Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis

Liang, Weiqi; Zhu, Hai‐Liang; Xu, Jin; Zhao, Zhijia; Zhou, Liming; Cai, Jie; Ji, Li

doi:10.1016/j.ecoenv.2023.114802

Cited by 16 publications

(14 citation statements)

References 84 publications

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“…BC and OC are mainly generated by combustion, whereas NO 3 – , NH 4 + , and SO 4 2– are mainly generated from primary pollutants by atmospheric chemical reactions. , We found stronger associations between the risk of macrosomia and prenatal exposure to NO 3 – and NH 4 + than to BC and OC. Although the mechanism remains unclear, previous studies have suggested that exposure to these components increased the risk of GDM, − while an increase in maternal glucose levels during pregnancy might further mediate birth weight gain . Thus, our findings indicate the urgent need to control fossil fuel combustion to reduce PM 2.5 -associated macrosomia.…”

Section: Discussionmentioning

confidence: 64%

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Huang

Luo

et al. 2023

Environ. Sci. Technol.

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To examine the associations between macrosomia risk and exposure to fine particulate matter (PM2.5) and its chemical components during pregnancy, we collected birth records between 2010 and 2015 in mainland China from the National Free Preconception Health Examination Project and used satellite-based models to estimate concentrations of PM2.5 mass and five main components, namely, black carbon (BC), organic carbon (OC), nitrate (NO3 –), sulfate (SO4 2–), and ammonium (NH4 +). Associations between macrosomia risk and prenatal exposure to PM2.5 were examined by logistic regression analysis, and the sensitive subgroups were explored by stratified analyses. Of the 3,248,263 singleton newborns from 336 cities, 165,119 (5.1%) had macrosomia. Each interquartile range increase in concentration of PM2.5 during the entire pregnancy was associated with increased risk of macrosomia (odds ratio (OR) = 1.18; 95% confidence interval (CI), 1.17–1.20). Among specific components, the largest effect estimates were found on NO3 – (OR = 1.36; 95% CI, 1.35–1.38) followed by OC (OR = 1.23; 95% CI, 1.22–1.24), NH4 + (OR = 1.22; 95% CI, 1.21–1.23), and BC (OR = 1.21; 95% CI, 1.20–1.22). We also that found boys, women with a normal or lower prepregnancy body mass index, and women with irregular or no folic acid supplementation experienced higher risk of macrosomia associated with PM2.5 exposure.

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Section: Discussionmentioning

confidence: 64%

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Huang

Luo

et al. 2023

Environ. Sci. Technol.

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“…8,11,15,30,31,38 An updated meta-analysis summarizing from three to six studies on different chemical components reported that the risk of GDM was increased by 12.8% (95% CI: 3.2%, 23.1%) and 5.6% (95% CI: 0.8%, 10.7%), respectively, with exposure to BC and NO 3 − . 14 However, the high correlations among PM 2.5 components make it challenging to draw valid inferences without considering the synergistic effects of the complex mixtures. 39 So far, only a retrospective cohort in southern California jointly estimated the PM 2.5 components as mixtures and indicated that BC, NO 3 − , and NH 4…”

Section: ■ Discussionmentioning

confidence: 99%

“…Certain components of PM 2.5 , such as black carbon (BC) and nitrate (NO 3 − ), have been considered to have greater effects on glucose metabolism. 14 Nonetheless, concerns have been raised about the high collinearity among PM 2.5 constituents, 15 potentially obscuring the actual toxic components. These gaps should be further addressed by comprehensive cohort studies.…”

Section: ■ Introductionmentioning

confidence: 99%

“…In addition, a thorough understanding of PM 2.5 toxicity necessitates further research into its chemical constituents. Certain components of PM 2.5 , such as black carbon (BC) and nitrate (NO 3 – ), have been considered to have greater effects on glucose metabolism . Nonetheless, concerns have been raised about the high collinearity among PM 2.5 constituents, potentially obscuring the actual toxic components.…”

Section: Introductionmentioning

confidence: 99%

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Gestational and Postpartum Exposure to PM_2.5 Components and Glucose Metabolism in Chinese Women: A Prospective Cohort Study

Chen,

Wang,

Chen

et al. 2024

Environ. Sci. Technol.

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Pregnant women are physiologically prone to glucose intolerance, while the puerperium represents a critical phase for recovery. However, how air pollution disrupts glucose homeostasis during the gestational and early postpartum periods remains unclear. This prospective cohort study conducted an oral glucose tolerance test and measured the insulin levels of 834 pregnant women in Guangzhou, with a follow-up for 443 puerperae at 6−8 weeks postpartum. Residential PM 2.5 and five chemical components were estimated by an established spatiotemporal model. The adjusted linear model showed that an IQR increase in gestational PM 2.5 exposure was associated with an increase of 0.17 mmol/L (95% CI: 0.06, 0.28) in fasting plasma glucose (FPG) and 0.24 (95% CI: 0.05, 0.42) in the insulin resistance index. Postpartum PM 2.5 exposure was linked to a 0.17 mmol/L (95% CI: 0.05, 0.28) elevation in FPG per IQR, with a strengthened association found in women with gestational diabetes (P interaction = 0.003). In the quantile-based g-computation model, NO 3 − consistently contributed to the combined effect of PM 2.5 components on gestational and postpartum FPG. This study was the first to suggest that PM 2.5 components were associated with exacerbated gestational insulin resistance and elevated postpartum FPG. Targeted interventions reducing the emissions of toxic PM 2.5 components are essential to improving maternal glucose metabolism.

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“…Given the scale and scope of the effect of cities on noncommunicable diseases, in general, and CMD, in particular globally, and with plans to build technologically advanced cities worldwide, there is a vast opportunity to transform the environment and health of cities. 109 This will need to occur through the mitigation of pervasive adverse urban exposures and make city systems less polluting, less unequal, and ecologically and economically sustainable. However, multiple challenges must be addressed.…”

Section: Gaps In Current Knowledge and Future Research Needsmentioning

confidence: 99%

The Urban Environment and Cardiometabolic Health

Rajagopalan,

Vergara-Martel,

Zhong

et al. 2024

Circulation

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Urban environments contribute substantially to the rising burden of cardiometabolic diseases worldwide. Cities are complex adaptive systems that continually exchange resources, shaping exposures relevant to human health such as air pollution, noise, and chemical exposures. In addition, urban infrastructure and provisioning systems influence multiple domains of health risk, including behaviors, psychological stress, pollution, and nutrition through various pathways (eg, physical inactivity, air pollution, noise, heat stress, food systems, the availability of green space, and contaminant exposures). Beyond cardiometabolic health, city design may also affect climate change through energy and material consumption that share many of the same drivers with cardiometabolic diseases. Integrated spatial planning focusing on developing sustainable compact cities could simultaneously create heart-healthy and environmentally healthy city designs. This article reviews current evidence on the associations between the urban exposome (totality of exposures a person experiences, including environmental, occupational, lifestyle, social, and psychological factors) and cardiometabolic diseases within a systems science framework, and examines urban planning principles (eg, connectivity, density, diversity of land use, destination accessibility, and distance to transit). We highlight critical knowledge gaps regarding built-environment feature thresholds for optimizing cardiometabolic health outcomes. Last, we discuss emerging models and metrics to align urban development with the dual goals of mitigating cardiometabolic diseases while reducing climate change through cross-sector collaboration, governance, and community engagement. This review demonstrates that cities represent crucial settings for implementing policies and interventions to simultaneously tackle the global epidemics of cardiovascular disease and climate change.

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Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis

Cited by 16 publications

References 84 publications

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Gestational and Postpartum Exposure to PM_2.5 Components and Glucose Metabolism in Chinese Women: A Prospective Cohort Study

The Urban Environment and Cardiometabolic Health

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Ambient air pollution and gestational diabetes mellitus: An updated systematic review and meta-analysis

Cited by 16 publications

References 84 publications

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Association of Fine Particulate Matter and Its Components with Macrosomia: A Nationwide Birth Cohort Study of 336 Chinese Cities

Gestational and Postpartum Exposure to PM2.5 Components and Glucose Metabolism in Chinese Women: A Prospective Cohort Study

The Urban Environment and Cardiometabolic Health

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Gestational and Postpartum Exposure to PM_2.5 Components and Glucose Metabolism in Chinese Women: A Prospective Cohort Study