Ambient air pollution exposure associated with glucose homeostasis during pregnancy and gestational diabetes mellitus

Lin, Qingmei; Zhang, Shiyu; Liang, Ying; Wang, Chongjian; Wang, Changke; Wu, Xueli; Luo, Chao; Ruan, Zengliang; Acharya, Bipin Kumar; Lin, Hualiang; Guo, Xiaoling; Yang, Yin

doi:10.1016/j.envres.2020.109990

Cited by 35 publications

(21 citation statements)

References 37 publications

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“…In this systematic review, the current evidence assessing environmental risk factors and GDM has been analyzed. Whilst we found clear evidence for an association between GDM and air pollution [29,[96][97][98][99][100][101][102][103][104][105][106][107], ambient temperature [31,[92][93][94][95], season [32,[85][86][87][88], cadmium [36,[80][81][82], arsenic [37,[70][71][72][73][74][75][76][77], POPs [55, 57-60, 62-64, 66, 67] and phthalates [45][46][47][48], the findings regarding phenols were rather heterogeneous. The results for adverse glycemic outcomes also showed clear associations regarding air pollution [98-100, 105, 107, 118-121], ambient temperature [92,94], season [32,85,…”

Section: Discussionmentioning

confidence: 79%

“…In summary, n = 22 of n = 25 studies showed that air pollution (through PM 2.5 [29,[96][97][98][99][100][101][102][103][104][105][106][107], NO [30,[108][109][110][111][112], NO 2 [30,108,109,[112][113][114], CO [30,113], PM 10 [98,100,104], BC [98], SO 2 [30,100,103,104,115], O 3 [30]) was clearly associated with an increased risk of GDM. Eight studies found a significant association (p < 0.01 [107,109], p < 0.05 [103,110,111,113], (aOR = 1.69 (1.41, 2.03) [108]).…”

Section: Air Pollution and Gdm (N = 25)mentioning

confidence: 94%

“…Overall, the most articles pointed out that exposure to air pollution (through PM 2.5 [98-100, 105, 107, 118-121], PM 10 [98,100,119,121], PM 1 [121], BC [98], NO 2 [119], CO [119], SO 2 [100]) was able to increase blood glucose levels in pregnant women. In n = 7 of n = 9 studies, air pollution was significantly associated (p < 0.05 [98,99,105,119,120], p < 0.01 [107,121]) with elevated fasting blood glucose concentrations.…”

Section: Air Pollution and Glycemic Outcomes (N = 9)mentioning

confidence: 99%

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Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review

Eberle

Stichling

2022

BMC Public Health

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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.

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Section: Discussionmentioning

confidence: 79%

Section: Air Pollution and Gdm (N = 25)mentioning

confidence: 94%

Section: Air Pollution and Glycemic Outcomes (N = 9)mentioning

confidence: 99%

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Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review

Eberle

Stichling

2022

BMC Public Health

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“…The significant associations between the two-pollutant models and GDM ( Table 3 ) are not surprising, since the gaseous pollutants (SO 2 , NO x , and O 3 ) have been associated with abnormal glucose regulation in pregnancy ( 33 – 39 ). It is interesting to note that the association was mainly observed in women with an age <30 years or a BMI <25 kg/m 2 ( Figure 2 ).…”

Section: Discussionmentioning

confidence: 94%

Association of exposure to air pollutants with gestational diabetes mellitus in Chiayi City, Taiwan

et al. 2023

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IntroductionWe investigated the associations of exposure to particulate matter with an aerodynamic diameter less than 2.5 μm (PM2.5) and several gaseous pollutants with risk of gestational diabetes mellitus (GDM) in Taiwan.MethodsWe retrospectively identified pregnant women who underwent a two-step approach to screen for GDM between 2006 and 2014. Information on concentrations of air pollutants (including PM2.5, sulfur dioxide [SO2], nitrogen oxides [NOx], and ozone [O3]) were collected from a single fixed-site monitoring station. We conducted logistic regression analyses to determine the associations between exposure to air pollutants and risk of GDM.ResultsA total of 11210 women were analyzed, and 705 were diagnosed with GDM. Exposure to PM2.5 during the second trimester was associated with a nearly 50% higher risk of GDM (odds ratio [OR] 1.47, 95% CI 0.96 to 2.24, p=0.077). The associations were consistent in the two-pollutant model (PM2.5 + SO2 [OR 1.73, p=0.038], PM2.5 + NOx [OR 1.52, p=0.064], PM2.5 + O3 [OR 1.96, p=0.015]), and were more prominent in women with age <30 years and body mass index <25 kg/m2 (interaction p values <0.01).DiscussionExposure to PM2.5 was associated with risk of GDM, especially in women who were younger or had a normal body mass index.

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“…Most studies had used the routine monitoring data of air as a measurement basis, then used the environment model [12 studies used the regression model of land use ( 19 , 22 , 25 , 30 , 36 - 38 , 41 , 43 , 45 , 47 , 48 ), 8 studies used the satellite remote sensing model ( 20 , 21 , 23 , 24 , 30 , 31 , 49 , 50 ), and the remaining 15 used discrete or novel models] to assign data to maternal residential address during delivery, and 6 studies defined exposure based on patients’ residential address at the city/town level ( 27 , 28 , 33 , 34 , 39 , 40 ). A total of 5 studies further considered residential mobility ( 10 , 11 , 32 , 44 , 46 ) and collected historical residential address information during pregnancy.…”

Section: Resultsmentioning

confidence: 99%

Association of air pollution and fine particulate matter (PM2.5) exposure with gestational diabetes: a systematic review and meta-analysis

Ren¹,

Yuan²,

Luo³

et al. 2023

Ann Transl Med

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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 (SO 2 ), 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 (NO X ), 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 O 3 , CO, and nitrogen dioxide (NO 2 ) exposure and GDM. Conclusions Exposure to PM2.5, PM10, SO 2 , NO, NO X , 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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Ambient air pollution exposure associated with glucose homeostasis during pregnancy and gestational diabetes mellitus

Cited by 35 publications

References 37 publications

Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review

Environmental health influences in pregnancy and risk of gestational diabetes mellitus: a systematic review

Association of exposure to air pollutants with gestational diabetes mellitus in Chiayi City, Taiwan

Association of air pollution and fine particulate matter (PM2.5) exposure with gestational diabetes: a systematic review and meta-analysis

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