95%CI 1.98;4.28), 3rd trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In "cold" pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49-0.94) for 1st trimester and RR = 0.62 (95% CI 0.44-0.87) for 3rd trimester. CONCLUSIONS 1) Elevated averaged temperature during the 1st or 3rd trimesters in "warm" pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health.
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Affiliation(s)
- Sagi Shashar
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Itai Kloog
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Offer Erez
- Division of Obstetrics and Gynecology, Maternity Department "D", Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Alexandra Shtein
- Department of Geography and Environmental Development, Faculty of Humanities and Social Sciences, Ben Gurion University, Beersheba, Israel
| | - Maayan Yitshak-Sade
- Department of Environmental Health Exposure, Epidemiology, and Risk Program Harvard T.H. Chan School of Public Health, Boston, Massachusetts, United States of America
| | - Batia Sarov
- Department of Public Health, Faculty of Heath Sciences, Ben-Gurion University of the Negev, Beersheba, Israel
| | - Lena Novack
- Clinical Research Center, Soroka University Medical Center, Ben-Gurion University of the Negev, Beersheba, Israel
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Benschop L, Schelling SJ, Duvekot JJ, Roeters van Lennep JE. Cardiovascular health and vascular age after severe preeclampsia: A cohort study. Atherosclerosis 2019; 292:136-142. [PMID: 31805453 DOI: 10.1016/j.atherosclerosis.2019.11.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/12/2019] [Accepted: 11/27/2019] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND AIMS Severe preeclampsia increases lifetime-risk for cardiovascular disease (CVD). It remains unclear when this risk translates to subclinical atherosclerosis and whether this is related to cardiovascular health (CVH) after pregnancy. Our aims were (1) to determine CVH after severe preeclampsia, (2) to relate CVH to carotid intima-media thickness (CIMT), as a marker of subclinical atherosclerosis and (3) to relate CVH to chronological and vascular age. METHODS A prospective cohort study was performed in women with previous severe pre-eclampsia. CVH, proposed by the American Heart Association, was assessed one year after pregnancy. The CVH score (range 0-14) includes seven metrics (blood pressure, total-cholesterol, glucose, smoking, physical activity, diet and body mass index [BMI]), each weighted as poor (0), intermediate (1) or ideal (2). Vascular age was determined by CIMT. We related CVH to delta age (chronological age - vascular age). RESULTS In 244 women, the median CVH score was 10 (90% range 7.0, 13.0). Low CVH (<10) was associated with a larger CIMT than high CVH (≥12) (median 626.3 μm vs. 567.0 μm, respectively). Higher CVH was also associated with a lower vascular age (-2.0 years, 95%CI -3.3, -0.60). Women with low CVH had a larger delta age (22.5 years [90% range -3.9, 49.6) than women with high CVH (16.5 years [90% range -11.9, 43.3). CONCLUSIONS CVH is inversely related to subclinical atherosclerosis and to vascular age one year after severe preeclampsia. Especially low CVH is associated with a large difference between chronological age and vascular age. CVH counseling might provide the opportunity for timely cardiovascular prevention.
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Affiliation(s)
- Laura Benschop
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Sara Jc Schelling
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Johannes J Duvekot
- Department of Obstetrics and Gynecology, Erasmus MC University Medical Center, Rotterdam, the Netherlands
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