Marie Pedersen1, Sjurdur F Olsen2, Thorhallur I Halldorsson3, Cuilin Zhang4, Dorrit Hjortebjerg5, Matthias Ketzel6, Charlotta Grandström7, Mette Sørensen5, Peter Damm8, Jens Langhoff-Roos9, Ole Raaschou-Nielsen10. 1. Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014 Copenhagen K, Denmark; Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark. Electronic address: mp@sund.ku.dk. 2. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark; Department of Nutrition, Harvard School of Public Health, 677 Huntington Avenue, Boston, MA 02115, USA. 3. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark; Faculty of Food Science and Nutrition, University of Iceland, Sæmundargata 2, 101 Reykjavik, Iceland; Unit for Nutrition Research, Landspitali University Hospital, Eiriksgata 29, Reykjavik, Iceland. 4. Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, 6100 Executive Blvd, Rm 7B03, Rockville, MD 20852, USA. 5. Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark. 6. Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark. 7. Centre for Fetal Programming, Department of Epidemiology Research, Statens Serum Institute, Artillerivej 5, 2300 Copenhagen S, Denmark. 8. Center for Pregnant Women with Diabetes, Copenhagen University Hospital (Rigshospitalet), Blegdamsvej 9, 2100 Copenhagen Ø, Denmark; Clinical Institute of Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen N, Denmark; Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. 9. Department of Obstetrics, Rigshospitalet, Blegdamsvej 9, 2100 Copenhagen Ø, Denmark. 10. Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
Abstract
BACKGROUND: Road traffic is a main source of air pollution and noise. Both exposures have been associated with type 2 diabetes, but associations with gestational diabetes mellitus (GDM) have been studied less. OBJECTIVES: We aimed to examine single and joint associations of exposure to air pollution and road traffic noise on GDM in a prospective cohort. METHODS: We identified GDM cases from self-reports and hospital records, using two different criteria, among 72,745 singleton pregnancies (1997-2002) from the Danish National Birth Cohort. We modeled nitrogen dioxide (NO2) and noise from road traffic (Lden) exposure at all pregnancy addresses. RESULTS: According to the two diagnostic criteria: the Danish clinical guidelines, which was our main outcome, and the WHO standard during recruitment period, a total of 565 and 210 women, respectively, had GDM. For both exposures no risk was evident for the common Danish criterion of GDM. A 10-μg/m3 increase in NO2 exposure during first trimester was, however, associated with an increased risk of WHO-GDM (adjusted odds ratio (OR)=1.24; 95% confidence interval (CI): 1.03, 1.49). The corresponding OR associated with a 10-dB higher road traffic noise level was 1.15 (0.94 to 1.18). In mutually adjusted models the OR for NO2 remained similar 1.22 (0.98, 1.53) whereas that for road traffic noise decreased to 1.03 (0.80, 1.32). Significant associations were also observed for exposure averaged over the 2nd and 3rd trimesters and the full pregnancy. CONCLUSIONS: No risk was evident for the common Danish criterion of GDM. NO2 was associated with higher risk for GDM according to the WHO criterion, which might be due to selection bias.
BACKGROUND: Road traffic is a main source of air pollution and noise. Both exposures have been associated with type 2 diabetes, but associations with gestational diabetes mellitus (GDM) have been studied less. OBJECTIVES: We aimed to examine single and joint associations of exposure to air pollution and road traffic noise on GDM in a prospective cohort. METHODS: We identified GDM cases from self-reports and hospital records, using two different criteria, among 72,745 singleton pregnancies (1997-2002) from the Danish National Birth Cohort. We modeled nitrogen dioxide (NO2) and noise from road traffic (Lden) exposure at all pregnancy addresses. RESULTS: According to the two diagnostic criteria: the Danish clinical guidelines, which was our main outcome, and the WHO standard during recruitment period, a total of 565 and 210 women, respectively, had GDM. For both exposures no risk was evident for the common Danish criterion of GDM. A 10-μg/m3 increase in NO2 exposure during first trimester was, however, associated with an increased risk of WHO-GDM (adjusted odds ratio (OR)=1.24; 95% confidence interval (CI): 1.03, 1.49). The corresponding OR associated with a 10-dB higher road traffic noise level was 1.15 (0.94 to 1.18). In mutually adjusted models the OR for NO2 remained similar 1.22 (0.98, 1.53) whereas that for road traffic noise decreased to 1.03 (0.80, 1.32). Significant associations were also observed for exposure averaged over the 2nd and 3rd trimesters and the full pregnancy. CONCLUSIONS: No risk was evident for the common Danish criterion of GDM. NO2 was associated with higher risk for GDM according to the WHO criterion, which might be due to selection bias.
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