Ambient air pollution and hypertensive disorders of pregnancy: A systematic review and meta-analysis

Hu, Hui; Ha, Sandie; Roth, Jeffrey; Kearney, Gregory D.; Talbott, Evelyn O.; Xu, Xiaohui

doi:10.1016/j.atmosenv.2014.08.027

Cited by 86 publications

(73 citation statements)

References 56 publications

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“…Our findings are consistent with the results of 2 previous meta-analyses that summarized the associations between air pollution exposure during pregnancy and pregnancy-induced hypertensive disorders. 35, 36 Pedersen et al found that pregnancy-induced hypertensive disorders were significantly associated with a 5 μg/m 3 increment in PM 2.5 (OR=1.57; 95% CI: 1.26-1.96), a 10-μg/ m 3 increment in NO 2 (OR=1.20; 95% CI: 1.00-1.44), and a 10 μg/m 3 increment in PM 10 (OR=1.13; 95% CI: 1.02-1.26).…”

Section: Discussionmentioning

confidence: 99%

“…However, a previous meta-analysis observed the significant associations of hypertensive disorder of pregnancy with CO and O 3 exposure during the pregnancy. 36 For example, a 1 ppm increase in average CO exposure during the first trimester was associated with a 79% (95% CI: 31%-145%) increase in the risk of hypertensive disorder during pregnancy. 36 These results indicate that more research is needed in the future to confirm the possible effects of CO, O 3 , SO 2 , and NO x on hypertension.…”

Section: 50mentioning

confidence: 99%

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Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension

et al. 2016

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C ardiovascular disease is the leading cause of death in the world. It is responsible for ≈30% of all deaths or ≈17.5 million people in 2012.1 As the major risk factor for cardiovascular disease, hypertension has been identified as the most important cause of disability and the leading risk factor for death globally and causes ≈16.5% of all deaths.2 The causes of hypertension are complex and are related to genetic factors, lifestyle, diet structure, and environmental factors, including air pollution.3 Since the 1990s, many epidemiological studies have investigated the associations between air pollution exposure and hypertension. However, the results remain controversial. Some studies have shown an association, 4-8 whereas other studies have found either no association or an association only for selected pollutants or limitation based on short-term or long-term exposure.9-12 These inconsistent and controversial results indicate the need to quantitatively synthesize and interpret the available evidence to provide more explicit information for policy decisions and clinical use. Meta-analysis is the most commonly used statistical technique to quantitatively synthesize results from ≥2 separate studies. 13 To our knowledge, there is only one meta-analysis that summarized the association between exposure to traffic-related air pollution and hypertension.14 However, this study included only cohort studies conducted in the Europe and mainly focused on the traffic-related air pollutants, which might limit the external validity of their findings. Therefore, more such meta-analyses are urgently needed.The previous published studies on hypertension and air pollution can be broadly divided into 2 categories: short-term and long-term studies. The former estimate the acute effects of air pollution exposure and mostly include time-series analyses over a few days. The latter evaluate the chronic effects of air pollution, such as cohort survival analyses over years of exposure. 15The short-term and long-term effects of air pollution may have Abstract-Hypertension is a major disease of burden worldwide. Previous studies have indicated that air pollution might be a risk factor for hypertension, but the results were controversial. To fill this gap, we performed a meta-analysis of epidemiological studies to investigate the associations of short-term and long-term exposure to ambient air pollutants with hypertension. We searched all of the studies published before September 1, 2015, on the associations of ozone (O 3 ), carbon monoxide (CO), nitrogen oxide (NO 2 and NO X ), sulfur dioxide (SO 2 ), and particulate matter (PM 10 and PM 2.5 ) with hypertension in the English electronic databases. A pooled odds ratio (OR) for hypertension in association with each 10 μg/m 3 increase in air pollutant was calculated by a random-effects model (for studies with significant heterogeneity) or a fixed-effect model (for studies without significant heterogeneity). A total of 17 studies examining the effects of short-term (n=6) and long-term exposure ...

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Section: Discussionmentioning

confidence: 99%

Section: 50mentioning

confidence: 99%

Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension

et al. 2016

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“…Indeed, 2 recent metaanalyses suggest heterogeneity in the association between air pollution and various pregnancy hypertensive disorders (10,11), among which gestational hypertension (GH) is common but has received less research attention. Specifically, given that only 3 (12)(13)(14) of 17 studies in one meta-analysis (10) reported specific data on GH, no synthesis could be derived for this outcome separately.…”

mentioning

confidence: 99%

Ambient Air Pollution and Risk of Gestational Hypertension

Zhu¹,

Zhang²,

Liu³

et al. 2017

American Journal of Epidemiology

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Air pollution has been linked to hypertension in the general population, but data on gestational hypertension (GH) are limited. We investigated criteria air pollutants and air toxics during the period before conception and in early gestation in relation to GH risk in the Consortium on Safe Labor/Air Quality and Reproductive Health Study (United States, 2002. Modified Community Multi-scale Air Quality models estimated air pollution exposures for 6,074 singleton pregnancies in which GH was present and 199,980 normotensive pregnancies. Generalized estimating equations estimated relative risks per interquartile-range increment for pollutants and high exposure (≥75th percentile) for air toxics after adjustment for major risk factors. For an interquartile-range increment, GH risk was significantly increased by 18% for sulfur dioxide during the 3 months before conception and, during gestational weeks 1-20, 17% for nitrogen oxides, 10% for particulate matter with an aerodynamic diameter <2.5 μm, 7% for particulate matter with an aerodynamic diameter <10 μm, and 22% for sulfur dioxide. High exposures to several polycyclic aromatic hydrocarbons before conception and during the first trimester were significantly associated with 8%-20% higher risk of GH. Further, preconceptional exposures to several volatile organic compounds were significantly associated with 11%-19% higher risk. Our findings suggest that early exposures to criteria air pollutants, particularly from transport emissions, and high exposure to several air toxics before conception may increase GH risk.

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“…Several studies which modelled prenatal exposure found a reduction in birth weight [23,24,26] however two studies negated the association [25,27]. Due to the lack of clarity and the methodology short comings of some studies [20][21][22][23][24]26] there is a need for additional evidence on the subject of air pollution and pregnancy.…”

Section: Air Pollution and Pregnancymentioning

confidence: 99%

“…Exposure to nitrogen dioxide during the entire pregnancy has been associated with a risk of pregnant woman developing pre-eclampsia [20,21]. Furthermore proximity to a major road has also been associated with pre -term birth [21,22].…”

Section: Air Pollution and Pregnancymentioning

confidence: 99%

A meta-analysis of the impact of traffic-related air pollution on health and the factors affecting exposure

Lockhart

Vaganay

Macintyre

et al. 2015

WIT Transactions on Ecology and the Environment

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Clean air is a basic requirement for health and well-being. One of the main sources of air pollution is traffic. It emits harmful pollutants including nitrogen dioxide and particulate matter. There is a large body of existing evidence regarding the public health impact of air pollution. A wide range of health problems including respiratory and cardiovascular illnesses have been found. The evidence in relation to the impact of traffic related air pollution is inconsistent therefore the aim of this paper is to provide clarity on the strength of evidence. In addition, the review will consider the impact of environmental and personal exposure factors. To identify relevant research, the database Science Direct was used along with a search strategy. This review found there is a large body of evidence in relation to air pollution from traffic, health impacts and environmental factors. Due to methodological limitations and the complexity of the interactions the strength of this evidence is mixed. Links to cardiovascular illnesses were considered the most significant. A number of environmental factors such as weather and built environment have significant impacts on traffic related air pollution levels. The review highlights the lack of comprehensive and robust evidence linking environmental factors, traffic related air pollution and health impacts. Future work should use appropriate methodologies to address these gaps.

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Ambient air pollution and hypertensive disorders of pregnancy: A systematic review and meta-analysis

Cited by 86 publications

References 56 publications

Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension

Associations of Short-Term and Long-Term Exposure to Ambient Air Pollutants With Hypertension

Ambient Air Pollution and Risk of Gestational Hypertension

A meta-analysis of the impact of traffic-related air pollution on health and the factors affecting exposure

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