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Ambient air pollution during pregnancy and risk of gestational diabetes in New York City.
Environ Res. 2019 08; 175:414-420.ER

Abstract

BACKGROUND

Emerging evidence suggests a potential association between ambient air pollution and risk of gestational diabetes mellitus (GDM), but results have been inconsistent. Accordingly, we assessed the associations between ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) levels with risk of GDM.

METHODS

Using linked data from birth certificates, hospital discharge diagnoses, and air pollution estimates informed by the New York City Community Air Survey, we fit conditional logistic regression models to evaluate the association between residential levels of PM2.5 and NO2 with risk of GDM among 256,372 singleton live births of non-smoking mothers in New York City born 2008-2010, adjusting for sociodemographic factors and stratified on zip code of maternal address.

RESULTS

GDM was identified in 17,065 women, yielding a risk of GDM in the study sample of 67 per 1000 deliveries. In single pollutant models, 1st and 2nd trimester PM2.5 was associated with a lower and higher risk of GDM, respectively. In models mutually adjusting for PM2.5 levels in both trimesters, GDM was associated with PM2.5 levels in the 2nd trimester (OR: 1.06, 95% CI: 1.02, 1.10 per interquartile range increase in PM2.5), but not the 1st trimester (OR: 0.99, 95% CI: 0.96, 1.02). Conversely, GDM was associated with NO2 during the 1st trimester (OR: 1.05, 95% CI: 1.01, 1.09), but not the 2nd trimester (OR: 1.02, 95% CI: 0.98, 1.06). The positive associations between pollutants and GDM were robust to different model specifications. PM2.5 in the 2nd trimester was more strongly associated with GDM among mothers who were aged <35 years and not Medicaid recipients. NO2 in the 1st trimester was more strongly associated with GDM among overweight and parous women.

CONCLUSIONS

In this large cohort of singleton births in New York City, NO2 in the 1st trimester and PM2.5 in the 2nd trimester were associated with higher odds of GDM, while 1st trimester PM2.5 was weakly and inconsistently associated with lower odds of GDM.

Authors+Show Affiliations

Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA; Department of Obstetrics and Gynecology, CHA University School of Medicine, Gyeonggi, South Korea.Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA.Department of Epidemiology, Brown University School of Public Health, Providence, RI, USA. Electronic address: Gregory_wellenius@brown.edu.

Pub Type(s)

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

Language

eng

PubMed ID

31154231

Citation

Choe, Seung-Ah, et al. "Ambient Air Pollution During Pregnancy and Risk of Gestational Diabetes in New York City." Environmental Research, vol. 175, 2019, pp. 414-420.
Choe SA, Eliot MN, Savitz DA, et al. Ambient air pollution during pregnancy and risk of gestational diabetes in New York City. Environ Res. 2019;175:414-420.
Choe, S. A., Eliot, M. N., Savitz, D. A., & Wellenius, G. A. (2019). Ambient air pollution during pregnancy and risk of gestational diabetes in New York City. Environmental Research, 175, 414-420. https://doi.org/10.1016/j.envres.2019.04.030
Choe SA, et al. Ambient Air Pollution During Pregnancy and Risk of Gestational Diabetes in New York City. Environ Res. 2019;175:414-420. PubMed PMID: 31154231.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ambient air pollution during pregnancy and risk of gestational diabetes in New York City. AU - Choe,Seung-Ah, AU - Eliot,Melissa N, AU - Savitz,David A, AU - Wellenius,Gregory A, Y1 - 2019/05/24/ PY - 2018/09/23/received PY - 2019/04/25/revised PY - 2019/04/26/accepted PY - 2019/6/4/pubmed PY - 2020/1/7/medline PY - 2019/6/3/entrez KW - Air pollution KW - Fine particulate matter KW - Gestational diabetes KW - Nitrogen dioxide SP - 414 EP - 420 JF - Environmental research JO - Environ. Res. VL - 175 N2 - BACKGROUND: Emerging evidence suggests a potential association between ambient air pollution and risk of gestational diabetes mellitus (GDM), but results have been inconsistent. Accordingly, we assessed the associations between ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) levels with risk of GDM. METHODS: Using linked data from birth certificates, hospital discharge diagnoses, and air pollution estimates informed by the New York City Community Air Survey, we fit conditional logistic regression models to evaluate the association between residential levels of PM2.5 and NO2 with risk of GDM among 256,372 singleton live births of non-smoking mothers in New York City born 2008-2010, adjusting for sociodemographic factors and stratified on zip code of maternal address. RESULTS: GDM was identified in 17,065 women, yielding a risk of GDM in the study sample of 67 per 1000 deliveries. In single pollutant models, 1st and 2nd trimester PM2.5 was associated with a lower and higher risk of GDM, respectively. In models mutually adjusting for PM2.5 levels in both trimesters, GDM was associated with PM2.5 levels in the 2nd trimester (OR: 1.06, 95% CI: 1.02, 1.10 per interquartile range increase in PM2.5), but not the 1st trimester (OR: 0.99, 95% CI: 0.96, 1.02). Conversely, GDM was associated with NO2 during the 1st trimester (OR: 1.05, 95% CI: 1.01, 1.09), but not the 2nd trimester (OR: 1.02, 95% CI: 0.98, 1.06). The positive associations between pollutants and GDM were robust to different model specifications. PM2.5 in the 2nd trimester was more strongly associated with GDM among mothers who were aged <35 years and not Medicaid recipients. NO2 in the 1st trimester was more strongly associated with GDM among overweight and parous women. CONCLUSIONS: In this large cohort of singleton births in New York City, NO2 in the 1st trimester and PM2.5 in the 2nd trimester were associated with higher odds of GDM, while 1st trimester PM2.5 was weakly and inconsistently associated with lower odds of GDM. SN - 1096-0953 UR - https://www.unboundmedicine.com/medline/citation/31154231/Ambient_air_pollution_during_pregnancy_and_risk_of_gestational_diabetes_in_New_York_City_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0013-9351(19)30246-4 DB - PRIME DP - Unbound Medicine ER -