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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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Erlandsson L, Ohlsson L, Masoumi Z, Rehnström M, Cronqvist T, Edvinsson L, Hansson SR. Preliminary evidence that blocking the uptake of placenta-derived preeclamptic extracellular vesicles protects the vascular endothelium and prevents vasoconstriction. Sci Rep 2023; 13:18425. [PMID: 37891193 PMCID: PMC10611745 DOI: 10.1038/s41598-023-45830-9] [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: 07/18/2023] [Accepted: 10/24/2023] [Indexed: 10/29/2023] Open
Abstract
Preeclampsia (PE) is a pregnancy syndrome characterized by hypertension and organ damage manifesting after 20 gestational weeks. The etiology is of multifactorial origin, where placental stress causes increased levels of placenta-derived extracellular vesicles (STBEVs) in the maternal circulation, shown to cause inflammation, endothelial activation, vasoconstriction, and anti-angiogenic activity. General endothelial dysfunction is believed to be initiated by endothelial insult during pregnancy that alters vascular function resulting in increased arterial stiffness, cardiac dysfunction, and increased risk of cardiovascular disease later in life. We compared the effect of normal and PE derived STBEVs in vitro on vascular contractility of human subcutaneous arteries using wire myography. Cellular structures of exposed vessels were investigated by transmission electron microscopy. We explored strategies to pharmacologically block the effects of the STBEVs on human vessels. The PE STBEVs caused significantly stronger angiotensin II-mediated contractions and extended structural damage to human subcutaneous arteries compared to normal STBEVs. These negative effects could be reduced by blocking vesicle uptake by endothelial cells, using chlorpromazine or specific antibodies towards the LOX-1 receptor. The therapeutic potential of blocking vesicle uptake should be further explored, to reduce the permanent damage caused on the vasculature during PE pregnancy to prevent future cardiovascular risk.
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Affiliation(s)
- Lena Erlandsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, Klinikgatan 28, 221 85, Lund, Sweden.
| | - Lena Ohlsson
- Experimental Vascular Research, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Zahra Masoumi
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, Klinikgatan 28, 221 85, Lund, Sweden
| | - Mimmi Rehnström
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, Klinikgatan 28, 221 85, Lund, Sweden
| | - Tina Cronqvist
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, Klinikgatan 28, 221 85, Lund, Sweden
| | - Lars Edvinsson
- Experimental Vascular Research, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
| | - Stefan R Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, BMC C14, Klinikgatan 28, 221 85, Lund, Sweden
- Skåne University Hospital, Lund, Sweden
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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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Tiako MJN, McCarthy C, Meisel ZF, Elovitz MA, Burris HH, South E. Association between Low Urban Neighborhood Greenness and Hypertensive Disorders of Pregnancy. Am J Perinatol 2023; 40:1185-1192. [PMID: 34450673 PMCID: PMC8882207 DOI: 10.1055/s-0041-1733786] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Urban neighborhood greenness is associated with greater cardiovascular health in the general population, and with better pregnancy and neonatal outcomes. Hypertension in pregnancy is a leading cause of maternal mortality and long-term cardiovascular morbidity and mortality in women. We sought to examine the association between greenness and hypertensive disorders of pregnancy. STUDY DESIGN This study is a secondary analysis of a prospective cohort study of 1,943 women who received prenatal care from December 2013 to December 2016 at a single, urban, and tertiary academic medical center in Philadelphia, PA. Greenness measure was quantified via residential tree canopy cover within circumferential buffers of 100- and 500-meter radii around participants' homes. Associations between greenness and hypertensive disorders of pregnancy (defined as gestational hypertension or preeclampsia) were estimated by using multilevel logistic regression accounting for maternal sociodemographic information (race-ethnicity, insurance status, and age) medical history (diabetes, body mass index, smoking history, and parity), neighborhood deprivation index, and including 1,225 Philadelphia residents for whom key exposure and outcome data were available. RESULTS At baseline, the participants' mean (SD) age was 27.5 (5.9) years, (range: 14-44 years). The majority of participants were non-Hispanic Black (857, 70.2%). Participants with less residential tree canopy cover were significantly more likely to have hypertensive disorders of pregnancy. The multivariable-adjusted odds ratio of hypertensive disorders of pregnancy among participants with less than 10% compared with those with greater than 30% tree canopy cover was 2.14 (95% confidence interval [CI]: 1.11-4.15) within 100-meter buffer. CONCLUSION In our cohort, greenness was associated with lower hypertensive disorders of pregnancy odds. Our findings add to evidence that greenness may confer health benefits and warrant further investigations in identifying whether there is a causal pathway through which greenness may be protective against hypertensive disorders of pregnancy. KEY POINTS · Low residential tree canopy is associated with increased risk of hypertensive disorders of pregnancy. · 100-meter buffers are most sensitive in identifying associations between tree canopy and HDP risk. · The role of greenness against hypertensive disorders of pregnancy should be further studied experimentally.
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Affiliation(s)
- Max Jordan Nguemeni Tiako
- Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Urban Health Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Yale School of Medicine, New Haven, Connecticut
| | - Clare McCarthy
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Zachary F Meisel
- Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, Wharton School of the University of Pennsylvania, Pennsylvania
| | - Michal A Elovitz
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Heather H Burris
- Department of Obstetrics and Gynecology, Maternal and Child Health Research Center, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
| | - Eugenia South
- Department of Emergency Medicine, Center for Emergency Care and Policy Research, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Urban Health Lab, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania
- Leonard Davis Institute of Health Economics, Wharton School of the University of Pennsylvania, Pennsylvania
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Teyton A, Sun Y, Molitor J, Chen JC, Sacks D, Avila C, Chiu V, Slezak J, Getahun D, Wu J, Benmarhnia T. Examining the Relationship Between Extreme Temperature, Microclimate Indicators, and Gestational Diabetes Mellitus in Pregnant Women Living in Southern California. Environ Epidemiol 2023; 7:e252. [PMID: 37304340 PMCID: PMC10256373 DOI: 10.1097/ee9.0000000000000252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 04/26/2023] [Indexed: 06/13/2023] Open
Abstract
Few studies have assessed extreme temperatures' impact on gestational diabetes mellitus (GDM). We examined the relation between GDM risk with weekly exposure to extreme high and low temperatures during the first 24 weeks of gestation and assessed potential effect modification by microclimate indicators. Methods We utilized 2008-2018 data for pregnant women from Kaiser Permanente Southern California electronic health records. GDM screening occurred between 24 and 28 gestational weeks for most women using the Carpenter-Coustan criteria or the International Association of Diabetes and Pregnancy Study Groups criteria. Daily maximum, minimum, and mean temperature data were linked to participants' residential address. We utilized distributed lag models, which assessed the lag from the first to the corresponding week, with logistic regression models to examine the exposure-lag-response associations between the 12 weekly extreme temperature exposures and GDM risk. We used the relative risk due to interaction (RERI) to estimate the additive modification of microclimate indicators on the relation between extreme temperature and GDM risk. Results GDM risks increased with extreme low temperature during gestational weeks 20--24 and with extreme high temperature at weeks 11-16. Microclimate indicators modified the influence of extreme temperatures on GDM risk. For example, there were positive RERIs for high-temperature extremes and less greenness, and a negative RERI for low-temperature extremes and increased impervious surface percentage. Discussion Susceptibility windows to extreme temperatures during pregnancy were observed. Modifiable microclimate indicators were identified that may attenuate temperature exposures during these windows, which could in turn reduce the health burden from GDM.
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Affiliation(s)
- Anais Teyton
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego, La Jolla, California
- School of Public Health, San Diego State University, La Jolla, California
| | - Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Los Angeles, California
| | - David Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, California
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, California
- Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California
| | - Tarik Benmarhnia
- Scripps Institution of Oceanography, University of California San Diego, La Jolla, California
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Liang W, Zhu H, Xu J, Zhao Z, Zhou L, Zhu Q, Cai J, Ji L. Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2023; 255:114802. [PMID: 36934545 DOI: 10.1016/j.ecoenv.2023.114802] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 03/15/2023] [Indexed: 06/18/2023]
Abstract
OBJECTIVE We aimed to evaluate the relationship between the composition of particulate matter (PM) and gestational diabetes mellitus (GDM) by a comprehensively review of epidemiological studies. METHODS We systematically identified cohort studies related to air pollution and GDM risk before February 8, 2023 from six databases (PubMed, Embase, Web of Science Core Collection, China National Knowledge Infrastructure, Wanfang Data Knowledge Service Platform and Chongqing VIP Chinese Science and Technology Periodical databases). We calculated the relative risk (RR) and its 95% confidence intervals (CIs) to assess the overall effect by using a random effects model. RESULTS This meta-analysis of 31 eligible cohort studies showed that exposure to PM2.5, PM10, SO2, and NO2 was associated with a significantly increased risk of GDM, especially in preconception and first trimester. Analysis of the components of PM2.5 found that the risk of GDM was strongly linked to black carbon (BC) and nitrates (NO3-). Specifically, BC exposure in the second trimester and NO3- exposure in the first trimester elevated the risk of GDM, with the RR of 1.128 (1.032-1.231) and 1.128 (1.032-1.231), respectively. The stratified analysis showed stronger correlations of GDM risk with higher levels of pollutants in Asia, except for PM2.5 and BC, which suggested that the specific composition of particulate pollutants had a greater effect on the exposure-outcome association than the concentration. CONCLUSIONS Our study found that ambient air pollutant is a critical factor for GDM and further studies on specific particulate matter components should be considered in the future.
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Affiliation(s)
- Weiqi Liang
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Hui Zhu
- Department of Internal Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Jin Xu
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China; Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China
| | - Zhijia Zhao
- Department of Preventive Medicine, School of Medicine, Ningbo University, Ningbo, China
| | - Liming Zhou
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China
| | - Qiong Zhu
- Department of Pediatrics, Affiliated People's Hospital of Ningbo University, Ningbo, China
| | - Jie Cai
- Center for Reproductive Medicine, Ningbo Women and Children's Hospital, Ningbo, China.
| | - Lindan Ji
- Zhejiang Key Laboratory of Pathophysiology, School of Medicine, Ningbo University, Ningbo, China; Department of Biochemistry, School of Medicine, Ningbo University, Ningbo, China.
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Dusza HM, van Boxel J, van Duursen MBM, Forsberg MM, Legler J, Vähäkangas KH. Experimental human placental models for studying uptake, transport and toxicity of micro- and nanoplastics. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 860:160403. [PMID: 36417947 DOI: 10.1016/j.scitotenv.2022.160403] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
Micro- and nanoplastics (MNPs) are ubiquitous in the environment and have recently been found in human lungs, blood and placenta. However, data on the possible effects of MNPs on human health is extremely scarce. The potential toxicity of MNPs during pregnancy, a period of increased susceptibility to environmental insults, is of particular concern. The placenta provides a unique interface between maternal and fetal circulation which is essential for in utero survival and healthy pregnancy. Placental toxicokinetics and toxicity of MNPs are still largely unexplored and the limited studies performed up to now focus mainly on polystyrene particles. Practical and ethical considerations limit research options in humans, and extrapolation from animal studies is challenging due to marked differences between species. Nevertheless, diverse in vitro and ex vivo human placental models exist e.g., plasma membrane vesicles, mono-culture and co-culture of placental cells, placenta-on-a-chip, villous tissue explants, and placental perfusion that can be used to advance this research area. The objective of this concise review is to recapitulate different human placental models, summarize the current understanding of placental uptake, transport and toxicity of MNPs and define knowledge gaps. Moreover, we provide perspectives for future research urgently needed to assess the potential hazards and risks of MNP exposure to maternal and fetal health.
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Affiliation(s)
- Hanna M Dusza
- Division of Toxicology, Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands.
| | - Jeske van Boxel
- Amsterdam Institute for Life and Environment, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
| | - Majorie B M van Duursen
- Amsterdam Institute for Life and Environment, Faculty of Science, Vrije Universiteit Amsterdam, the Netherlands
| | - Markus M Forsberg
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Juliette Legler
- Division of Toxicology, Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Kirsi H Vähäkangas
- School of Pharmacy, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
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Nazarpour S, Ramezani Tehrani F, Valizadeh R, Amiri M. The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis. J Endocrinol Invest 2023:10.1007/s40618-023-02037-z. [PMID: 36807891 DOI: 10.1007/s40618-023-02037-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2022] [Accepted: 02/08/2023] [Indexed: 02/21/2023]
Abstract
PURPOSE Air pollution is an environmental stimulus that may predispose pregnant women to gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted to investigate the relationship between air pollutants and GDM. METHODS PubMed, Web of Science, and Scopus were systematically searched for retrieving English articles published from January 2020 to September 2021, investigating the relationship of exposure to ambient air pollution or levels of air pollutants with GDM and related parameters, including fasting plasma glucose (FPG), insulin resistance, and impaired glucose tolerance. Heterogeneity and publication bias were evaluated using I-squared (I2), and Begg's statistics, respectively. We also performed the subgroup analysis for particulate matters (PM2.5, PM10), Ozone (O3), and sulfur dioxide (SO2) in the different exposure periods. RESULTS A total of 13 studies examining 2,826,544 patients were included in this meta-analysis. Compared to non-exposed women, exposure to PM2.5 increases the odds (likelihood of occurrence outcome) of GDM by 1.09 times (95% CI 1.06, 1.12), whereas exposure to PM10 has more effect by OR of 1.17 (95% CI 1.04, 1.32). Exposure to O3 and SO2 increases the odds of GDM by 1.10 times (95% CI 1.03, 1.18) and 1.10 times (95% CI 1.01, 1.19), respectively. CONCLUSIONS The results of the study show a relationship between air pollutants PM2.5, PM10, O3, and SO2 and the risk of GDM. Although evidence from various studies can provide insights into the linkage between maternal exposure to air pollution and GDM, more well-designed longitudinal studies are recommended for precise interpretation of the association between GDM and air pollution by adjusting all potential confounders.
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Affiliation(s)
- S Nazarpour
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
- Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran
| | - F Ramezani Tehrani
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran.
| | - R Valizadeh
- Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran.
- Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran.
| | - M Amiri
- Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran
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Laine MK, Kautiainen H, Anttila P, Gissler M, Pennanen P, Eriksson JG. Early pregnancy particulate matter exposure, pre-pregnancy adiposity and risk of gestational diabetes mellitus in Finnish primiparous women: An observational cohort study. Prim Care Diabetes 2023; 17:79-84. [PMID: 36464621 DOI: 10.1016/j.pcd.2022.11.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2021] [Revised: 11/23/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
AIMS To evaluate the association between the exposure of particulate matter with an aerodynamic diameter of ≤ 2.5μm (PM2.5) and with an aerodynamic diameter of ≤ 10μm (PM10) over the first trimester and the risk of gestational diabetes mellitus (GDM), and to assess whether maternal pre-pregnancy body mass index (BMI) modified the GDM risk. METHODS All Finnish primiparous women without previously diagnosed diabetes who delivered between 2009 and 2015 in the city of Vantaa, Finland, composed the study cohort (N = 6189). Diagnosis of GDM was based on a standard 75 g 2-hour oral glucose tolerance test. The average daily concentration of PM2.5 and PM10 over the first trimester was calculated individually for each woman. The relationship between exposure of PM2.5 and PM10 and GDM was analyzed with logistic models. RESULTS No association was observed between the average daily concentrations of PM2.5 and PM10 over the first trimester and the GDM risk. When simultaneously taking BMI and PM10 into account both mean daily PM10 concentration (p = 0.047) and pre-pregnancy BMI (p = 0.016) increased GDM risk independently and an interaction (p = 0.013) was observed between PM10 concentration and pre-pregnancy BMI. CONCLUSIONS Even globally low PM10 exposure level together with elevated maternal pre-pregnancy BMI seems to increase the GDM risk.
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Affiliation(s)
- Merja K Laine
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland.
| | - Hannu Kautiainen
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland.
| | - Pia Anttila
- Finnish Meteorological Institute, Helsinki, Finland.
| | - Mika Gissler
- Finnish Institute for Health and Welfare (THL), Helsinki, Finland; Karolinska Institute, Stockholm, Sweden.
| | | | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Folkhälsan Research Center, Helsinki, Finland; National University Singapore, Yong Loo Lin School of Medicine, Department of Obstetrics and Gynecology, Singapore, Singapore; Singapore Institute for Clinical Sciences (SCIS), Agency for Science, Technology and Research (A⁎STAR), Singapore.
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Zhang L, Wang P, Zhou Y, Cheng Y, Li J, Xiao X, Yin C, Li J, Meng X, Zhang Y. Associations of ozone exposure with gestational diabetes mellitus and glucose homeostasis: Evidence from a birth cohort in Shanghai, China. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 857:159184. [PMID: 36202368 DOI: 10.1016/j.scitotenv.2022.159184] [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: 07/30/2022] [Revised: 09/28/2022] [Accepted: 09/29/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Associations between individual exposure to ozone (O3) and gestational diabetes mellitus (GDM) have rarely been investigated, and critical windows of O3 exposure for GDM have not been identified. OBJECTIVES We aimed to explore the associations of gestational O3 exposure with GDM and glucose homeostasis as well as to identify the potential critical windows. METHODS A total of 7834 pregnant women were included. Individual O3 exposure concentrations were evaluated using a high temporal-spatial resolution model. Each participant underwent an oral glucose tolerance test (OGTT) to screen for GDM between 24 and 28 gestational weeks. Multiple logistic and multiple linear regression models were used to estimate the associations of O3 with GDM risks and with blood glucose levels of OGTT, respectively. Distributed lag nonlinear models (DLNMs) were used to estimate the critical windows of O3 exposure for GDM. RESULTS Nearly 13.29 % of participants developed GDM. After controlling for covariates, we observed increased GDM risks per IQR increment of O3 exposure in the first trimester (OR = 1.738, 95 % CI: 1.002-3.016) and the first two trimesters (OR = 1.576, 95 % CI: 1.005-2.473). Gestational O3 exposure was positively associated with increased fasting blood glucose (the first trimester: β = 2.964, 95 % CI: 1.529-4.398; the first two trimesters: β = 1.620, 95 % CI: 0.436-2.804) and 2 h blood glucose (the first trimester: β = 6.569, 95 % CI: 1.775-11.363; the first two trimesters: β = 6.839, 95 % CI: 2.896-10.782). We also observed a concentration-response relationship of gestational O3 exposure with GDM risk, as well as fasting and 2 h blood glucose levels. Additionally, 5-10 gestational weeks was identified as a critical window of O3 exposure for GDM development. CONCLUSION In summary, we found that gestational O3 exposure disrupts glucose homeostasis and increases the risk of GDM in pregnant women. Furthermore, 5-10 gestational weeks could be a critical window for the effects of O3 exposure on GDM.
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Affiliation(s)
- Liyi Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Pengpeng Wang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yuhan Zhou
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Yukai Cheng
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Jialin Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xirong Xiao
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Chuanmin Yin
- Department of Obstetrics and Gynecology, Obstetrics and Gynecology Hospital of Fudan University, Shanghai 200011, China
| | - Jiufeng Li
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China
| | - Xia Meng
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
| | - Yunhui Zhang
- Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China, Fudan University, Shanghai 200032, China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
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Ren Z, Yuan J, Luo Y, Wang J, Li Y. Association of air pollution and fine particulate matter (PM2.5) exposure with gestational diabetes: a systematic review and meta-analysis. ANNALS OF TRANSLATIONAL MEDICINE 2023; 11:23. [PMID: 36760250 PMCID: PMC9906206 DOI: 10.21037/atm-22-6306] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 01/12/2023] [Indexed: 01/16/2023]
Abstract
Background The association between air pollution (AP) and gestational diabetes mellitus (GDM), especially between different pollutants and GDM, remains controversial and debatable. Hence, we conducted this systematic review and meta-analysis to provide comprehensive evidence-based support for the association between AP and GDM. Methods The databases of the Cochrane Library, Embase, PubMed, and Web of Science were searched from inception to 1 April 2022, in combination with manual retrieval. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of case-control studies and cohort studies, while the Joana Brigg's Institute (JBI) critical appraisal checklist was used for the quality assessment of cross-sectional studies. Results We identified 35 epidemiological studies (including 33 cohort studies, 1 cross-sectional study, and 1 case-control study) covering 6,939,725 pregnant women, of whom 865,460 were GDM patients. The NOS score of all included case-control studies and cohort studies was higher than six, and one of the included cross-sectional studies was rated as high quality according to the JBI assessment. Meta-analysis showed that fine particulate matter and air pollutants [PM2.5, odds ratio (OR) =1.06, 95% confidence interval (CI): 1.05-1.08, Z =7.76, P<0.001; PM10, OR =1.06, 95% CI: 1.01-1.11, Z =2.62, P=0.009; sulfur dioxide (SO2), OR =1.18, 95% CI: 1.10-1.26, Z = 4.69, P<0.001; nitric oxide (NO), OR =1.04, 95% CI: 1.03-1.06,Z =3.33, P=0.001; nitrogen oxides (NOX), OR =1.07, 95% CI: 1.04-1.11, Z =3.93, P<0.001; black carbon (BC), OR =1.08, 95% CI: 1.06-1.10, Z =7.58, P<0.001] was associated with GDM. Furthermore, no significant association was observed between O3, CO, and nitrogen dioxide (NO2) exposure and GDM. Conclusions Exposure to PM2.5, PM10, SO2, NO, NOX, and BC significantly increases the risk of GDM. AP is a remediable environmental trigger that can be prevented by human interventions, such as lowering AP levels or limiting human exposure to air pollutants. The government should strengthen the supervision of air quality and make air quality information more transparent. Besides, living conditions are crucial during pregnancy. Living in a place with more green areas is recommended, and indoor air purification should also be enhanced.
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Affiliation(s)
- Zhonglian Ren
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Jiaying Yuan
- Science and education section, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Ya Luo
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Juan Wang
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
| | - Yanqin Li
- Department of Obstetrics and Gynecology, Chengdu Shuangliu District Maternal and Child Health Hospital, Chengdu, China
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12
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Liu W, Zhang Q, Liu W, Qiu C. Association between air pollution exposure and gestational diabetes mellitus in pregnant women: a retrospective cohort study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:2891-2903. [PMID: 35941503 DOI: 10.1007/s11356-022-22379-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/26/2022] [Accepted: 07/31/2022] [Indexed: 06/15/2023]
Abstract
The global prevalence of gestational diabetes mellitus (GDM) is increasing annually, and previous research reports on the relationship between exposure to air pollutants and GDM are not completely consistent. We investigated the association between air pollutant exposure and GDM in pregnant women in a retrospective cohort study in Guangzhou. We found that in the first trimester, exposure to PM2.5 and CO showed a significant association with GDM. In the second trimester, exposure to PM10 was significantly associated with GDM. In the third trimester, exposure to PM2.5, PM10, NO2, SO2, and CO at IQR4 (odds ratio [OR] = 1.271, 95% confidence interval [CI]: 1.179-1.370; OR = 1.283, 95% CI: 1.191-1.383; OR = 1.230, 95% CI: 1.145-1.322; OR = 1.408, 95% CI: 1.303-1.522; OR = 1.150, 95% CI: 1.067-1.240, respectively) compared with IQR1 was positively associated with GDM. However, exposure to NO2 was negatively associated with GDM in the first and second trimesters, and O3 was negatively associated with GDM in the second and third trimesters. We found that the correlation between air pollutants and GDM in different trimesters of pregnancy was not completely consistent in this retrospective cohort study. During pregnancy, there may be an interaction between air pollutant exposure and other factors, such as pregnant women's age, occupation, anemia status, pregnancy-induced hypertension status, and pregnancy season.
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Affiliation(s)
- Weiqi Liu
- Department of Clinical Laboratory, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China.
| | - Qingui Zhang
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Weiling Liu
- Department of Clinical Laboratory, Foshan Fosun Chancheng Hospital, Foshan, Guangdong, 528000, People's Republic of China
| | - Cuiqing Qiu
- Medical Information Office, The Maternal and Children Health Care Hospital (Huzhong Hospital) of Huadu, Guangzhou, Guangdong, 510800, People's Republic of China
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Flanagan E, Malmqvist E, Gustafsson S, Oudin A. Estimated public health benefits of a low-emission zone in Malmö, Sweden. ENVIRONMENTAL RESEARCH 2022; 214:114124. [PMID: 35998694 DOI: 10.1016/j.envres.2022.114124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Revised: 06/27/2022] [Accepted: 08/13/2022] [Indexed: 06/15/2023]
Abstract
Air pollution is one of the leading causes of morbidity and mortality worldwide. Low-emission zones (LEZ) have been increasingly implemented in cities throughout Europe as a measure to reduce the adverse health effects and premature deaths associated with traffic-related air pollution. In the present study, a health impact analysis was conducted to estimate the effect of a hypothetical LEZ on mortality and morbidity in Malmö, Sweden. Baseline health statistics were gathered from health registers and applied to each resident according to individual-level data on age and/or sex. Concentration-response parameters were derived from current epidemiological literature, specifically meta-analyses. A Gaussian dispersion model (AERMOD) combined with a detailed emission database was used to calculate NO2 emissions from traffic, which could be applied on an individual-level using data on each person's residential coordinates. The adjusted exposure scenario replaced all vehicles on municipal roads having Euro 5 or lower emission standards with Euro 6 equivalents. This LEZ would, on average, decrease NO2 concentrations by 13.4%, preventing an estimated 9-26 deaths in Malmö each year. Additionally, 12 respiratory disease hospitalizations, 8 childhood asthma cases, and 9 cases of hypertensive disorders of pregnancy were estimated to be avoided annually. These results suggest that LEZs can effectively improve air quality, reduce greenhouse gas emissions, and safeguard public health.
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Affiliation(s)
- Erin Flanagan
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22242, Lund, Skåne, Sweden.
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22242, Lund, Skåne, Sweden.
| | - Susanna Gustafsson
- Environmental Department of the City of Malmö, 21154, Malmö, Skåne, Sweden.
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22242, Lund, Skåne, Sweden; Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, 90187, Umeå, Västerbotten, Sweden.
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Dusza HM, Katrukha EA, Nijmeijer SM, Akhmanova A, Vethaak AD, Walker DI, Legler J. Uptake, Transport, and Toxicity of Pristine and Weathered Micro- and Nanoplastics in Human Placenta Cells. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:97006. [PMID: 36129437 PMCID: PMC9491364 DOI: 10.1289/ehp10873] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
BACKGROUND The first evidence of micro- and nanoplastic (MNP) exposure in the human placenta is emerging. However, the toxicokinetics and toxicity of MNPs in the placenta, specifically environmentally relevant particles, remain unclear. OBJECTIVES We examined the transport, uptake, and toxicity of pristine and experimentally weathered MNPs in nonsyncytialized and syncytialized BeWo b30 choriocarcinoma cells. METHODS We performed untargeted chemical characterization of pristine and weathered MNPs using liquid chromatography high-resolution mass spectrometry to evaluate compositional differences following particle weathering. We investigated cellular internalization of pristine and weathered polystyrene (PS; 0.05-10μm) and high-density polyethylene (HDPE; 0-80μm) particles using high-resolution confocal imaging and three-dimensional rendering. We investigated the influence of particle coating with human plasma on the cellular transport of PS particles using a transwell setup and examined the influence of acute MNP exposure on cell viability, damage to the plasma membrane, and expression of genes involved in steroidogenesis. RESULTS Chemical characterization of MNPs showed a significantly higher number of unique features in pristine particles in comparison with weathered particles. Size-dependent placental uptake of pristine and weathered MNPs was observed in both placental cell types after 24 h exposure. Cellular transport was limited and size-dependent and was not influenced by particle coating with human plasma. None of the MNPs affected cell viability. Damage to the plasma membrane was observed only for 0.05μm PS particles in the nonsyncytialized cells at the highest concentration tested (100μg/mL). Modest down-regulation of hsd17b1 was observed in syncytialized cells exposed to pristine MNPs. DISCUSSION Our results suggest that pristine and weathered MNPs are internalized and translocated in placental cells in vitro. Effects on gene expression observed upon pristine PS and HDPE particle exposure warrant further examination. More in-depth investigations are needed to better understand the potential health risks of MNP and chemicals associated with them under environmentally relevant exposure scenarios. https://doi.org/10.1289/EHP10873.
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Affiliation(s)
- Hanna M. Dusza
- Division of Toxicology, Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Eugene A. Katrukha
- Cell Biology, Department of Biology, Faculty of Sciences, Utrecht University, Utrecht, the Netherlands
| | - Sandra M. Nijmeijer
- Division of Toxicology, Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
| | - Anna Akhmanova
- Cell Biology, Department of Biology, Faculty of Sciences, Utrecht University, Utrecht, the Netherlands
| | - A. Dick Vethaak
- Deltares, Delft, the Netherlands
- Department of Environment and Health, Faculty of Science, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Douglas I. Walker
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Juliette Legler
- Division of Toxicology, Institute for Risk Assessment Sciences, Department of Population Health Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
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Zhou X, Li C, Cheng H, Xie J, Li F, Wang L, Ding R. Association between ambient air pollution exposure during pregnancy and gestational diabetes mellitus: a meta-analysis of cohort studies. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:68615-68635. [PMID: 35543789 DOI: 10.1007/s11356-022-20594-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 04/29/2022] [Indexed: 06/15/2023]
Abstract
Numerous studies have evaluated the association between air pollution and gestational diabetes mellitus (GDM), but the findings were inconsistent. This meta-analysis aimed to provide higher grade evidence on the association of air pollution with GDM based on previous studies. PubMed, Web of science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform (Wanfang) were searched comprehensively up to September 2021. Totally, 20 eligible cohort studies were finally included, for which the pooled RR and 95% CIs were estimated. Stratified analyses by study regions and units of pollutant increase were conducted for further investigation. Sensitivity analyses were also performed to assess the robustness. The finding showed that PM2.5, PM10, NO2, and SO2 exposure increased the risk of GDM, while O3 exposure reduced GDM risk. Specifically, PM2.5 exposure in the first and second trimesters, NO2 and SO2 exposure in the first trimester significantly increased the risk of GDM, with the RR ranging from 1.015 to 1.032. In addition, the elevation of GDM risk induced by PM2.5, PM10, and O3 exposure was more pronounced in Asian subjects than in American subjects. The meta-analysis provides high-quality evidence on the effect of maternal air pollution exposure on GDM in each exposure period.
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Affiliation(s)
- Xinyu Zhou
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Changlian Li
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Han Cheng
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Junyi Xie
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Feng Li
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Lishan Wang
- First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Rui Ding
- Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
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Eberle C, Stichling S. Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review. BMC Public Health 2022; 22:1572. [PMID: 35982427 PMCID: PMC9389831 DOI: 10.1186/s12889-022-13965-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 06/27/2022] [Indexed: 11/10/2022] Open
Abstract
Background Gestational diabetes mellitus (GDM) is one of the most common pregnancy complications globally. Environmental risk factors may lead to increased glucose levels and GDM, which in turn may affect not only the health of the mother but assuming hypotheses of "fetal programming", also the health of the offspring. In addition to traditional GDM risk factors, the evidence is growing that environmental influences might affect the development of GDM. We conducted a systematic review analyzing the association between several environmental health risk factors in pregnancy, including climate factors, chemicals and metals, and GDM. Methods We performed a systematic literature search in Medline (PubMed), EMBASE, CINAHL, Cochrane Library and Web of Science Core Collection databases for research articles published until March 2021. Epidemiological human and animal model studies that examined GDM as an outcome and / or glycemic outcomes and at least one environmental risk factor for GDM were included. Results Of n = 91 studies, we classified n = 28 air pollution, n = 18 persistent organic pollutants (POP), n = 11 arsenic, n = 9 phthalate n = 8 bisphenol A (BPA), n = 8 seasonality, n = 6 cadmium and n = 5 ambient temperature studies. In total, we identified two animal model studies. Whilst we found clear evidence for an association between GDM and air pollution, ambient temperature, season, cadmium, arsenic, POPs and phthalates, the findings regarding phenols were rather inconsistent. There were clear associations between adverse glycemic outcomes and air pollution, ambient temperature, season, POPs, phenols, and phthalates. Findings regarding cadmium and arsenic were heterogeneous (n = 2 publications in each case). Conclusions Environmental risk factors are important to consider in the management and prevention of GDM. In view of mechanisms of fetal programming, the environmental risk factors investigated may impair the health of mother and offspring in the short and long term. Further research is needed. Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-13965-5.
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Affiliation(s)
- Claudia Eberle
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany.
| | - Stefanie Stichling
- Medicine With Specialization in Internal Medicine and General Medicine, Hochschule Fulda, University of Applied Sciences, Leipziger Strasse 123, 36037, Fulda, Germany
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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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Carlsen HK, Andersson EM, Molnár P, Oudin A, Xu Y, Wichmann J, Spanne M, Stroh E, Engström G, Stockfelt L. Incident cardiovascular disease and long-term exposure to source-specific air pollutants in a Swedish cohort. ENVIRONMENTAL RESEARCH 2022; 209:112698. [PMID: 35074356 DOI: 10.1016/j.envres.2022.112698] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 01/04/2022] [Accepted: 01/05/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Air pollution is associated with cardiovascular morbidity and mortality, but its role in the development of congestive heart failure (CHF) and the role of different pollution sources in cardiovascular disease remain uncertain. METHODS Participants were enrolled in the Malmö Diet and Cancer cohort in 1991-1996 with information on lifestyle and clinical indicators of cardiovascular disease. The cohort participants were followed through registers until 2016. Annual total and local source-specific concentrations of particulate matter less than 10 μm and 2.5 μm (PM10 and PM2.5), black carbon (BC), and nitrogen oxides (NOx) from traffic, residential heating, and industry were assigned to each participant's address throughout the study period. Cox proportional hazards models adjusted for possible confounders was used to estimate associations between air pollution 1-5 years prior to outcomes of incident CHF, fatal myocardial infarction (MI), major adverse coronary events (MACE), and ischemic stroke. RESULTS Air pollution exposure levels (mean annual exposures to PM2.5 of 11 μg/m3 and NOx of 26 μg/m3) within the cohort were moderate in terms of environmental standards. After adjusting for confounders, we observed statistically significant associations between NOx and CHF (hazard ratio [HR] 1.11, 95% confidence interval [CI] 1.01-1.22) and NOx and fatal MI (HR 1.10, 95%CI 1.01-1.20) per interquartile range (IQR) of 9.6 μg/m3. In fully adjusted models, the estimates were similar, but the precision worse. In stratified analyses, the associations were stronger in males, ever-smokers, older participants, and those with baseline carotid artery plaques. Locally emitted and traffic-related air pollutants generally showed positive associations with CHF and fatal MI. There were no associations between air pollution and MACE or stroke. DISCUSSION/CONCLUSION In an area with low to moderate air pollution exposure, we observed significant associations of long-term residential NOx with increased risk of incident CHF and fatal MI, but not with coronary events and stroke.
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Affiliation(s)
- Hanne Krage Carlsen
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Eva M Andersson
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Peter Molnár
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Anna Oudin
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden; Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Sweden
| | - Yiyi Xu
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Janine Wichmann
- School of Health Systems and Public Health, University of Pretoria, South Africa
| | - Mårten Spanne
- Environmental Department of the City of Malmö, Sweden
| | - Emilie Stroh
- Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Sweden
| | - Gunnar Engström
- Department of Clinical Sciences at Malmö, CRC, Lund University and Skåne University Hospital, Malmö, Sweden
| | - Leo Stockfelt
- Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden; Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Gothenburg, Sweden
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Zou X, Fang J, Yang Y, Wu R, Wang S, Xu H, Jia J, Yang H, Yuan N, Hu M, Zhao Y, Xie Y, Zhu Y, Wang T, Deng Y, Song X, Ma X, Huang W. Maternal exposure to traffic-related ambient particles and risk of gestational diabetes mellitus with isolated fasting hyperglycaemia: A retrospective cohort study in Beijing, China. Int J Hyg Environ Health 2022; 242:113973. [PMID: 35447399 DOI: 10.1016/j.ijheh.2022.113973] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/12/2022] [Accepted: 04/13/2022] [Indexed: 10/18/2022]
Abstract
BACKGROUND Ambient particles have been associated with gestational diabetes mellitus (GDM), however, no study has evaluated the effects of traffic-related ambient particles on the risks of GDM subgroups classified by oral glucose tolerance test (OGTT) values. METHODS A retrospective analysis was conducted among 24,001 pregnant women who underwent regular prenatal care and received OGTT at Haidian Maternal and Child Health Hospital in Beijing, China, 2014-2017. A total of 3,168 (13.2%) pregnant women were diagnosed with GDM, including 1,206 with isolated fasting hyperglycaemia (GDM-IFH). At a fixed-location monitoring station, routinely monitored ambient particles included fine particulate matter (PM2.5), black carbon (BC) and particles in size ranges of 5-560 nm (PNC5-560). Contributions of PNC5-560 sources were apportioned by positive matrix factorization model. Logistic regression model was applied to estimate odds ratio (OR) of ambient particles on GDM risk. RESULTS Among the 24,001 pregnancy women recruited in this study, 3,168 (13.2%) were diagnosed with GDM, including 1,206 with isolated fasting hyperglycaemia (GDM-IFH) and 1,295 with isolated post-load hyperglycaemia (GDM-IPH). We observed increased GDM-IFH risk with per interquartile range increase in first-trimester exposures to PM2.5 (OR = 1.94; 95% Confidence Intervals: 1.23-3.07), BC (OR = 2.14; 1.73-2.66) and PNC5-560 (OR = 2.46; 1.90-3.19). PNC5-560 originated from diesel and gasoline vehicle emissions were found in associations with increases in GDM-IFH risk, but not in GDM-IPH risk. CONCLUSION Our findings suggest that exposure to traffic-related ambient particles may increase GDM risk by exerting adverse effects on fasting glucose levels during pregnancy, and support continuing efforts to reduce traffic emissions for protecting vulnerable population who are at greater risk of glucose metabolism disorder.
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Affiliation(s)
- Xiaoxuan Zou
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Jiakun Fang
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Ying Yang
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China; National Human Genetic Resources Center, Haidian District, Beijing, China.
| | - Rongshan Wu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China; State Key Laboratory of Environmental Criteria and Risk Assessment, State Environmental Protection Key Laboratory of Ecological Effect and Risk Assessment of Chemicals, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Shuo Wang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Hongbing Xu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Jiajing Jia
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China
| | - Haishan Yang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Ningman Yuan
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Meina Hu
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Yinzhu Zhao
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China
| | - Yunfei Xie
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Yutong Zhu
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Tong Wang
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Yuzhi Deng
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China
| | - Xiaoming Song
- Department of Occupational and Environmental Health, Peking University School of Public Health, And Peking University Institute of Environmental Medicine, Beijing, China
| | - Xu Ma
- National Research Institute for Family Planning, China; Graduate School of Peking Union Medical College, Dongcheng District, Beijing, China; National Human Genetic Resources Center, Haidian District, Beijing, China
| | - Wei Huang
- Hadian Maternal and Child Health Hospital, Haidian District, Beijing, China; Key Laboratory of Molecular Cardiovascular Sciences of Ministry of Education, Peking University, Beijing, China.
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Mandakh Y, Oudin A, Erlandsson L, Isaxon C, Hansson SR, Broberg K, Malmqvist E. Association of Prenatal Ambient Air Pollution Exposure With Placental Mitochondrial DNA Copy Number, Telomere Length and Preeclampsia. FRONTIERS IN TOXICOLOGY 2022; 3:659407. [PMID: 35295138 PMCID: PMC8915808 DOI: 10.3389/ftox.2021.659407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 04/19/2021] [Indexed: 12/22/2022] Open
Abstract
Background: Studies have shown that ambient air pollution is linked to preeclampsia (PE), possibly via generation of oxidative stress in the placenta. Telomere length and mitochondrial DNA copy number (mtDNAcn) are sensitive to oxidative stress damage. Objective: To study the association between prenatal exposure to ambient nitrogen oxides (NOx, a marker for traffic-related air pollution), and PE, as well as potential mediation effects by placental telomere length and mtDNAcn. Methods: This is a cross-sectional study of 42 preeclamptic and 95 arbitrarily selected normotensive pregnant women with gestational ambient NOx exposure assessment in southern Scania, Sweden. Hourly concentrations of NOx were estimated at the residential addresses by a Gaussian-plume dispersion model with 100 × 100 m spatial resolutions and aggregated into trimester-specific mean concentrations. Placental relative mtDNAcn and telomere length were measured using qPCR. Linear and logistic regression models were used to investigate associations, adjusted for perinatal and seasonal characteristics. Results: Exposure was categorized into low and high exposures by median cut-offs during first [11.9 μg/m3; interquartile range (IQR) 7.9, 17.9], second (11.6 μg/m3; IQR: 7.1, 21.1), third trimesters (11.9 μg/m3; IQR: 7.7, 19.5) and entire pregnancy (12.0 μg/m3; IQR: 7.6, 20.1). Increased risk of PE was found for high prenatal NOx exposure during the first trimester (OR 4.0; 95% CI: 1.4, 11.1; p = 0.008), and entire pregnancy (OR 3.7; 95% CI: 1.3, 10.4; p = 0.012). High exposed group during the first trimester had lower placental relative mtDNAcn compared with low exposed group (-0.20; 95% CI: -0.36, -0.04; p = 0.01). Changes in relative mtDNAcn did not mediate the association between prenatal NOx exposure and PE. No statistically significant association was found between placental relative telomere length, prenatal NOx exposure and PE. Conclusion: In this region with relatively low levels of air pollution, ambient NOx exposure during the first trimester was associated with reduced placental relative mtDNAcn and an increased risk of PE. However, we did not find any evidence that mtDNAcn or TL mediated the association between air pollution and PE. Future research should further investigate the role of mtDNAcn for pregnancy complications in relation to exposure to ambient air pollution during pregnancy.
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Affiliation(s)
- Yumjirmaa Mandakh
- Environment Society and Health, Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Anna Oudin
- Environment Society and Health, Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.,Section of Sustainable Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Lena Erlandsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Christina Isaxon
- Ergonomics and Aerosol Technology, Department of Design Sciences, Lund University, Lund, Sweden
| | - Stefan R Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.,Department of Obstetrics & Gynaecology, Skåne University Hospital, Malmö, Sweden
| | - Karin Broberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
| | - Ebba Malmqvist
- Environment Society and Health, Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden
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21
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Amegah AK, Sewor C, Obeng AA, Coker ES, Eliason S. Vitamin D intake modifies the association of household air pollution exposure with maternal disorders of pregnancy. INDOOR AIR 2022; 32:e12963. [PMID: 34837417 DOI: 10.1111/ina.12963] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 10/07/2021] [Accepted: 11/06/2021] [Indexed: 06/13/2023]
Abstract
To date, only three studies have investigated the association of household air pollution (HAP) exposure with pregnancy disorders. The ameliorating role of diet and nutrition in the association has never been explored. We conducted a cross-sectional study among 799 mothers who had recently given singleton birth in the Cape Coast Metropolis, Ghana. Structured questionnaire and semi-quantitative food frequency questionnaire were used to assess HAP exposure (from use of biomass fuels for cooking and garbage burning at home) and vitamin D (vitD) intake, respectively. Multivariable binary logistic regression was used to investigate the association between HAP exposure and pregnancy disorders. HAP exposure due to cooking with biomass fuels and garbage burning at home was associated with two fold (AOR = 2.15; 95% confidence interval [CI]: 1.05, 4.43) and six fold (AOR = 6.35; 95% CI: 2.43, 16.58) increased odds of hypertensive disorders of pregnancy (HDP). For gestational diabetes (GDM), the increased odds were two folds for both exposures but the 95% CI included the null value. Stove stacking was also associated with two folds increased odds of GDM (AOR = 1.83; 95% CI: 0.91, 3.68). In stratified analysis, the odds of HDP and GDM associated with biomass fuels use decreased with increasing vitD intake. All the interaction p values were, however, greater than 0.05. We provide the first evidence on the ameliorating role of vitD intake on the effect of HAP exposure on pregnancy disorders. In LMICs where solid fuel use and garbage burning at home is widespread, health workers should advise mothers during antenatal care visits to increase intake of vitamin D rich foods.
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Affiliation(s)
- Adeladza K Amegah
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Christian Sewor
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Akua A Obeng
- Public Health Research Group, Department of Biomedical Sciences, University of Cape Coast, Cape Coast, Ghana
| | - Eric S Coker
- Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, USA
| | - Sebastian Eliason
- Department of Community Medicine, School of Medical Sciences, University of Cape Coast, Cape Coast, Ghana
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Mai D, Xu C, Lin W, Yue D, Fu S, Lin J, Yuan L, Zhao Y, Zhai Y, Mai H, Zeng X, Jiang T, Li X, Dai J, You B, Xiao Q, Wei Q, Hu Q. Association of abnormal-glucose tolerance during pregnancy with exposure to PM 2.5 components and sources. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2022; 292:118468. [PMID: 34748887 DOI: 10.1016/j.envpol.2021.118468] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Revised: 10/15/2021] [Accepted: 11/03/2021] [Indexed: 06/13/2023]
Abstract
Maternal exposure to PM2.5 has been associated with abnormal glucose tolerance during pregnancy, but little is known about which constituents and sources are most relevant to glycemic effects. We conducted a retrospective cohort study of 1148 pregnant women to investigate associations of PM2.5 chemical components with gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) and to identify the most harmful sources in Heshan, China from January 2015 to July 2016. We measured PM2.5 using filter-based method and analyzed them for 28 constituents, including carbonaceous species, water-soluble ions and metal elements. Contributions of PM2.5 sources were assessed by positive matrix factorization (PMF). Logistic regression model was used to estimate composition-specific and source-specific effects on GDM/IGT. Random forest algorithm was applied to evaluate the relative importance of components to GDM and IGT. PM2.5 total mass and several chemical constituents were associated with GDM and IGT across the early to mid-gestation periods, as were the PM2.5 sources fossil fuel/oil combustion, road dust, metal smelting, construction dust, electronic waster, vehicular emissions and industrial emissions. The trimester-specific associations differed among pollutants and sources. The third and highest quartile of elemental carbon, ammonium (NH4+), iron (Fe) and manganese (Mn) across gestation were consistently associated with higher odds of GDM/IGT. Maternal exposures to zinc (Zn), titanium (Ti) and vehicular emissions during the first trimester, and vanadium (V), nickel (Ni), road dust and fossil fuel/oil combustion during the second trimester were more important for GDM/IGT. This study provides important new evidence that maternal exposure to PM2.5 components and sources is significantly related to elevated risk for abnormal glucose tolerance during pregnancy.
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Affiliation(s)
- Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Chengfang Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China.
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Jianqing Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Luan Yuan
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yan Zhao
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou, 510308, China
| | - Huiying Mai
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Xiaoling Zeng
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Tingwu Jiang
- Department of Clinical Laboratory, Heshan Maternal and Child Health Hospital, Heshan, 529700, Jiangmen, Guangdong, China
| | - Xuejiao Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou, 510630, Guangdong, China
| | - Jiajia Dai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Boning You
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qin Xiao
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qing Wei
- Experimental Teaching Center, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
| | - Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou, 510080, China
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23
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Sun Y, Li X, Benmarhnia T, Chen JC, Avila C, Sacks DA, Chiu V, Slezak J, Molitor J, Getahun D, Wu J. Exposure to air pollutant mixture and gestational diabetes mellitus in Southern California: Results from electronic health record data of a large pregnancy cohort. ENVIRONMENT INTERNATIONAL 2022; 158:106888. [PMID: 34563749 PMCID: PMC9022440 DOI: 10.1016/j.envint.2021.106888] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Revised: 09/07/2021] [Accepted: 09/17/2021] [Indexed: 05/14/2023]
Abstract
BACKGROUND Epidemiological findings are inconsistent regarding the associations between air pollution exposure during pregnancy and gestational diabetes mellitus (GDM). Several limitations exist in previous studies, including potential outcome and exposure misclassification, unassessed confounding, and lack of simultaneous consideration of air pollution mixtures and particulate matter (PM) constituents. OBJECTIVES To assess the association between GDM and maternal residential exposure to air pollution, and the joint effect of the mixture of air pollutants and PM constituents. METHODS Detailed clinical data were obtained for 395,927 pregnancies in southern California (2008-2018) from Kaiser Permanente Southern California (KPSC) electronic health records. GDM diagnosis was based on KPSC laboratory tests. Monthly average concentrations of fine particulate matter < 2.5 μm (PM2.5), <10 μm (PM10), nitrogen dioxide (NO2), and ozone (O3) were estimated using kriging interpolation of Environmental Protection Agency's routine monitoring station data, while PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon) were estimated using a fine-resolution geoscience-derived model. A multilevel logistic regression was used to fit single-pollutant models; quantile g-computation approach was applied to estimate the joint effect of air pollution and PM component mixtures. Main analyses adjusted for maternal age, race/ethnicity, education, median family household income, pre-pregnancy BMI, smoking during pregnancy, insurance type, season of conception and year of delivery. RESULTS The incidence of GDM was 10.9% in the study population. In single-pollutant models, we observed an increased odds for GDM associated with exposures to PM2.5, PM10, NO2 and PM2.5 constituents. The association was strongest for NO2 [adjusted odds ratio (OR) per interquartile range: 1.176, 95% confidence interval (CI): 1.147-1.205)]. In multi-pollutant models, increased ORs for GDM in association with one quartile increase in air pollution mixtures were found for both kriging-based regional air pollutants (NO2, PM2.5, and PM10, OR = 1.095, 95% CI: 1.082-1.108) and PM2.5 constituents (i.e., sulfate, nitrate, ammonium, organic matter and black carbon, OR = 1.258, 95% CI: 1.206-1.314); NO2 (78%) and black carbon (48%) contributed the most to the overall mixture effects among all krigged air pollutants and all PM2.5 constituents, respectively. The risk of GDM associated with air pollution exposure were significantly higher among Hispanic mothers, and overweight/obese mothers. CONCLUSION This study found that exposure to a mixture of ambient PM2.5, PM10, NO2, and PM2.5 chemical constituents was associated with an increased risk of GDM. NO2 and black carbon PM2.5 contributed most to GDM risk.
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Affiliation(s)
- Yi Sun
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA
| | - Xia Li
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Tarik Benmarhnia
- Herbert Wertheim School of Public Health and Scripps Institution of Oceanography, University of California, San Diego, 9500 Gilman Drive #0725, CA La Jolla 92093, USA
| | - Jiu-Chiuan Chen
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90033, USA
| | - Chantal Avila
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - David A Sacks
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Obstetrics and Gynecology, University of Southern California, Keck School of Medicine, Los Angeles, CA, USA
| | - Vicki Chiu
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - Jeff Slezak
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA
| | - John Molitor
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Darios Getahun
- Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA; Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, CA, USA.
| | - Jun Wu
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, CA, USA.
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Fan H, Wang Y, Wang Y, Coyte PC. The impact of environmental pollution on the physical health of middle-aged and older adults in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:4219-4231. [PMID: 34403062 DOI: 10.1007/s11356-021-15832-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 08/02/2021] [Indexed: 06/13/2023]
Abstract
While several studies have demonstrated the negative impacts of environmental pollution on population health, in general, few studies have examined the potential differential effects on the physical health of middle-aged and older populations, i.e., 45 years and older. Given the twin concerns of environmental pollution and population aging in China, this article employed a fixed effects model to infer the impact of environmental pollution on public health with a particular focus on middle-aged and older adults. The analyses were based on data from the 2011 to 2018 waves of the CHARLS and pollutant data from prefecture-level cities. The results showed that both the level and intensity of environmental pollution significantly increased the risk of chronic diseases and negatively impacted the physical health of middle-aged and older adults. Environmental pollution had its greatest negative effect on the physical health of the elderly, urban residents, residents of the Eastern region, and those with lower incomes than their counterparts. We further found that the potential channels of health effect were through reduced physical exercise and sleep duration and an increase in depressive symptoms, and the pollution prevention actions alleviated the health deterioration of environmental pollution for the middle-aged and the elderly. It is imperative for the government to urgently reinforce policy enforcement to decrease air and water pollution and enhance the ability to circumvent pollution for the lower socioeconomic groups.
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Affiliation(s)
- Hongli Fan
- School of Insurance, Shandong University of Finance and Economics, 40 Shungeng Street, Jinan, 250000, Shandong, China.
| | - Yingcheng Wang
- School of Insurance, Shandong University of Finance and Economics, 40 Shungeng Street, Jinan, 250000, Shandong, China
| | - Ying Wang
- School of Finance, Shandong University of Finance and Economics, Jinan, Shandong, China
| | - Peter C Coyte
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
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Ambient air pollution and inflammatory effects in a Canadian pregnancy cohort. Environ Epidemiol 2021; 5:e168. [PMID: 34934889 PMCID: PMC8683146 DOI: 10.1097/ee9.0000000000000168] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/05/2021] [Indexed: 12/04/2022] Open
Abstract
Supplemental Digital Content is available in the text. Background: Epidemiologic studies have consistently reported associations between air pollution and pregnancy outcomes including preeclampsia and gestational diabetes. However, the biologic mechanisms underlying these relationships remain unclear as few studies have collected relevant biomarker data. We examined relationships between ambient PM2.5 and NO2 with markers of inflammation during pregnancy in a prospective cohort of Canadian women. Methods: We analyzed data from 1170 women enrolled in the Maternal-Infant Research on Environmental Chemicals study. Daily residential PM2.5 and NO2 exposures during pregnancy were estimated using satellite-based and land-use regression models and used to create 14-day and 30-day exposure windows before blood-draw. Inflammatory markers C-reactive protein, interleukin-6, interleukin-8, and tumor necrosis factor-α were measured in third trimester plasma samples. Multivariable linear regression was used to estimate associations for an interquartile range (IQR) increase in PM2.5 and NO2 and markers of inflammation, while adjusting for individual-level confounders. Results: Fourteen-day (IQR: 6.85 µg/m3) and 30-day (IQR: 6.15 µg/m3) average PM2.5 exposures before blood-draw were positively associated with C-reactive protein after adjustment for covariates (24.6% [95% CI = 9.4, 41.9] and 17.4% [95% CI = 1.0, 35.0] increases, respectively). This association was found to be robust in several sensitivity analyses. Neither PM2.5 nor NO2 exposures were associated with interleukin-6, interleukin-8, or tumor necrosis factor-α. Conclusion: Exposure to ambient PM2.5 is positively associated with maternal inflammatory pathways in late pregnancy. This may contribute to positive associations between ambient PM2.5 and risk of adverse pregnancy outcomes.
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Early Pregnancy Exposure to Ambient Air Pollution among Late-Onset Preeclamptic Cases Is Associated with Placental DNA Hypomethylation of Specific Genes and Slower Placental Maturation. TOXICS 2021; 9:toxics9120338. [PMID: 34941772 PMCID: PMC8708250 DOI: 10.3390/toxics9120338] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 11/25/2021] [Accepted: 11/29/2021] [Indexed: 01/19/2023]
Abstract
Exposure to ambient air pollution during pregnancy has been associated with an increased risk of preeclampsia (PE). Some suggested mechanisms behind this association are changes in placental DNA methylation and gene expression. The objective of this study was to identify how early pregnancy exposure to ambient nitrogen oxides (NOx) among PE cases and normotensive controls influence DNA methylation (EPIC array) and gene expression (RNA-seq). The study included placentas from 111 women (29 PE cases/82 controls) in Scania, Sweden. First-trimester NOx exposure was assessed at the participants’ residence using a dispersion model and categorized via median split into high or low NOx. Placental gestational epigenetic age was derived from the DNA methylation data. We identified six differentially methylated positions (DMPs, q < 0.05) comparing controls with low NOx vs. cases with high NOx and 14 DMPs comparing cases and controls with high NOx. Placentas with female fetuses showed more DMPs (N = 309) than male-derived placentas (N = 1). Placentas from PE cases with high NOx demonstrated gestational age deceleration compared to controls with low NOx (p = 0.034). No differentially expressed genes (DEGs, q < 0.05) were found. In conclusion, early pregnancy exposure to NOx affected placental DNA methylation in PE, resulting in placental immaturity and showing sexual dimorphism.
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Goin DE, Sudat S, Riddell C, Morello-Frosch R, Apte JS, Glymour MM, Karasek D, Casey JA. Hyperlocalized Measures of Air Pollution and Preeclampsia in Oakland, California. ENVIRONMENTAL SCIENCE & TECHNOLOGY 2021; 55:14710-14719. [PMID: 34648281 PMCID: PMC8968652 DOI: 10.1021/acs.est.1c02151] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Exposure to nitrogen dioxide (NO2), black carbon (BC), and ultrafine particles (UFPs) during pregnancy may increase the risk of preeclampsia, but previous studies have not assessed hyperlocalized differences in pollutant levels, which may cause exposure misclassification. We used data from Google Street View cars with mobile air monitors that repeatedly sampled NO2, BC, and UFPs every 30 m in Downtown and West Oakland neighborhoods during 2015-2017. Data were linked to electronic health records of pregnant women in the 2014-2016 Sutter Health population, who resided within 120 m of monitoring data (N = 1095), to identify preeclampsia cases. We used G-computation with log-binomial regression to estimate risk differences (RDs) associated with a hypothetical intervention reducing pollutant levels to the 25th percentile observed in our sample on preeclampsia risk, overall and stratified by race/ethnicity. Prevalence of preeclampsia was 6.8%. Median (interquartile range) levels of NO2, BC, and UFPs were 10.8 ppb (9.0, 13.0), 0.34 μg/m3 (0.27, 0.42), and 29.2 # × 103/cm3 (26.6, 32.6), respectively. Changes in the risk of preeclampsia achievable by limiting each pollutant to the 25th percentile were NO2 RD = -1.5 per 100 women (95% confidence interval (CI): -2.5, -0.5); BC RD = -1.0 (95% CI: -2.2, 0.02); and UFP RD = -0.5 (95% CI: -1.8, 0.7). Estimated effects were the largest for non-Latina Black mothers: NO2 RD = -2.8 (95% CI: -5.2, -0.3) and BC RD = -3.0 (95% CI: -6.4, 0.4).
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Affiliation(s)
- Dana E. Goin
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, California, 94158, United States of America
| | - Sylvia Sudat
- Research, Development and Dissemination, Sutter Health, Walnut Creek, California, 94596, United States of America
| | - Corinne Riddell
- Division of Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, California, 94720, United States of America
- Division of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, 94720, United States of America
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy, and Management & School of Public Health, University of California, Berkeley, Berkeley, California, 94720, United States of America
| | - Joshua S. Apte
- Department of Civil and Environmental Engineering & School of Public Health, University of California, Berkeley, Berkeley, California, 94720, United States of America
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, 94158, United States of America
| | - Deborah Karasek
- Preterm Birth Initiative, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California, 94158, United States of America
| | - Joan A. Casey
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, New York, 10032, United States of America
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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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Garcia M, Salazar R, Wilson T, Lucas S, Herbert G, Young T, Begay J, Denson JL, Zychowski K, Ashley R, Byrum S, Mackintosh S, Bleske BE, Ottens AK, Campen MJ. Early Gestational Exposure to Inhaled Ozone Impairs Maternal Uterine Artery and Cardiac Function. Toxicol Sci 2021; 179:121-134. [PMID: 33146391 DOI: 10.1093/toxsci/kfaa164] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Exposure to air pollutants such as ozone (O3) is associated with adverse pregnancy outcomes, including higher incidence of gestational hypertension, preeclampsia, and peripartum cardiomyopathy; however, the underlying mechanisms of this association remain unclear. We hypothesized that O3 exposures during early placental formation would lead to more adverse cardiovascular effects at term for exposed dams, as compared with late-term exposures. Pregnant Sprague Dawley rats were exposed (4 h) to either filtered air (FA) or O3 (0.3 or 1.0 ppm) at either gestational day (GD)10 or GD20, with longitudinal functional assessments and molecular endpoints conducted at term. Exposure at GD10 led to placental transcriptional changes at term that were consistent with markers in human preeclampsia, including reduced mmp10 and increased cd36, fzd1, and col1a1. O3 exposure, at both early and late gestation, induced a significant increase in maternal circulating soluble FMS-like tyrosine kinase-1 (sFlt-1), a known driver of preeclampsia. Otherwise, exposure to 0.3 ppm O3 at GD10 led to several late-stage cardiovascular outcomes in dams that were not evident in GD20-exposed dams, including elevated uterine artery resistance index and reduced cardiac output and stroke volume. GD10 O3 exposure proteomic profile in maternal hearts characterized by a reduction in proteins with essential roles in metabolism and mitochondrial function, whereas phosphoproteomic changes were consistent with pathways involved in cardiomyopathic responses. Thus, the developing placenta is an indirect target of inhaled O3 and systemic maternal cardiovascular abnormalities may be induced by O3 exposure at a specific window of gestation.
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Affiliation(s)
- Marcus Garcia
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Raul Salazar
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Thomas Wilson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Selita Lucas
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Guy Herbert
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Tamara Young
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jessica Begay
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Jesse L Denson
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Katherine Zychowski
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Ryan Ashley
- Department of Animal and Range Sciences, New Mexico State University, Las Cruces, New Mexico 88003
| | - Stephanie Byrum
- Arkansas Children's Research Institute, Little Rock, Arkansas 72202
| | - Samuel Mackintosh
- Biochemistry and Molecular Biology, University of Arkansas for Medical Sciences, Little Rock, Arkansas 72205
| | - Barry E Bleske
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
| | - Andrew K Ottens
- Department of Anatomy and Neurobiology, Virginia Commonwealth University, Richmond, Virginia 23298-0709
| | - Matthew J Campen
- Department of Pharmaceutical Sciences, University of New Mexico Health Sciences Center, Albuquerque, New Mexico 87131
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Qi C, Shang L, Yang W, Huang L, Yang L, Xin J, Wang S, Yue J, Zeng L, Chung MC. Maternal exposure to O 3 and NO 2 may increase the risk of newborn congenital hypothyroidism: a national data-based analysis in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:34621-34629. [PMID: 33655476 PMCID: PMC8275538 DOI: 10.1007/s11356-021-13083-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Accepted: 02/17/2021] [Indexed: 06/12/2023]
Abstract
Maternal exposure to air pollution during pregnancy is associated with adverse outcomes in the offspring, but limited studies focused on the impacts of gaseous air pollution on newborn congenital hypothyroidism (CH). Therefore, a national data-based analysis was conducted to explore the association between maternal exposure to gaseous air pollution and the incidence of CH in China. Annual average exposure levels of SO2, NO2, CO, and O3 from January 1, 2014, to December 30, 2014, were acquired from the Chinese Air Quality Online Monitoring and Analysis Platform. The annual incidence of newborn CH from October 1, 2014, to September 30, 2015, was collected from the Chinese Maternal and Child Health Surveillance Network. Temperature and toxic metal in wastewater in 2014 were also collected as covariates. Maternal exposure to O3 and NO2 in 1 μg/m3 level increment was positively associated with newborn CH, with an OR of 1.055 (95% CI 1.011, 1.102) and 1.097 (95% CI 1.019, 1.182) after adjusting for covariates completely. Compared with the lowest level of O3, maternal exposure to the 4th quartile of O3 was positively associated with newborn CH (OR 1.393, 95% CI 1.081, 1.794) after adjusting for covariates completely. And the 3rd and 4th quartiles of NO2 were associated positively with CH (OR 1.576, 95% CI 1.025, 2.424, and OR 1.553, 95% CI 0.999, 2.414, respectively) compared with the lowest level of NO2. By fitting the ROC curve, 93.688 μg/m3 in O3 might be used as cutoff to predict the incidence of newborn CH in China.
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Affiliation(s)
- Cuifang Qi
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Li Shang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Wenfang Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Liyan Huang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Liren Yang
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Juan Xin
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Shanshan Wang
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Jie Yue
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Lingxia Zeng
- School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an,, Shaanxi 710061 People’s Republic of China
| | - Mei Chun Chung
- Department of Obstetrics and Gynecology, Maternal & Child Health Center, The First Affiliated Hospital of Xi’an Jiaotong University, No. 277, West Yanta Road, Xi’an,, Shaanxi 710061 People’s Republic of China
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA USA
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Huang Y, Kioumourtzoglou MA, Mittleman MA, Ross Z, Williams MA, Friedman AM, Schwartz J, Wapner RJ, Ananth CV. Air Pollution and Risk of Placental Abruption: A Study of Births in New York City, 2008-2014. Am J Epidemiol 2021; 190:1021-1033. [PMID: 33295612 DOI: 10.1093/aje/kwaa259] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2020] [Revised: 10/27/2020] [Accepted: 12/03/2020] [Indexed: 12/11/2022] Open
Abstract
We evaluated the associations of exposure to fine particulate matter (particulate matter with an aerodynamic diameter ≤2.5 μm (PM2.5) at concentrations of <12 μg/m3, 12-14 μg/m3, and ≥15 μg/m3) and nitrogen dioxide (at concentrations of <26 parts per billion (ppb), 26-29 ppb, and ≥30 ppb) with placental abruption in a prospective cohort study of 685,908 pregnancies in New York, New York (2008-2014). In copollutant analyses, these associations were examined using distributed-lag nonlinear models based on Cox models. The prevalence of abruption was 0.9% (n = 6,025). Compared with a PM2.5 concentration less than 12 μg/m3, women exposed to PM2.5 levels of ≥15 μg/m3 in the third trimester had a higher rate of abruption (hazard ratio (HR) = 1.68, 95% confidence interval (CI): 1.41, 2.00). Compared with a nitrogen dioxide concentration less than 26 ppb, women exposed to nitrogen dioxide levels of 26-29 ppb (HR = 1.11, 95% CI: 1.02, 1.20) and ≥30 ppb (HR = 1.06, 95% CI: 0.96, 1.24) in the first trimester had higher rates of abruption. Compared with both PM2.5 and nitrogen dioxide levels less than the 95th percentile in the third trimester, rates of abruption were increased with both PM2.5 and nitrogen dioxide ≥95th percentile (HR = 1.44, 95% CI: 1.15, 1.80) and PM2.5 ≥95th percentile and nitrogen dioxide <95th percentile (HR = 1.43 95% CI: 1.23, 1.66). Increased levels of PM2.5 exposure in the third trimester and nitrogen dioxide exposure in the first trimester are associated with elevated rates of placental abruption, suggesting that these exposures may be important triggers of premature placental separation through different pathways.
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Wang W, Xie X, Yuan T, Wang Y, Zhao F, Zhou Z, Zhang H. Epidemiological trends of maternal hypertensive disorders of pregnancy at the global, regional, and national levels: a population-based study. BMC Pregnancy Childbirth 2021; 21:364. [PMID: 33964896 PMCID: PMC8106862 DOI: 10.1186/s12884-021-03809-2] [Citation(s) in RCA: 113] [Impact Index Per Article: 37.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Accepted: 04/19/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Relevant studies focusing on epidemiological of profiles hypertensive disorders of pregnancy from global data that report the cause-specific prevalence and trends of hypertensive disorders of pregnancy at global, regional and national levels from 1990 to 2019 by age and sociodemographic index are still limited. METHODS For hypertensive disorders of pregnancy, point prevalence, annual incidence, and years lived with disability numbers and age standardized rates per 100,000 population were compared at regional and national levels by age and sociodemographic index using data from the global Burden of Disease 2019 Study, covering populations from 204 countries and territories. Estimates are reported with uncertainty intervals to exhibit the changing trends during a specific period. RESULTS The incidence of hypertensive disorders of pregnancy increased from 16.30 million to 18.08 million globally, with a total increase of 10.92 % from 1990 to 2019. The age-standardized incidence rate decreased, with an estimated annual percent change of -0.68 (95 % confidence interval [CI] -0.49 to -0.86). The number of deaths due to hypertensive disorders of pregnancy was approximately 27.83 thousand in 2019, representing a 30.05 % decrease from 1990. Based on the incidence and prevalence, the number of deaths and years lived with disability were highest in the group aged 25-29 years, followed by the groups aged 30-34 and 20-24 years, while the lowest estimated incidence rate was observed in the group aged 25-29 years and higher incidence rates were observed in the youngest and oldest groups. Positive associations between incidence rates and the sociodemographic index and human development index were found for all countries and regions in 2019. Age-standardized incidence rates were higher in countries/regions with lower sociodemographic indices and human development indices. CONCLUSIONS Our study provides a comprehensive overview of the global burden of hypertensive disorders of pregnancy. The death and incidence rates are decreasing in most countries and all regions except for those with low sociodemographic and human development indexes. This difference is mainly due to the increasing attention to prenatal examinations and health education. Further investigations should focus on forecasting the global disease burden of specific hypertensive disorders of pregnancy and modifiable risk factors.
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Affiliation(s)
- Wei Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Xin Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Ting Yuan
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Yanyan Wang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Fei Zhao
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China
| | - Zhangjian Zhou
- Department of Oncology, The Second Affiliated Hospital of Xi'an Jiaotong University, 710004, Xi'an, Shaanxi, China
| | - Hao Zhang
- Department of Surgical Oncology, The First Affiliated Hospital of Xi'an Jiaotong University, 710061, Xi'an, Shaanxi, China. .,Department of Public Health, Baoji High-tech People's Hospital, Shaanxi, 721000, Baoji, China.
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Williams AD, Ha S, Shenassa E, Messer LC, Kanner J, Mendola P. Joint effects of ethnic enclave residence and ambient volatile organic compounds exposure on risk of gestational diabetes mellitus among Asian/Pacific Islander women in the United States. Environ Health 2021; 20:56. [PMID: 33964949 PMCID: PMC8106843 DOI: 10.1186/s12940-021-00738-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 04/26/2021] [Indexed: 05/06/2023]
Abstract
BACKGROUND Asian/Pacific Islander (API) communities in the United States often reside in metropolitan areas with distinct social and environmental attributes. Residence in an ethnic enclave, a socially distinct area, is associated with lower gestational diabetes mellitus (GDM) risk, yet exposure to high levels of air pollution, including volatile organic compounds (VOCS), is associated with increased GDM risk. We examined the joint effects of ethnic enclaves and VOCs to better understand GDM risk among API women, the group with the highest prevalence of GDM. METHODS We examined 9069 API births in the Consortium on Safe Labor (19 hospitals, 2002-2008). API ethnic enclaves were defined as areas ≥66th percentile for percent API residents, dissimilarity (geographic dispersal of API and White residents), and isolation (degree that API individuals interact with another API individual). High levels of 14 volatile organic compounds (VOC) were defined as ≥75th percentile. Four joint categories were created for each VOC: Low VOC/Enclave (reference group), Low VOC/No Enclave, High VOC/Enclave, High VOC/No Enclave. GDM was reported in medical records. Hierarchical logistic regression estimated odds ratios (OR) and 95% confidence intervals (95%CI) between joint exposures and GDM, adjusted for maternal factors and area-level poverty. Risk was estimated for 3-months preconception and first trimester exposures. RESULTS Enclave residence was associated with lower GDM risk regardless of VOC exposure. Preconception benzene exposure was associated with increased risk when women resided outside enclaves [High VOC/No Enclave (OR:3.45, 95%CI:1.77,6.72)], and the effect was somewhat mitigated within enclaves, [High VOC/Enclave (OR:2.07, 95%:1.09,3.94)]. Risks were similar for 12 of 14 VOCs during preconception and 10 of 14 during the first trimester. CONCLUSIONS API residence in non-enclave areas is associated with higher GDM risk, regardless of VOC level. Ethnic enclave residence may mitigate effects of VOC exposure, perhaps due to lower stress levels. The potential benefit of ethnic enclaves warrants further study.
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Affiliation(s)
- Andrew D. Williams
- Public Health program, Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, Room E162, 1301 North Columbia Road Stop 9037, Grand Forks, ND 58202-9037 USA
| | - Sandie Ha
- School of Social Sciences, Humanities and Arts, Health Science Research Institute, University of California, 5200 N. Lake Road, Merced, CA USA
| | - Edmond Shenassa
- Maternal and Child Health Program, Department of Family Science, University of Maryland College Park, 4200 Valley Drive, College Park, MD USA
| | - Lynne C. Messer
- OHSU-PSU School of Public Health, Portland State University, 506 SW Mill Street 470H, Portland, OR USA
| | - Jenna Kanner
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, MSC, Bethesda, MD 7004 USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6710B Rockledge Drive, MSC, Bethesda, MD 7004 USA
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Padula AM, Ma C, Huang H, Morello-Frosch R, Woodruff TJ, Carmichael SL. Drinking water contaminants in California and hypertensive disorders in pregnancy. Environ Epidemiol 2021; 5:e149. [PMID: 33870020 PMCID: PMC8043732 DOI: 10.1097/ee9.0000000000000149] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 03/04/2021] [Indexed: 12/07/2022] Open
Abstract
Environmental pollutants have been associated with hypertensive disorders in pregnancy including gestational hypertension, preeclampsia, and eclampsia, though few have focused on drinking water contamination. Water pollution can be an important source of exposures that may contribute to adverse pregnancy outcomes. METHODS We linked water quality data on 13 contaminants and two violations from the California Communities Environmental Health Screening Tool to birth records from vital statistics and hospital discharge records (2007-2012) to examine the relationship between drinking water contamination and hypertensive disorders in pregnancy. We examined contaminants in single- and multipollutant models. Additionally, we examined if the relationship between water contamination and hypertensive disorders in pregnancy differed by neighborhood poverty, individual socioeconomic status, and race/ethnicity. RESULTS Arsenic, nitrate, trihalomethane, hexavalent chromium, and uranium were detected in a majority of water systems. Increased risk of hypertensive disorders in pregnancy was modestly associated with exposure to cadmium, lead, trihalomethane, and hexavalent chromium in drinking water after adjusting for covariates in single pollutant models with odds ratios ranging from 1.01 to 1.08. In multipollutant models, cadmium was consistent, lead and trihalomethane were stronger, and additional contaminants were associated with hypertensive disorders in pregnancy including trichloroethylene, 1,2-Dibromo-3-chloropropane, nitrate, and tetrachloroethylene. Other contaminants either showed null results or modest inverse associations. The relationship between water contaminants and hypertensive disorders in pregnancy did not differ by neighborhood poverty. CONCLUSIONS We found increased risk of hypertensive disorders in pregnancy associated with exposure to several contaminants in drinking water in California. Results for cadmium, lead, trihalomethane, and hexavalent chromium were robust in multipollutant models.
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Affiliation(s)
- Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Chen Ma
- Department of Pediatrics, Stanford University School of Medicine, Stanford, California
| | - Hongtai Huang
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Rachel Morello-Frosch
- Department of Environmental Science, Policy and Management & School of Public Health, University of California, Berkeley, Berkeley, California
| | - Tracey J. Woodruff
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, California
| | - Suzan L. Carmichael
- Department of Environmental Science, Policy and Management & School of Public Health, University of California, Berkeley, Berkeley, California
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Hu Q, Wang D, Yue D, Xu C, Hu B, Cheng P, Zhai Y, Mai H, Li P, Gong J, Zeng X, Jiang T, Mai D, Fu S, Guo L, Lin W. Association of ambient particle pollution with gestational diabetes mellitus and fasting blood glucose levels in pregnant women from two Chinese birth cohorts. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 762:143176. [PMID: 33158526 DOI: 10.1016/j.scitotenv.2020.143176] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 08/21/2020] [Accepted: 10/13/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Fasting blood glucose may capture the adverse effects of air pollution on pregnant women better than the incidence of gestational diabetes mellitus (GDM), but evidence on the association between air pollution and maternal glucose concentrations is limited. OBJECTIVE To investigate the associations between air pollutants, GDM and fasting blood glucose during pregnancy. METHODS We recruited 2326 pregnant women from two birth cohorts located in Guangzhou and Heshan, the Pearl River Delta region (PRD), China. PM10, PM2.5 and black carbon (BC) exposure concentrations in the first and second trimesters of pregnancy were collected at fixed-site monitoring stations for each cohort. Multiple logistic regressions were employed to estimate the associations between particle pollution and GDM. Mixed-effects models were used to evaluate the associations of air pollutants with blood glucose levels. Restricted cubic spline functions were fitted to visualize the concentration-response relationships. Distributed lag non-linear models were used to estimate week-specific lag effects of particle pollution exposure on GDM and blood glucose. Unconstrained distributed lag models with lags of 0-3 weeks were used to examine potential cumulative effects. RESULTS We observed positive and significant associations of PM10, PM2.5 and BC exposure with fasting glucose, particularly in the second trimester. PM10, PM2.5 and BC were strongly correlated and displayed similar cumulative (lag 0-3 weeks) associations with fasting blood glucose. Exposure to particle pollution was not associated with 1-h or 2-h blood glucose. Models estimating the association between air pollutants and GDM were consistent with statistical insignificance. CONCLUSIONS Based on the results of the present study, exposure to air pollution during pregnancy exerts cumulative, adverse effects on fasting glucose levels. This study provides preliminary support for the use of blood glucose levels to explore the potential health impact of air pollution on pregnant women.
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Affiliation(s)
- Qiansheng Hu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Duo Wang
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Dingli Yue
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, Guangdong, China
| | - Chengfang Xu
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Bo Hu
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Peng Cheng
- Institute of Mass Spectrometer and Atmospheric Environment, Jinan University, Guangzhou 510632, Guangdong, China
| | - Yuhong Zhai
- Guangdong Environmental Monitoring Center, State Environmental Protection Key Laboratory of Regional Air Quality Monitoring, Guangzhou 510308, Guangdong, China
| | - Huiying Mai
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Ping Li
- Department of Obstetrics and Gynecology, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Jiao Gong
- Department of Clinical Laboratory, The Third Affiliated Hospital, Sun Yat-sen University, Guangzhou 510630, Guangdong, China
| | - Xiaoling Zeng
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Tingwu Jiang
- Department of Clinical Laboratory, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Dejian Mai
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Shaojie Fu
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China
| | - Lihua Guo
- Department of Obstetrics and Gynecology, Heshan Maternal and Child Health Hospital, Heshan, 529700 Jiangmen, Guangdong, China
| | - Weiwei Lin
- Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, Guangdong, China.
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Air Pollution and Adverse Pregnancy and Birth Outcomes: Mediation Analysis Using Metabolomic Profiles. Curr Environ Health Rep 2021; 7:231-242. [PMID: 32770318 DOI: 10.1007/s40572-020-00284-3] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
PURPOSE OF REVIEW Review how to use metabolomic profiling in causal mediation analysis to assess epidemiological evidence for air pollution impacts on birth outcomes. RECENT FINDINGS Maternal exposures to air pollutants have been associated with pregnancy complications and adverse pregnancy and birth outcomes. Causal mediation analysis enables us to estimate direct and indirect effects on outcomes (i.e., effect decomposition), elucidating causal mechanisms or effect pathways. Maternal metabolites and metabolic pathways are perturbed by air pollution exposures may lead to adverse pregnancy and birth outcomes, thus they can be considered mediators in the causal pathways. Metabolomic markers have been used to explain the biological mechanisms linking air pollution and respiratory function, and of arsenic exposure and birth weight. However, mediation analysis of metabolomic markers has not been used to assess air pollution effects on adverse birth outcomes. In this article, we describe the assumptions and applications of mediation analysis using metabolomic markers that elucidate the potential mechanisms of the effects of air pollution on adverse pregnancy and birth outcomes. The hypothesis of mediation along specified pathways can be assessed within the structural causal modeling framework. For causal inferences, several assumptions that go beyond the data-including no uncontrolled confounding-need to be made to justify the effect decomposition. Nevertheless, studies that integrate metabolomic information in causal mediation analysis may greatly improve our understanding of the effects of ambient air pollution on adverse pregnancy and birth outcomes as they allow us to suggest and test hypotheses about underlying biological mechanisms in studies of pregnant women.
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Najafi ML, Zarei M, Gohari A, Haghighi L, Heydari H, Miri M. Preconception air pollution exposure and glucose tolerance in healthy pregnant women in a middle-income country. Environ Health 2020; 19:131. [PMID: 33298083 PMCID: PMC7727159 DOI: 10.1186/s12940-020-00682-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2020] [Accepted: 12/01/2020] [Indexed: 05/11/2023]
Abstract
BACKGROUND Preconception exposure to air pollution has been associated with glucose tolerance during pregnancy. However, the evidence in low and middle-income countries (LMICs) is under debate yet. Therefore, this study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019). METHODS Two-hundred and fifty healthy pregnant women with singleton pregnancies and 24-26 weeks of gestations participated in our study. Land use regression (LUR) models were applied to estimate the annual mean of PM1, PM2.5 and PM10 at the residential address. Traffic indicators, including proximity of women to major roads as well as total streets length in 100, 300 and 500 m buffers around the home were calculated using the street map of Sabzevar. The oral glucose tolerance test (OGTT) was used to assess glucose tolerance during pregnancy. Multiple linear regression adjusted for relevant covariates was used to estimate the association of fasting blood glucose (FBG), 1-h and 2-h post-load glucose with PMs and traffic indicators. RESULTS Exposure to PM1, PM2.5 and PM10 was significantly associated with higher FBG concentration. Higher total streets length in a 100 m buffer was associated with higher FBG and 1-h glucose concentrations. An interquartile range (IQR) increase in proximity to major roads was associated with a decrease of - 3.29 mg/dL (95% confidence interval (CI): - 4.35, - 2.23, P-value < 0.01) in FBG level and - 3.65 mg/dL (95% CI, - 7.01, - 0.28, P-value = 0.03) decrease in 1-h post-load glucose. CONCLUSION We found that higher preconception exposure to air pollution was associated with higher FBG and 1-h glucose concentrations during pregnancy.
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Affiliation(s)
- Moslem Lari Najafi
- Pharmaceutical Sciences and Cosmetic Products Research Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Mehdi Zarei
- Department of Physical Education and Sport Science, Faculty of Human Science, University of Neyshabur, Neyshabur, Iran
| | - Ali Gohari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Leyla Haghighi
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran
| | - Hafez Heydari
- Cellular and Molecular Research Center, Sabzevar University of Medical Sciences, Sabzevar, Iran.
| | - Mohammad Miri
- Non-Communicable Diseases Research Center, Department of Environmental Health, School of Health, Sabzevar University of Medical Sciences, PO Box 319, Sabzevar, Iran.
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Karimi SM, Maziyaki A, Ahmadian Moghadam S, Jafarkhani M, Zarei H, Moradi-Lakeh M, Pouran H. Continuous exposure to ambient air pollution and chronic diseases: prevalence, burden, and economic costs. REVIEWS ON ENVIRONMENTAL HEALTH 2020; 35:379-399. [PMID: 32324166 DOI: 10.1515/reveh-2019-0106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 03/17/2020] [Indexed: 06/11/2023]
Abstract
Studies that assess the connection between the prevalence of chronic diseases and continuous exposure to air pollution are scarce in developing countries, mainly due to data limitations. Largely overcoming data limitations, this study aimed to investigate the association between the likelihood of reporting a set of chronic diseases (diabetes, cancer, stroke and myocardial infarction, asthma, and hypertension) and continuous exposure to carbon monoxide (CO), nitrogen dioxide (NO2), ozone (O3), and coarse particulate matter (PM10). Using the estimated associations, the disease burden and economic costs of continuous exposure to air pollutants were also approximated. A 2011 Health Equity Assessment and Response Tool survey from Tehran, Iran, was used in the main analyses. A sample of 67,049 individuals who had not changed their place of residence for at least 2 years before the survey and reported all relevant socioeconomic information was selected. The individuals were assigned with the average monthly air pollutant levels of the nearest of 16 air quality monitors during the 2 years leading to the survey. Both single- and multi-pollutant analyses were conducted. The country's annual household surveys from 2002 to 2011 were used to calculate the associated economic losses. The single-pollutant analysis showed that a one-unit increase in monthly CO (ppm), NO2 (ppb), O3 (ppb), and PM10 (μg/m3) during the 2 years was associated with 751 [confidence interval (CI): 512-990], 18 (CI: 12-24), 46 (CI: -27-120), and 24 (CI: 13-35) more reported chronic diseases in 100,000, respectively. The disease-specific analyses showed that a unit change in average monthly CO was associated with 329, 321, 232, and 129 more reported cases of diabetes, hypertension, stroke and myocardial infarction, and asthma in 100,000, respectively. The measured associations were greater in samples with older individuals. Also, a unit change in average monthly O3 was associated with 21 (in 100,000) more reported cases of asthma. The multi-pollutant analyses confirmed the results from single-pollutant analyses. The supplementary analyses showed that a one-unit decrease in monthly CO level could have been associated with about 208 (CI: 147-275) years of life gained or 15.195 (CI: 10.296-20.094) thousand US dollars (USD) in life-time labor market income gained per 100,000 30-plus-year-old Tehranis.
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Affiliation(s)
- Seyed M Karimi
- Department of Health Management and System Sciences, University of Louisville, 485 E. Gray St, Louisville, KY 40202, USA, Phone: +1(502)852-0417. Fax: +1(502)852-3294
| | - Ali Maziyaki
- Department of Economics, Allameh Tabatabai University, Tehran, Iran
| | - Samaneh Ahmadian Moghadam
- Department of Neuroscience and Addiction Studies, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahtab Jafarkhani
- Department of Economics, Institute for Management and Planning Studies, Tehran, Iran
| | - Hamid Zarei
- Department of Economics, Institute for Management and Planning Studies, Tehran, Iran
| | - Maziar Moradi-Lakeh
- Department of Community Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Hamid Pouran
- Department of Science and Engineering, University of Wolverhampton, Wolverhampton, UK
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Preston EV, Eberle C, Brown FM, James-Todd T. Climate factors and gestational diabetes mellitus risk - a systematic review. Environ Health 2020; 19:112. [PMID: 33168031 PMCID: PMC7653781 DOI: 10.1186/s12940-020-00668-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/15/2020] [Indexed: 05/04/2023]
Abstract
BACKGROUND Current and projected increases in global temperatures and extreme climate events have led to heightened interest in the impact of climate factors (i.e. ambient temperature, season/seasonality, and humidity) on human health. There is growing evidence that climate factors may impact metabolic function, including insulin sensitivity. Gestational diabetes mellitus (GDM) is a common pregnancy complication, with an estimated global prevalence of up to 14%. While lifestyle and genetic risk factors for GDM are well established, environmental factors may also contribute to GDM risk. Previous reviews have summarized the growing evidence of environmental risk factors for GDM including endocrine disrupting chemicals and ambient air pollution. However, studies of the effects of climate factors on GDM risk have not been systematically evaluated. Therefore, we conducted a systematic review to summarize and evaluate the current literature on the associations of climate factors with GDM risk. METHODS We conducted systematic searches in PubMed and EMBASE databases for original research articles on associations of climate factors (i.e. ambient temperature, season/seasonality, and humidity) with GDM and/or related glycemic outcomes for all publication dates through September 20th, 2020. RESULTS Our search identified 16 articles on the associations of ambient temperature and/or season with GDM and maternal glycemic outcomes during pregnancy, which were included in this review. Despite inconsistencies in exposure and outcome assessment, we found consistent evidence of a seasonal effect on GDM risk, with higher prevalence of GDM and higher pregnancy glucose levels in summer months. We found suggestive evidence of an association between higher ambient temperature and elevated glucose levels from GDM screening tests. CONCLUSION Climate factors may be associated with GDM risk. However, further research is needed to evaluate these associations and to elucidate the specific mechanisms involved.
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Affiliation(s)
- Emma V. Preston
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, Room 1411, 677 Huntington Ave, Boston, MA 02118 USA
| | - Claudia Eberle
- Medicine with specialization in Internal Medicine and General Medicine, Hochschule Fulda - University of Applied Sciences, Fulda, Germany
| | | | - Tamarra James-Todd
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Building 1, Room 1411, 677 Huntington Ave, Boston, MA 02118 USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA USA
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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
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Papatheodorou S, Gold DR, Blomberg AJ, Hacker M, Wylie BJ, Requia WJ, Oken E, Fleisch AF, Schwartz JD, Koutrakis P. Ambient particle radioactivity and gestational diabetes: A cohort study of more than 1 million pregnant women in Massachusetts, USA. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 733:139340. [PMID: 32464573 PMCID: PMC7472683 DOI: 10.1016/j.scitotenv.2020.139340] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/07/2020] [Accepted: 05/08/2020] [Indexed: 05/26/2023]
Abstract
BACKGROUND Exposure to ionizing radiation increases the risk of chronic metabolic disorders such as insulin resistance and type 2 diabetes. Internal ionizing radiation from inhaled radioactive aerosol may contribute to the associations between fine particulate matter (PM2.5) and gestational diabetes mellitus (GDM). METHODS We used the Massachusetts Registry of Vital Records to study 1,061,937 pregnant women from 2001 to 2015 with a singleton pregnancy without pre-existing diabetes. Gross β activity measured by seven monitors of the U.S. Environmental Protection Agency's RadNet monitoring network was utilized to represent ambient particle radioactivity (PR). We obtained GDM status from birth certificates and used logistic regression analyses adjusted for socio-demographics, maternal comorbidities, PM2.5, temperature and relative humidity. We also examined effect modification by smoking habits. RESULTS Ambient particle radioactivity exposure during first and second trimester of pregnancy was associated with higher odds of GDM (OR: 1.18 (95% CI 1.10 to 1.22). Controlling for PM2.5 did not substantially change the effects of PR on GDM. In women that reported being former or current smokers, the association between PR and GDM was null. In the full cohort, the overall effect of PM2.5 on GDM without adjusting for PR was not significant. CONCLUSION This is the first population-based study to examine the association between particle radioactivity and gestational diabetes mellitus - one of the most common pregnancy-related diseases with lifelong effects for the mother and the fetus. This finding has important public health policy implications because it enhances our understanding about the toxicity of PR, a modifiable risk factor, which to date, has been considered only as an indoor and occupational air quality risk.
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Affiliation(s)
| | - Diane R Gold
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital Harvard Medical School, Boston, MA 02115, USA
| | - Annelise J Blomberg
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Michele Hacker
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Blair J Wylie
- Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Weeberb J Requia
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA; Department of Nutrition, Harvard School of Public Health, Boston, MA, USA
| | - Abby F Fleisch
- Pediatric Endocrinology and Diabetes, Maine Medical Center, Portland, ME, USA; Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA
| | - Joel D Schwartz
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Petros Koutrakis
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Lin SY, Yang YC, Chang CYY, Hsu WH, Lin CC, Jiang CC, Wang IK, Lin CD, Hsu CY, Kao CH. Association of fine-particulate and acidic-gas air pollution with premenstrual syndrome risk. QJM 2020; 113:643-650. [PMID: 32186731 DOI: 10.1093/qjmed/hcaa096] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2020] [Revised: 03/04/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Air pollution had been reported to be associated with the reproductive health of women. However, the association of particulate matter (PM) and acid gases air pollution with premenstrual syndrome (PMS) warrants investigation. This study investigated the effects of air pollution on PMS risk. POPULATION We combined data from the Taiwan Air Quality-Monitoring Database and the Longitudinal Health Insurance Database. In total, an observational cohort of 85 078 Taiwanese women not diagnosed as having PMS. METHODS Air pollutant concentrations were grouped into four levels based on the concentration quartiles of several types of air pollutants. MAIN OUTCOME MEASURES We then applied univariable and multivariable Cox proportional hazard regression models to assess PMS risk in association with each pollutant type. RESULTS Women exposed to Q4-level SO2 exhibited a 7.77 times higher PMS risk compared with those to Q1-level SO2 (95% confidence interval [CI] = 6.22-9.71). Women exposed to Q4-level NOx exhibited a 2.86 times higher PMS risk compared with those exposed to Q1-level NOx (95% CI = 2.39-3.43). Women exposed to Q4-level NO exhibited a 3.17 times higher PMS risk compared with women exposed to Q1-level NO (95% CI = 2.68-3.75). Finally, women exposed to Q4-level PM with a ≤2.5-µm diameter (PM2.5) exhibited a 3.41 times higher PMS risk compared with those exposed to Q1-level PM2.5 (95% CI = 2.88-4.04). CONCLUSIONS High incidences of PMS were noted in women who lived in areas with higher concentrations of SO2, NOx, NO, NO2 and PM2.5.
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Affiliation(s)
- S-Y Lin
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Division of Nephrology and Kidney Institute
| | - Y-C Yang
- Management Office for Health Data
- College of Medicine
| | - C Y-Y Chang
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Department of Gynecology
| | - W-H Hsu
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Department of Chest Medicine
| | - C-C Lin
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Department of Family Medicine
| | - C-C Jiang
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Division of Nephrology and Kidney Institute
| | - I-K Wang
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Division of Nephrology and Kidney Institute
| | - C-D Lin
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Department Teaching
- Department Otolaryngology
| | - C-Y Hsu
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
| | - C-H Kao
- Graduate Institute of Biomedical Sciences and School of Medicine, College of Medicine
- Department of Nuclear Medicine and PET Center, China Medical University Hospital, No 2 Yu-Der Road, 40447, Taichung, Taiwan
- Department of Bioinformatics and Medical Engineering, Asia University, No. 500, Liufeng Rd., Wufeng Dist., Taichung City 413, Taiwan
- Center of Augmented Intelligence in Healthcare, China Medical University Hospital, No 2 Yu-Der Road, 40447, Taichung, Taiwan
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Erlandsson L, Lindgren R, Nääv Å, Krais AM, Strandberg B, Lundh T, Boman C, Isaxon C, Hansson SR, Malmqvist E. Exposure to wood smoke particles leads to inflammation, disrupted proliferation and damage to cellular structures in a human first trimester trophoblast cell line. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2020; 264:114790. [PMID: 32417587 DOI: 10.1016/j.envpol.2020.114790] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 05/08/2020] [Accepted: 05/09/2020] [Indexed: 06/11/2023]
Abstract
The ongoing transition to renewable fuel sources has led to increased use of wood and other biomass fuels. The physiochemical characteristics of biomass combustion derived aerosols depends on appliances, fuel and operation procedures, and particles generated during incomplete combustion are linked to toxicity. Frequent indoor wood burning is related to severe health problems such as negative effects on airways and inflammation, as well as chronic hypoxia and pathological changes in placentas, adverse pregnancy outcome, preterm delivery and increased risk of preeclampsia. The presence of combustion-derived black carbon particles at both the maternal and fetal side of placentas suggests that particles can reach the fetus. Air pollution particles have also been shown to inhibit trophoblast migration and invasion, which are vital functions for the development of the placenta during the first trimester. In this study we exposed a placental first trimester trophoblast cell line to wood smoke particles emitted under Nominal Burn rate (NB) or High Burn rate (HB). The particles were visible inside exposed cells and localized to the mitochondria, causing ultrastructural changes in mitochondria and endoplasmic reticulum. Exposed cells showed decreased secretion of the pregnancy marker human chorionic gonadotropin, increased secretion of IL-6, disrupted membrane integrity, disrupted proliferation and contained specific polycyclic aromatic hydrocarbons (PAHs) from the particles. Taken together, these results suggest that wood smoke particles can enter trophoblasts and have detrimental effects early in pregnancy by disrupting critical trophoblast functions needed for normal placenta development and function. This could contribute to the underlying mechanisms leading to pregnancy complications such as miscarriage, premature birth, preeclampsia and/or fetal growth restriction. This study support the general recommendation that more efficient combustion technologies and burning practices should be adopted to reduce some of the toxicity generated during wood burning.
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Affiliation(s)
- Lena Erlandsson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Robert Lindgren
- Thermochemical Energy Conversion Laboratory, Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.
| | - Åsa Nääv
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Annette M Krais
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Bo Strandberg
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Thomas Lundh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
| | - Christoffer Boman
- Thermochemical Energy Conversion Laboratory, Department of Applied Physics and Electronics, Umeå University, Umeå, Sweden.
| | - Christina Isaxon
- Department of Ergonomics and Aerosol Technology, Lund University, Lund, Sweden.
| | - Stefan R Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences Lund, Lund University, Lund, Sweden.
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Lund, Sweden.
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Rittner R, Flanagan E, Oudin A, Malmqvist E. Health Impacts from Ambient Particle Exposure in Southern Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17145064. [PMID: 32674378 PMCID: PMC7400131 DOI: 10.3390/ijerph17145064] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 12/31/2022]
Abstract
A health impact assessment (HIA) is an important tool for making informed decisions regarding the design and evaluation of environmental interventions. In this study, we performed a quantitative HIA for the population of Scania (1,247,993), the southernmost county in Sweden, in 2016. The impact of annual mean concentrations of particulate matter with an aerodynamic diameter <2.5 µm (PM2.5), modeled at their home residences for the year 2011, on mortality, asthma, dementia, autism spectrum disorders, preeclampsia and low birth weight (LBW) was explored. Concentration–response (C-R) functions were taken from epidemiological studies reporting meta-analyses when available, and otherwise from single epidemiological studies. The average level of PM2.5 experienced by the study population was 11.88 µg/m3. The PM2.5 exposure was estimated to cause 9–11% of cases of LBW and 6% of deaths from natural causes. Locally produced PM2.5 alone contributed to 2–9% of the cases of diseases and disorders investigated. Reducing concentrations to a maximum of 10 µg/m3 would, according to our estimations, reduce mortality by 3% and reduce cases of LBW by 2%. Further analyses of separate emission sources’ distinct effects were also presented. Reduction of air pollution levels in the study area would, as expected, have a substantial effect on both mortality and adverse health outcomes. Reductions should be aimed for by local authorities and on national and even international levels.
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Affiliation(s)
- Ralf Rittner
- Division of Occupational and Environmental Health, Lund University, 221 00 Lund, Sweden; (E.F.); (A.O.); (E.M.)
- Correspondence: ; Tel.: +46-4617-3189
| | - Erin Flanagan
- Division of Occupational and Environmental Health, Lund University, 221 00 Lund, Sweden; (E.F.); (A.O.); (E.M.)
| | - Anna Oudin
- Division of Occupational and Environmental Health, Lund University, 221 00 Lund, Sweden; (E.F.); (A.O.); (E.M.)
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, 901 87 Umeå, Sweden
| | - Ebba Malmqvist
- Division of Occupational and Environmental Health, Lund University, 221 00 Lund, Sweden; (E.F.); (A.O.); (E.M.)
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Rittner R, Gustafsson S, Spanne M, Malmqvist E. Particle concentrations, dispersion modelling and evaluation in southern Sweden. SN APPLIED SCIENCES 2020. [DOI: 10.1007/s42452-020-2769-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
AbstractHealth impact assessments of differential air pollution rely on epidemiologically established relationships between concentration levels where people are exposed and adverse health outcomes. To assess air pollution concentrations, land use regression is commonly used. However, an alternative tool is dispersion modelling, where a detailed inventory of pollution sources together with meteorological data drives calculations of compound dispersion. With this, both spatial and temporal variation can be assessed. In this study, we evaluated results of a Gaussian dispersion model applied to an emissions inventory for Scania, the southernmost county in Sweden. The dispersion considered was particulate matter of aerodynamic diameter < 10 µm (PM10), particulate matter of aerodynamic diameter < 2.5 µm (PM2.5) and black carbon (BC) during an 11-year period (2000–2011). Mean concentrations and 95th percentiles expressed in µg/m3 ranged from 10.1 to 12.6 and 16.6 to 20.7 for PM2.5 and from 14.0 to 18.8 and 22.6 to 27.0 for PM10, respectively. Seven monitoring stations were used for evaluation. Correlations (R2) ranged from 0.44 to 0.86 for PM2.5 (mean bias from − 9.0 to 0.1 µg/m3) and from 0.46 to 0.83 for PM10 (mean bias − 6.1 to 3.5 µg/m3). An evaluated database of PM and BC concentrations for Scania is now available for future exposure assessment projects. Calculations were based on a well-known dispersion model with detailed emission data as input. The evaluation showed correlation coefficients for PM in line with previous literature. The data on PM10, PM2.5 and BC concentrations will, therefore, be used in subsequent studies, epidemiological as well as health impact assessments.
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Zhang H, Wang Q, He S, Wu K, Ren M, Dong H, Di J, Yu Z, Huang C. Ambient air pollution and gestational diabetes mellitus: A review of evidence from biological mechanisms to population epidemiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 719:137349. [PMID: 32114225 DOI: 10.1016/j.scitotenv.2020.137349] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 02/06/2020] [Accepted: 02/14/2020] [Indexed: 05/26/2023]
Abstract
Gestational diabetes mellitus (GDM) is a serious complication of pregnancy that could cause adverse health effects on both mothers and fetuses, and its prevalence has been increasing worldwide. Experimental and epidemiological studies suggest that air pollution may be an important risk factor of GDM, but conclusions are inconsistent. To provide a comprehensive overview of ambient air pollution on GDM, we summarized existing evidence concerning biological linkages between maternal exposure to air pollutants and GDM based on mechanism studies. We also performed a quantitative meta-analysis based on human epidemiological studies by searching English databases (Pubmed, Web of Science and Embase) and Chinese databases (Wanfang, CNKI). As a result, the limited mechanism studies indicated that β-cell dysfunction, neurohormonal disturbance, inflammation, oxidative stress, imbalance of gut microbiome and insulin resistance may be involved in air pollution-GDM relationship, but few studies were performed to explore the direct biological linkage. Additionally, a total of 13 epidemiological studies were included in the meta-analysis, and the air pollutants considered included PM2.5, PM10, SO2, NO2 and O3. Most studies were retrospective and mainly conducted in developed regions. The results of meta-analysis indicated that maternal first trimester exposure to SO2 increased the risk of GDM (standardized odds ratio (OR) = 1.392, 95% confidence intervals (CI): 1.010, 1.773), while pre-pregnancy O3 exposure was inversely associated with GDM risk (standardized OR = 0.981, 95% CI: 0.977, 0.985). No significant effects were observed for PM2.5, PM10 and NO2. In conclusion, additional mechanism studies on the molecular level are needed to provide persuasive rationale underlying the air pollution-GDM relationship. Moreover, other important risk factors of GDM, including maternal lifestyle and road traffic noise exposure that may modify the air pollution-GDM relationship should be considered in future epidemiological studies. More prospective cohort studies are also warranted in developing countries with high levels of air pollution.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China; School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Simin He
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Kaipu Wu
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Haotian Dong
- School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China.
| | - Cunrui Huang
- School of Public Health, Zhengzhou University, Zhengzhou 450001, China; School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Shanghai Typhoon Institute, China Meteorological Administration, Shanghai 200030, China; Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai 200030, China.
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Melody SM, Ford JB, Wills K, Venn A, Johnston FH. Maternal exposure to fine particulate matter from a large coal mine fire is associated with gestational diabetes mellitus: A prospective cohort study. ENVIRONMENTAL RESEARCH 2020; 183:108956. [PMID: 31831154 DOI: 10.1016/j.envres.2019.108956] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 11/20/2019] [Accepted: 11/22/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND In 2014, the Hazelwood coal mine fire was an unprecedented event that resulted in a six-week period of poor air quality in the Latrobe Valley in regional Australia. We aimed to determine whether maternal exposure to fine particulate matter in coal mine fire smoke was associated with selected obstetric complications, including gestational diabetes mellitus, hypertensive disorders of pregnancy and abnormal placentation. METHODS We defined a complete cohort of pregnant women with births >20 weeks in the Latrobe Valley from March 1, 2012-Dec 31, 2015 utilising administrative perinatal data. Average and peak fine particulate matter (PM2.5) was assigned to residential address at delivery using a chemical transport model. Maternal, meteorological and temporal variables were included in final log-binomial regression models. RESULTS 3612 singleton pregnancies were included in the analysis; 766 were exposed to the smoke event. Average maternal PM2.5 exposure was 4.4 μg/m3 (SD 7.7; IQR 2.12). Average peak PM2.5 exposure was 44.9 μg/m3 (SD 57.1; IQR 35.0). An interquartile range increase in peak PM2.5 was associated with a 16% increased likelihood of gestational diabetes mellitus (95%CI 1.09, 1.22; <0.0001). Whereas, an interquartile range increase in average PM2.5 was associated with a 7% increased likelihood of gestational diabetes mellitus (95%CI 1.03, 1.10; <0.0001). Second trimester exposure was of critical importance. No association for hypertensive disorders or abnormal placentation was observed. CONCLUSION this is the first study to examine obstetric complications relating to a discrete smoke event. These findings may guide the public health response to future similar events.
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Affiliation(s)
- Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7001, Australia. http://
| | - Jane B Ford
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, 2065, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, 2065, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7001, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7001, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, 7001, Australia
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Wang E, Glazer KB, Howell EA, Janevic TM. Social Determinants of Pregnancy-Related Mortality and Morbidity in the United States: A Systematic Review. Obstet Gynecol 2020; 135:896-915. [PMID: 32168209 PMCID: PMC7104722 DOI: 10.1097/aog.0000000000003762] [Citation(s) in RCA: 185] [Impact Index Per Article: 46.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To synthesize the literature on associations between social determinants of health and pregnancy-related mortality and morbidity in the United States and to highlight opportunities for intervention and future research. DATA SOURCES We performed a systematic search using Ovid MEDLINE, CINAHL, Popline, Scopus, and ClinicalTrials.gov (1990-2018) using MeSH terms related to maternal mortality, morbidity, and social determinants of health, and limited to the United States. METHODS OF STUDY SELECTION Selection criteria included studies examining associations between social determinants and adverse maternal outcomes including pregnancy-related death, severe maternal morbidity, and emergency hospitalizations or readmissions. Using Covidence, three authors screened abstracts and two screened full articles for inclusion. TABULATION, INTEGRATION, AND RESULTS Two authors extracted data from each article and the data were analyzed using a descriptive approach. A total of 83 studies met inclusion criteria and were analyzed. Seventy-eight of 83 studies examined socioeconomic position or individual factors as predictors, demonstrating evidence of associations between minority race and ethnicity (58/67 studies with positive findings), public or no insurance coverage (21/30), and lower education levels (8/12), and increased incidence of maternal death and severe maternal morbidity. Only 2 of 83 studies investigated associations between these outcomes and socioeconomic, political, and cultural context (eg, public policy), and 20 of 83 studies investigated material and physical circumstances (eg, neighborhood environment, segregation), limiting the diversity of social determinants of health studied as well as evaluation of such evidence. CONCLUSION Empirical studies provide evidence for the role of race and ethnicity, insurance, and education in pregnancy-related mortality and severe maternal morbidity risk, although many other important social determinants, including mechanisms of effect, remain to be studied in greater depth. SYSTEMATIC REVIEW REGISTRATION PROSPERO, CRD42018102415.
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Affiliation(s)
- Eileen Wang
- Department of Medical Education, Icahn School of Medicine at Mount Sinai
| | - Kimberly B. Glazer
- Blavatnik Family Women’s Health Institute, Icahn School of Medicine at Mount Sinai; Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elizabeth A. Howell
- Blavatnik Family Women’s Health Institute, Icahn School of Medicine at Mount Sinai; Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Obstetrics, Gynecology, and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Teresa M. Janevic
- Blavatnik Family Women’s Health Institute, Icahn School of Medicine at Mount Sinai; Department of Population Health Science & Policy, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Mandakh Y, Rittner R, Flanagan E, Oudin A, Isaxon C, Familari M, Hansson SR, Malmqvist E. Maternal Exposure to Ambient Air Pollution and Risk of Preeclampsia: A Population-Based Cohort Study in Scania, Sweden. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E1744. [PMID: 32155988 PMCID: PMC7084298 DOI: 10.3390/ijerph17051744] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/16/2022]
Abstract
The aim of this study was to investigate the risk of developing preeclampsia (PE) associated with gestational exposure to ambient air pollutants in southern Sweden, a low-exposure area. We used a cohort of 43,688 singleton pregnancies and monthly mean exposure levels of black carbon (BC), local and total particulate matter (PM2.5 and PM10), and NOX at the maternal residential address estimated by Gaussian dispersion modeling from 2000 to 2009. Analyses were conducted using binary logistic regression. A subtype analysis for small-for-gestational age (SGA) was performed. All analyses were adjusted for obstetrical risk factors and socioeconomic predictors. There were 1286 (2.9%) PE cases in the analysis. An adjusted odds ratio (AOR) of 1.35 with a 95% confidence interval (CI) of 1.11-1.63 was found when comparing the lowest quartile of BC exposure to the highest quartile in the third trimester The AOR for PE associated with each 5 µg/m3 increase in locally emitted PM2.5 was 2.74 (95% CI: 1.68, 4.47) in the entire pregnancy. Similar patterns were observed for each 5 µg/m3 increment in locally emitted PM10. In pregnancies complicated by PE with SGA, the corresponding AOR for linear increases in BC was 3.48 (95% CI: 1.67, 7.27). In this low-level setting, maternal exposure to ambient air pollution during gestation was associated with the risk of developing PE. The associations seemed more pronounced in pregnancies with SGA complications, a finding that should be investigated further.
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Affiliation(s)
- Yumjirmaa Mandakh
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Scheelevägen 8, Building 402A, 22381 Lund, Sweden; (Y.M.); (R.R.); (E.F.); (A.O.)
| | - Ralf Rittner
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Scheelevägen 8, Building 402A, 22381 Lund, Sweden; (Y.M.); (R.R.); (E.F.); (A.O.)
| | - Erin Flanagan
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Scheelevägen 8, Building 402A, 22381 Lund, Sweden; (Y.M.); (R.R.); (E.F.); (A.O.)
| | - Anna Oudin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Scheelevägen 8, Building 402A, 22381 Lund, Sweden; (Y.M.); (R.R.); (E.F.); (A.O.)
| | - Christina Isaxon
- Department of Ergonomics and Aerosol Technology, Lund University, Sölvegatan 26, Box 118, 22100 Lund, Sweden;
| | - Mary Familari
- School of BioSciences, University of Melbourne, Parkville, Melbourne 3010, Australia;
| | - Stefan Rocco Hansson
- Division of Obstetrics and Gynecology, Department of Clinical Sciences, Lund University, Klinikgatan 12, 22185 Lund, Sweden;
| | - Ebba Malmqvist
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, Scheelevägen 8, Building 402A, 22381 Lund, Sweden; (Y.M.); (R.R.); (E.F.); (A.O.)
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Tang X, Zhou JB, Luo F, Han Y, Heianza Y, Cardoso MA, Qi L. Air pollution and gestational diabetes mellitus: evidence from cohort studies. BMJ Open Diabetes Res Care 2020; 8:8/1/e000937. [PMID: 32193198 PMCID: PMC7103802 DOI: 10.1136/bmjdrc-2019-000937] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 01/07/2020] [Accepted: 01/14/2020] [Indexed: 12/16/2022] Open
Abstract
Exposure to different air pollutants has been linked to type 2 diabetes mellitus, but the evidence for the association between air pollutants and gestational diabetes mellitus (GDM) has not been systematically evaluated. We systematically retrieved relevant studies from PubMed, Embase, and the Web of Science, and performed stratified analyses and regression analyses. Thirteen studies were analyzed, comprising 1 547 154 individuals from nine retrospective studies, three prospective studies, and one case-control study. Increased exposure to particulate matter ≤2.5 µm in diameter (PM2.5) was not associated with the increased risk of GDM (adjusted OR 1.03, 95% CI 0.99 to 1.06). However, subgroup analysis showed positive correlation of PM2.5 exposure in the second trimester with an increased risk of GDM (combined OR 1.07, 95% CI 1.00 to 1.13). Among pollutants other than PM2.5, significant association between GDM and nitrogen dioxide (NO2) (OR 1.05, 95% CI 1.01 to 1.10), nitrogen oxide (NOx) (OR 1.03, 95% CI 1.01 to 1.05), and sulfur dioxide (SO2) (OR 1.09, 95% CI 1.03 to 1.15) was noted. There was no significant association between exposure to black carbon or ozone or carbon monoxide or particulate matter ≤10 µm in diameter and GDM. Thus, systematic review of existing evidence demonstrated association of exposure to NO2, NOx, and SO2, and the second trimester exposure of PM2.5 with the increased risk of GDM. Caution may be exercised while deriving conclusions from existing evidence base because of the limited number and the observational nature of studies.
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Affiliation(s)
- Xingyao Tang
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Jian-Bo Zhou
- Department of Endocrinology, Beijing Tongren Hospital, Beijing, China
| | - Fuqiang Luo
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Yipeng Han
- Department of Education, Beijing Tongren Hospital, Beijing, China
| | - Yoriko Heianza
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
| | - Marly Augusto Cardoso
- Department of Nutrition, School of Public Health, University of São Paulo, São Paulo, Brazil
| | - Lu Qi
- Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, Louisiana, USA
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