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Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia.
Hypertension. 2019 08; 74(2):384-390.H

Abstract

Although ambient air pollution may increase hypertension risk through endothelial damage and oxidative stress, evidence is inconsistent regarding its effect on hypertension in pregnancy. Prior research has evaluated a limited scope of pollution species and often not differentiated preeclampsia, which may have a placental origin, from gestational hypertension. Among 49 607 women with at least 2 singleton deliveries in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Consecutive Pregnancies Study (2002-2010), we estimated criteria pollutant and volatile organic compound levels during pregnancy using Community Multiscale Air Quality models and abstracted gestational hypertension and preeclampsia diagnoses from medical records. Generalized estimating equations accounted for repeat pregnancies and adjusted for ambient temperature and maternal age, race/ethnicity, body mass index, smoking, alcohol, parity, insurance, marital status, and asthma. Air pollution levels were low to moderate (eg, median 41.6 ppb [interquartile range, 38.9-43.7 ppb] for ozone and 35.1 ppb [28.9-40.3 ppb] for nitrogen oxides). Higher levels of most criteria pollutants during preconception and the first trimester were associated with lower preeclampsia risk, while higher second-trimester levels were associated with greater gestational hypertension risk. For example, an interquartile increase in first-trimester carbon monoxide was associated with a relative risk of 0.88 (95% CI, 0.81-0.95) for preeclampsia and second-trimester carbon monoxide a relative risk of 1.14 (95% CI, 1.07-1.22) for gestational hypertension. Volatile organic compounds, conversely, were not associated with gestational hypertension but consistently associated with higher preeclampsia risk. These findings further suggest air pollution may affect the development of hypertension in pregnancy, although differing causes of preeclampsia and gestational hypertension may alter these relationships.

Authors+Show Affiliations

From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.).From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.).From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.).Emmes Company, Rockville, MD (S.S.).From the Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD (C.J.N., A.W., M.O., P.M.).

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Intramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

31230552

Citation

Nobles, Carrie J., et al. "Differential Effect of Ambient Air Pollution Exposure On Risk of Gestational Hypertension and Preeclampsia." Hypertension (Dallas, Tex. : 1979), vol. 74, no. 2, 2019, pp. 384-390.
Nobles CJ, Williams A, Ouidir M, et al. Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia. Hypertension. 2019;74(2):384-390.
Nobles, C. J., Williams, A., Ouidir, M., Sherman, S., & Mendola, P. (2019). Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia. Hypertension (Dallas, Tex. : 1979), 74(2), 384-390. https://doi.org/10.1161/HYPERTENSIONAHA.119.12731
Nobles CJ, et al. Differential Effect of Ambient Air Pollution Exposure On Risk of Gestational Hypertension and Preeclampsia. Hypertension. 2019;74(2):384-390. PubMed PMID: 31230552.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Differential Effect of Ambient Air Pollution Exposure on Risk of Gestational Hypertension and Preeclampsia. AU - Nobles,Carrie J, AU - Williams,Andrew, AU - Ouidir,Marion, AU - Sherman,Seth, AU - Mendola,Pauline, Y1 - 2019/06/24/ PY - 2019/6/25/pubmed PY - 2019/11/19/medline PY - 2019/6/25/entrez KW - air pollution KW - blood pressure KW - environment KW - epidemiology KW - hypertension KW - pregnancy SP - 384 EP - 390 JF - Hypertension (Dallas, Tex. : 1979) JO - Hypertension VL - 74 IS - 2 N2 - Although ambient air pollution may increase hypertension risk through endothelial damage and oxidative stress, evidence is inconsistent regarding its effect on hypertension in pregnancy. Prior research has evaluated a limited scope of pollution species and often not differentiated preeclampsia, which may have a placental origin, from gestational hypertension. Among 49 607 women with at least 2 singleton deliveries in the Eunice Kennedy Shriver National Institute of Child Health and Human Development Consecutive Pregnancies Study (2002-2010), we estimated criteria pollutant and volatile organic compound levels during pregnancy using Community Multiscale Air Quality models and abstracted gestational hypertension and preeclampsia diagnoses from medical records. Generalized estimating equations accounted for repeat pregnancies and adjusted for ambient temperature and maternal age, race/ethnicity, body mass index, smoking, alcohol, parity, insurance, marital status, and asthma. Air pollution levels were low to moderate (eg, median 41.6 ppb [interquartile range, 38.9-43.7 ppb] for ozone and 35.1 ppb [28.9-40.3 ppb] for nitrogen oxides). Higher levels of most criteria pollutants during preconception and the first trimester were associated with lower preeclampsia risk, while higher second-trimester levels were associated with greater gestational hypertension risk. For example, an interquartile increase in first-trimester carbon monoxide was associated with a relative risk of 0.88 (95% CI, 0.81-0.95) for preeclampsia and second-trimester carbon monoxide a relative risk of 1.14 (95% CI, 1.07-1.22) for gestational hypertension. Volatile organic compounds, conversely, were not associated with gestational hypertension but consistently associated with higher preeclampsia risk. These findings further suggest air pollution may affect the development of hypertension in pregnancy, although differing causes of preeclampsia and gestational hypertension may alter these relationships. SN - 1524-4563 UR - https://www.unboundmedicine.com/medline/citation/31230552/Differential_Effect_of_Ambient_Air_Pollution_Exposure_on_Risk_of_Gestational_Hypertension_and_Preeclampsia_ L2 - http://dx.doi.org/10.11622/smedj.2016020 DB - PRIME DP - Unbound Medicine ER -