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Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort.
Environ Int. 2019 09; 130:104933.EI

Abstract

BACKGROUND

Studies of effects of air pollution on gestational diabetes mellitus (GDM) have not been consistent, and there has been little investigation of effects of exposure preceding pregnancy. In previous studies, the temporal relationship between exposure and GDM onset has been difficult to establish.

METHODS

Data were obtained for 239,574 pregnancies between 1999 and 2009 in a population-based health care system with comprehensive electronic medical records. Concentrations of ambient nitrogen dioxide (NO2), particulate matter (PM) ≤2.5 μm in aerodynamic diameter (PM2.5) and ≤10 μm (PM10), and ozone (O3) during preconception and the first trimester of pregnancy at the residential birth address were estimated from regulatory air monitoring stations. Odds ratios (ORs) of GDM diagnosed in the second and third trimesters in association with pollutant exposure were estimated using generalized estimating equation models adjusted for birth year, medical center service areas, maternal age, race/ethnicity, education, census-tract household income, and parity.

RESULTS

In single-pollutant models, preconception NO2 was associated with increased risk of GDM (OR = 1.10 per 10.4 ppb, 95% confidence interval [CI]: 1.07, 1.13). First trimester NO2 was weakly associated with GDM, and this was not statistically significant (OR = 1.02 per 10.4 ppb, 95% CI: 0.99, 1.05). Preconception NO2 associations were robust in multi-pollutant models adjusted for first trimester NO2 with another co-pollutant from both exposure windows. In single-pollutant models, preconception PM2.5 and PM10 associations were associated with increased risk of GDM (OR = 1.04 per 6.5 μg/m3, 95% CI: 1.01, 1.06; OR = 1.03 per 16.1 μg/m3, 95% CI: 1.00, 1.06, respectively), but these effect estimates were not robust to adjustment for other pollutants. In single-pollutant models, preconception and first trimester O3 were associated with reduced risk of GDM (OR = 0.94 per 15.7 ppb, 95% CI: 0.92, 0.95; OR = 0.95 per 15.7 ppb, 95% CI: 0.94, 0.97), associations that were robust to adjustment for co-pollutants.

CONCLUSIONS

Maternal exposure to NO2 during the preconception trimester may increase risk of GDM.

Authors+Show Affiliations

Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America; Department of Epidemiology, University of Colorado School of Public Health, Aurora, CO, United States of America.Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America.Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America.Sonoma Technology, Inc., Petaluma, CA, United States of America.Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America.Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States of America.Department of Research & Evaluation, Kaiser Permanente Southern California, Pasadena, CA, United States of America. Electronic address: anny.h.xiang@kp.org.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

31234004

Citation

Jo, Heejoo, et al. "Associations of Gestational Diabetes Mellitus With Residential Air Pollution Exposure in a Large Southern California Pregnancy Cohort." Environment International, vol. 130, 2019, p. 104933.
Jo H, Eckel SP, Chen JC, et al. Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. Environ Int. 2019;130:104933.
Jo, H., Eckel, S. P., Chen, J. C., Cockburn, M., Martinez, M. P., Chow, T., Lurmann, F., Funk, W. E., McConnell, R., & Xiang, A. H. (2019). Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. Environment International, 130, 104933. https://doi.org/10.1016/j.envint.2019.104933
Jo H, et al. Associations of Gestational Diabetes Mellitus With Residential Air Pollution Exposure in a Large Southern California Pregnancy Cohort. Environ Int. 2019;130:104933. PubMed PMID: 31234004.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. AU - Jo,Heejoo, AU - Eckel,Sandrah P, AU - Chen,Jiu-Chiuan, AU - Cockburn,Myles, AU - Martinez,Mayra P, AU - Chow,Ting, AU - Lurmann,Fred, AU - Funk,William E, AU - McConnell,Rob, AU - Xiang,Anny H, Y1 - 2019/06/21/ PY - 2019/03/13/received PY - 2019/05/31/revised PY - 2019/06/13/accepted PY - 2019/6/25/pubmed PY - 2020/2/26/medline PY - 2019/6/25/entrez KW - Air pollution KW - Gestational diabetes mellitus KW - Preconception KW - Pregnancy SP - 104933 EP - 104933 JF - Environment international JO - Environ Int VL - 130 N2 - BACKGROUND: Studies of effects of air pollution on gestational diabetes mellitus (GDM) have not been consistent, and there has been little investigation of effects of exposure preceding pregnancy. In previous studies, the temporal relationship between exposure and GDM onset has been difficult to establish. METHODS: Data were obtained for 239,574 pregnancies between 1999 and 2009 in a population-based health care system with comprehensive electronic medical records. Concentrations of ambient nitrogen dioxide (NO2), particulate matter (PM) ≤2.5 μm in aerodynamic diameter (PM2.5) and ≤10 μm (PM10), and ozone (O3) during preconception and the first trimester of pregnancy at the residential birth address were estimated from regulatory air monitoring stations. Odds ratios (ORs) of GDM diagnosed in the second and third trimesters in association with pollutant exposure were estimated using generalized estimating equation models adjusted for birth year, medical center service areas, maternal age, race/ethnicity, education, census-tract household income, and parity. RESULTS: In single-pollutant models, preconception NO2 was associated with increased risk of GDM (OR = 1.10 per 10.4 ppb, 95% confidence interval [CI]: 1.07, 1.13). First trimester NO2 was weakly associated with GDM, and this was not statistically significant (OR = 1.02 per 10.4 ppb, 95% CI: 0.99, 1.05). Preconception NO2 associations were robust in multi-pollutant models adjusted for first trimester NO2 with another co-pollutant from both exposure windows. In single-pollutant models, preconception PM2.5 and PM10 associations were associated with increased risk of GDM (OR = 1.04 per 6.5 μg/m3, 95% CI: 1.01, 1.06; OR = 1.03 per 16.1 μg/m3, 95% CI: 1.00, 1.06, respectively), but these effect estimates were not robust to adjustment for other pollutants. In single-pollutant models, preconception and first trimester O3 were associated with reduced risk of GDM (OR = 0.94 per 15.7 ppb, 95% CI: 0.92, 0.95; OR = 0.95 per 15.7 ppb, 95% CI: 0.94, 0.97), associations that were robust to adjustment for co-pollutants. CONCLUSIONS: Maternal exposure to NO2 during the preconception trimester may increase risk of GDM. SN - 1873-6750 UR - https://www.unboundmedicine.com/medline/citation/31234004/Associations_of_gestational_diabetes_mellitus_with_residential_air_pollution_exposure_in_a_large_Southern_California_pregnancy_cohort_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0160-4120(19)30843-8 DB - PRIME DP - Unbound Medicine ER -