Ambient air pollution exposure and gestational diabetes mellitus in Guangzhou, China: A prospective cohort study.
Ambient air pollution exposure and gestational diabetes mellitus in Guangzhou, China: A prospective cohort study.
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DOI：
10.1016/j.scitotenv.2019.134390
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发表时间：
2020-01
期刊：
影响因子：
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通讯作者：
Huanhuan Zhang;Haotian Dong;M. Ren;Qianhong Liang;Xiaoting Shen;Qiang Wang;Le Yu;Hualiang Lin
中科院分区：
文献类型：
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作者：
Huanhuan Zhang;Haotian Dong;M. Ren;Qianhong Liang;Xiaoting Shen;Qiang Wang;Le Yu;Hualiang Lin
背景环境空气污染暴露对妊娠期糖尿病（GDM）影响的证据有限。没有发表的研究已经审查了产妇每周空气污染暴露和GDM，并可能影响修改叶酸补充剂尚未assessed.ObjectivesTo评估妊娠期和每周水平的空气污染暴露和GDM之间的关联，并探讨潜在的影响修改叶酸补充剂.MethodsA共5421孕妇在2011-2014年期间在广州招募，中国10个监测站的PM2.5、PM10、SO2和NO2的日平均浓度为0. 05 × 10 - 4。采用反距离加权法估算个体妊娠期间的暴露量。二元逻辑回归被用来检查特定的三个月的空气污染暴露和GDM之间的关联。应用分布滞后模型（DLMs）估计孕妇每周空气污染暴露和GDM。结果GDM发病率为11.69%。在单一污染物模型中，孕早期SO2的四分位距（IQR）增加与GDM风险增加相关，校正比值比（aOR）和95%可信区间（CI）为1.22（1.02-1.47）。在DLMs中，第4 - 10孕周SO2 IQR增加与GDM风险增加相关，第7孕周影响最大。当按母亲补充叶酸分层时，在服用叶酸补充剂的妇女中，妊娠早期暴露于SO2与GDM风险增加相关（aOR = 1.25，95%CI：1.03-1.53），相互作用的P值为0.13。PM2.5、PM10和NO2浓度无明显影响。结论妊娠早期SO2暴露与GDM风险增加有关，尤其是在妊娠第4 ~ 10周。服用叶酸补充剂的女性效果可能更强。
BackgroundEvidence concerning the effect of ambient air pollution exposure on gestational diabetes mellitus (GDM) is limited. No published studies have examined maternal weekly air pollution exposure and GDM, and the possible effect modification by folic acid supplementation has not been assessed.ObjectivesTo evaluate the association between air pollution exposure and GDM at trimester and weekly levels, and to explore the potential effect modification by folic acid supplementation.MethodsA total of 5421 pregnant women were recruited during 2011–2014 in Guangzhou, China. Daily PM2.5, PM10, SO2and NO2levels were collected from 10 monitoring stations. Individual's exposure during pregnancy was estimated using inverse-distance weighting approach. Binary logistic regression was used to examine the trimester-specific association between air pollution exposure and GDM. Distributed lag models (DLMs) were applied to estimate maternal weekly air pollution exposure and GDM. Stratified analyses by folic acid supplementation and interaction test were performed.ResultsThe GDM incidence was 11.69%. An interquartile range (IQR) increase in first trimester SO2was associated with increased GDM risk in the single pollutant model, the adjusted odds ratio (aOR) and 95% confidence interval (CI) was 1.22 (1.02–1.47). In DLMs, an IQR increase in SO2during 4th to 10th gestational weeks was associated with increased GDM risk, with the strongest effect in the 7th gestational week. When stratified by maternal folic acid supplementation, first trimester exposure to SO2was associated with increased GDM risk among women taking folic acid supplements (aOR = 1.25, 95% CI: 1.03–1.53) andPvalue for interaction was 0.13. No significant effects were observed for PM2.5, PM10and NO2.ConclusionFirst trimester exposure to SO2was associated with increased GDM risk,especially during the 4th to 10th gestational weeks. The effect might be stronger among women taking folic acid supplements.