Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort.

Autor: Jo H; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America., Eckel SP; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America., Chen JC; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America., Cockburn M; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO, United States of America., Martinez MP; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America., Chow T; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America., Lurmann F; Sonoma Technology, Inc., Petaluma, CA, United States of America., Funk WE; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America., McConnell R; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America., Xiang AH; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America. Electronic address: anny.h.xiang@kp.org.
Jazyk: angličtina
Zdroj: Environment international [Environ Int] 2019 Sep; Vol. 130, pp. 104933. Date of Electronic Publication: 2019 Jun 21.
DOI: 10.1016/j.envint.2019.104933
Abstrakt: Background: Studies of effects of air pollution on gestational diabetes mellitus (GDM) have not been consistent, and there has been little investigation of effects of exposure preceding pregnancy. In previous studies, the temporal relationship between exposure and GDM onset has been difficult to establish.
Methods: Data were obtained for 239,574 pregnancies between 1999 and 2009 in a population-based health care system with comprehensive electronic medical records. Concentrations of ambient nitrogen dioxide (NO 2 ), particulate matter (PM) ≤2.5 μm in aerodynamic diameter (PM 2.5 ) and ≤10 μm (PM 10 ), and ozone (O 3 ) during preconception and the first trimester of pregnancy at the residential birth address were estimated from regulatory air monitoring stations. Odds ratios (ORs) of GDM diagnosed in the second and third trimesters in association with pollutant exposure were estimated using generalized estimating equation models adjusted for birth year, medical center service areas, maternal age, race/ethnicity, education, census-tract household income, and parity.
Results: In single-pollutant models, preconception NO 2 was associated with increased risk of GDM (OR = 1.10 per 10.4 ppb, 95% confidence interval [CI]: 1.07, 1.13). First trimester NO 2 was weakly associated with GDM, and this was not statistically significant (OR = 1.02 per 10.4 ppb, 95% CI: 0.99, 1.05). Preconception NO 2 associations were robust in multi-pollutant models adjusted for first trimester NO 2 with another co-pollutant from both exposure windows. In single-pollutant models, preconception PM 2.5 and PM 10 associations were associated with increased risk of GDM (OR = 1.04 per 6.5 μg/m 3 , 95% CI: 1.01, 1.06; OR = 1.03 per 16.1 μg/m 3 , 95% CI: 1.00, 1.06, respectively), but these effect estimates were not robust to adjustment for other pollutants. In single-pollutant models, preconception and first trimester O 3 were associated with reduced risk of GDM (OR = 0.94 per 15.7 ppb, 95% CI: 0.92, 0.95; OR = 0.95 per 15.7 ppb, 95% CI: 0.94, 0.97), associations that were robust to adjustment for co-pollutants.
Conclusions: Maternal exposure to NO 2 during the preconception trimester may increase risk of GDM.
(Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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