Association of Prenatal and Perinatal Exposures to Particulate Matter With Changes in Hemoglobin A_1c Levels in Children Aged 4 to 6 Years

Abstract

IMPORTANCE Environmental risk factors for childhood type 2 diabetes, an increasing global problem, are understudied. Air pollution exposure has been reported to be a risk factor for this condition. OBJECTIVE To examine the association between prenatal and perinatal exposures to fine particulate matter with a diameter less than 2.5 μm (PM 2.5) and changes in hemoglobin A 1c (HbA 1c), a measure of glycated hemoglobin and marker of glucose dysregulation, in children aged 4 to 7 years. DESIGN, SETTING, AND PARTICIPANTS The Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) study, a birth cohort study conducted in Mexico City, Mexico, recruited pregnant women from July 3, 2007, to February 21, 2011, through public health maternity clinics. The present analysis includes 365 mother-child pairs followed up until the child was approximately 7 years of age. This study included data from only study visits at approximately 4 to 5 years (visit 1) and 6 to 7 years (visit 2) post partum because HbA 1c levels were not measured in earlier visits. The data were analyzed from March 11, 2018, to May 3, 2019. EXPOSURES Daily PM 2.5 exposure estimates at participants' home addresses from 4 weeks prior to mothers' date of last menstrual period (LMP), a marker of the beginning of pregnancy, to 12 weeks after the due date. Exposure was estimated from satellite measurements and calibrated against ground PM 2.5 measurements, land use, and meteorological variables. MAIN OUTCOMES AND MEASURES Outcomes included HbA 1c levels at 4 to 5 years and 6 to 7 years of age, and the change in the level from the former age group to the latter. RESULTS The sample included 365 children, of whom 184 (50.4%) were girls. The mean (range) age of the children was 4.8 (4.0-6.4) years at visit 1, and 6.7 (6.0-9.7) years at visit 2. At the time of delivery, the mean (range) age of the mothers was 27.7 (18.3-44.4) years, with a mean (range) prepregnancy body mass index of 26.4 (18.5-43.5). The mean (SD) prenatal PM 2.5 exposure (22.4 μg/m 3 [2.7 μg/m 3 ]) was associated with an annual increase in HbA 1c levels of 0.25% (95% CI,

Air pollution and children’s health—a review of adverse effects associated with prenatal exposure from fine to ultrafine particulate matter

“…In a follow-up study, landscape “greenness” attenuated the effect, which could be attributable to lower pollution exposure [ 40 ]. Moody et al [ 41 ] observed prenatal and perinatal PM 2.5 exposure was associated with changes in HbA1c levels in early childhood. This marker is indicative of glucose dysregulation, providing evidence that early life exposure may influence diabetes risk.…”

Integrated RNA Sequencing Reveals Epigenetic Impacts of Diesel Particulate Matter Exposure in Human Cerebral Organoids

“…Diesel particulate matter (DPM) is a major component of air pollution, originating from truck exhaust. Prenatal DPM exposure has been linked to glucose dysregulation in early childhood [4], low birth weight [5], preterm birth, and autism spectrum disorders (ASDs) [6]. However, few molecular mechanisms and the involvement of specific cell types have been proposed for the DPM exposure risk to date.…”

Ambient air pollution and endocrinologic disorders in childhood

“…Three reports investigating the effect of prenatal exposure to ambient AP on insulin resistance showed inconsistent results (Table 3). [48][49][50] Prenatal exposure to NO2 was not associated with cord plasma insulin level in infants, 48) which might be a risk factor of metabolic disease later in life. However, the exposure paradoxically was associated with fasting glucose, insulin, and homeostatic model assessment for insulin resistance (HOMA-IR) in adolescents between 10-15 years of age.…”

“…50) Higher prenatal PM2.5 and PM10 exposures were associated with increased cord plasma insulin level, 48) and prenatal and perinatal PM2.5 exposure was associated with an annual increase in serum HbA1c level in girls from 4-5 years to 6-7 years of age. 49) These 2 studies commonly reported that the second trimester of www.e-apem.org pregnancy was an exposure window associated with increased serum HbA1c level later in childhood.…”