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Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus.
Environ Res. 2015 Feb; 137:316-22.ER

Abstract

BACKGROUND

Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk.

METHODS

Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5μm (PM2.5) and PM2.5 constituents, PM ≤ 10μm (PM10), nitrogen oxides (NOx), carbon monoxide, sulfur dioxide (SO2) and ozone (O3) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1-24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity.

RESULTS

Preconception maternal exposure to NOX (RR=1.09, 95% CI: 1.04, 1.13) and SO2 (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O3 was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy.

CONCLUSION

Maternal exposures to NOx and SO2 preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O3 appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation.

Authors+Show Affiliations

Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892, USA.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892, USA. Electronic address: pauline.mendola@mail.nih.gov.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892, USA.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892, USA.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Biostatistics and Bioinformatics Branch, Rockville, MD 20892, USA.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Biostatistics and Bioinformatics Branch, Rockville, MD 20892, USA.Texas A&M University, Zachary Department of Civil Engineering, College Station, TX 77845, USA.The EMMES Corporation, Rockville, MD 20852, USA.Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Division of Intramural Population Health Research, Epidemiology Branch, Rockville, MD 20892, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, N.I.H., Intramural

Language

eng

PubMed ID

25601734

Citation

Robledo, Candace A., et al. "Preconception and Early Pregnancy Air Pollution Exposures and Risk of Gestational Diabetes Mellitus." Environmental Research, vol. 137, 2015, pp. 316-22.
Robledo CA, Mendola P, Yeung E, et al. Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus. Environ Res. 2015;137:316-22.
Robledo, C. A., Mendola, P., Yeung, E., Männistö, T., Sundaram, R., Liu, D., Ying, Q., Sherman, S., & Grantz, K. L. (2015). Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus. Environmental Research, 137, 316-22. https://doi.org/10.1016/j.envres.2014.12.020
Robledo CA, et al. Preconception and Early Pregnancy Air Pollution Exposures and Risk of Gestational Diabetes Mellitus. Environ Res. 2015;137:316-22. PubMed PMID: 25601734.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Preconception and early pregnancy air pollution exposures and risk of gestational diabetes mellitus. AU - Robledo,Candace A, AU - Mendola,Pauline, AU - Yeung,Edwina, AU - Männistö,Tuija, AU - Sundaram,Rajeshwari, AU - Liu,Danping, AU - Ying,Qi, AU - Sherman,Seth, AU - Grantz,Katherine L, Y1 - 2015/01/17/ PY - 2014/08/29/received PY - 2014/12/23/revised PY - 2014/12/24/accepted PY - 2015/1/21/entrez PY - 2015/1/21/pubmed PY - 2015/5/6/medline KW - Air pollution KW - Gestational diabetes KW - Preconception KW - Pregnancy SP - 316 EP - 22 JF - Environmental research JO - Environ. Res. VL - 137 N2 - BACKGROUND: Air pollution has been linked to gestational diabetes mellitus (GDM) but no studies have evaluated impact of preconception and early pregnancy air pollution exposures on GDM risk. METHODS: Electronic medical records provided data on 219,952 singleton deliveries to mothers with (n=11,334) and without GDM (n=208,618). Average maternal exposures to particulate matter (PM) ≤ 2.5μm (PM2.5) and PM2.5 constituents, PM ≤ 10μm (PM10), nitrogen oxides (NOx), carbon monoxide, sulfur dioxide (SO2) and ozone (O3) were estimated for the 3-month preconception window, first trimester, and gestational weeks 1-24 based on modified Community Multiscale Air Quality models for delivery hospital referral regions. Binary regression models with robust standard errors estimated relative risks (RR) for GDM per interquartile range (IQR) increase in pollutant concentrations adjusted for study site, maternal age and race/ethnicity. RESULTS: Preconception maternal exposure to NOX (RR=1.09, 95% CI: 1.04, 1.13) and SO2 (RR=1.05, 1.01, 1.09) were associated with increased risk of subsequent GDM and risk estimates remained elevated for first trimester exposure. Preconception O3 was associated with lower risk of subsequent GDM (RR=0.93, 0.90, 0.96) but risks increased later in pregnancy. CONCLUSION: Maternal exposures to NOx and SO2 preconception and during the first few weeks of pregnancy were associated with increased GDM risk. O3 appeared to increase GDM risk in association with mid-pregnancy exposure but not in earlier time windows. These common exposures merit further investigation. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/25601734/Preconception_and_early_pregnancy_air_pollution_exposures_and_risk_of_gestational_diabetes_mellitus_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(14)00471-X DB - PRIME DP - Unbound Medicine ER -