Wei Bai1, Yuanyuan Li1, Yaling Niu1, Ye Ding1, Xiao Yu1, Bo Zhu1, Ruixin Duan1, Huawei Duan2, Changgui Kou3, Yanbo Li4, Zhiwei Sun5. 1. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China. 2. Key Laboratory of Chemical Safety and Health, National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention, Beijing, China. 3. Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin Province, China. Electronic address: koucg@jlu.edu.cn. 4. School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China. Electronic address: ybli@ccmu.edu.cn. 5. School of Public Health, Capital Medical University, Beijing, China; Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, China.
Abstract
BACKGROUND: Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS: PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS: This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 μg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 μg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 μg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION: Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.
BACKGROUND: Pregnancy complications, such as gestational diabetes mellitus (GDM) and hypertensive disorders of pregnancy (HDP), have a great impact on public health. Exposure to ambient air pollution during pregnancy may cause pregnancy complications. The aim of our study is to explore the risk of trimester-specific maternal exposure to air pollutants on complications of pregnancy. METHODS: PubMed, EMBASE, Web of Science, and Cochrane were systematically searched for cohort studies published before October 27, 2019 which reported the association between ambient air pollutants (PM2.5, PM10, CO, NO, NO2, NOx, O3, and SO2) and pregnancy complications (GDM, HDP, preeclampsia, and gestational hypertension) during different exposure windows. A meta-analysis was applied to combine relative risks (RRs) and their confidence intervals (CIs) from eligible studies. Quality assessment was conducted and Egger test was used to evaluate the publication bias. All statistical analyses were performed by STATA software (Version 15, StataCorp, College Station, Texas, USA). RESULTS: This meta-analysis consisted of 33 cohort studies conducted on 22,253,277 pregnant women. Meta-analyses showed during the first trimester, there were significant associations of PM10 with gestational hypertension (RR = 1.07, 95% CI: 1.02-1.12 per 10 μg/m3, I2 = 0.0%), of SO2 with GDM (RR = 1.04, 95% CI: 1.00-1.08 per 1 ppb increment, I2 = 54.1%), of PM2.5 with preeclampsia (RR = 0.97, 95% CI: 0.95-1.00 per 5 μg/m3, I2 = 4.1%). During the entire pregnancy, PM2.5 significantly increased the risk of hypertensive disorders of pregnancy (RR = 1.18, 95% CI: 1.02-1.34 per 5 μg/m3, I2 = 85.1%). Egger test indicated that wide-scale publication bias was unlikely. CONCLUSION: Maternal exposure to ambient air pollutants is associated with pregnancy complications especially during the first trimester. Further large multicenter cohort studies considering different constituents of pollutants, levels of disease severity, sensitive populations, and various exposure windows are warranted in the future research.
Authors: Yumjirmaa Mandakh; Anna Oudin; Lena Erlandsson; Christina Isaxon; Stefan R Hansson; Karin Broberg; Ebba Malmqvist Journal: Front Toxicol Date: 2021-05-26
Authors: Karin Engström; Yumjirmaa Mandakh; Lana Garmire; Zahra Masoumi; Christina Isaxon; Ebba Malmqvist; Lena Erlandsson; Stefan R Hansson Journal: Toxics Date: 2021-12-06
Authors: Amal Rammah; Kristina W Whitworth; Christopher I Amos; Marisa Estarlich; Mònica Guxens; Jesús Ibarluzea; Carmen Iñiguez; Mikel Subiza-Pérez; Martine Vrijheid; Elaine Symanski Journal: Int J Environ Res Public Health Date: 2021-09-04 Impact factor: 3.390