Association of ambient fine particulate matter exposure with gestational diabetes mellitus and blood glucose levels during pregnancy

Rujie Liu; Jun Zhang; Li Chu; Jun Zhang; Yanjun Guo; Lihua Qiao; Zhongzheng Niu; Meng Wang; Zeinab Farhat; Alexandra Grippo; Yifan Zhang; Changxing Ma; Yingying Zhang; Kexin Zhu; Lina Mu; Lijian Lei

doi:10.1016/j.envres.2022.114008

Association of ambient fine particulate matter exposure with gestational diabetes mellitus and blood glucose levels during pregnancy

Environ Res. 2022 Nov;214(Pt 3):114008. doi: 10.1016/j.envres.2022.114008. Epub 2022 Aug 3.

Authors

Rujie Liu¹, Jun Zhang², Li Chu³, Jun Zhang³, Yanjun Guo⁴, Lihua Qiao², Zhongzheng Niu⁵, Meng Wang⁵, Zeinab Farhat⁵, Alexandra Grippo⁵, Yifan Zhang¹, Changxing Ma⁶, Yingying Zhang¹, Kexin Zhu⁵, Lina Mu⁷, Lijian Lei⁸

Affiliations

¹ Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China.
² Research Center for Public Health, Tsinghua University, Beijing, China.
³ Department of Obstetrics and Gynecology, Beijing Anzhen Hospital, Capital Medical University, Beijing, China.
⁴ Department of Obstetrics and Gynecology, Aerospace Center Hospital, Beijing, China.
⁵ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA.
⁶ Department of Biostatistics, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA.
⁷ Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, The State University of New York at Buffalo, Buffalo, NY, USA. Electronic address: linamu@buffalo.edu.
⁸ Department of Epidemiology, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, China. Electronic address: wwdlijian@sxmu.edu.cn.

PMID: 35931192
DOI: 10.1016/j.envres.2022.114008

Abstract

Background: Previous studies have examined the associations between ambient fine particulate matter (PM_2.5) exposure and gestational diabetes mellitus (GDM). However, limited studies explored the relationships between PM_2.5 exposure and blood glucose levels during pregnancy, especially in highly polluted areas.

Objectives: To examine the associations of prenatal ambient PM_2.5 exposure with GDM and blood glucose levels, and to identify the sensitive exposure windows in a highly air-polluted area.

Methods: From July 2016 to October 2017, a birth cohort study was conducted in Beijing, China. Participants were interviewed in each trimester regarding demographics, lifestyle, living and working environment, and medical conditions. Participant's daily ambient PM_2.5 levels from 3 m before last menstrual period (LMP) to the third trimester was estimated by a hybrid spatiotemporal model. Indoor air quality index was calculated based on environmental tobacco smoke, ventilation, cooking, painting, pesticide, and herbicide use. Distributed lag non-linear model was applied to explore the sensitive weeks of PM_2.5 exposure.

Results: Of 165 pregnant women, 23 (13.94%) developed GDM. After adjusting for potential confounders, PM_2.5 exposure during the 1^st trimester was associated with higher odds of GDM (10 μg/m³ increase: OR = 1.89, 95% CI: 1.04-3.49). Each 10 μg/m³ increase in PM_2.5 during the 2^nd trimester was associated with 17.70% (2.21-33.20), 15.99% (2.96-29.01), 18.82% (4.11-33.52), and 17.10% (3.28-30.92) increase in 1-h, 2-h, Δ1h-fasting (1-h minus fasting), and Δ2h-fasting (2-h minus fasting) blood glucose levels, respectively. PM_2.5 exposure at 24^th-27^th weeks after LMP was associated with increased GDM risk. We identified sensitive exposure windows of 21^st-24^th weeks for higher 1-h and 2-h blood glucose levels and of 20^th-22^nd weeks for increased Δ1h-fasting and Δ2h-fasting.

Conclusions: Ambient PM_2.5 exposure during the second trimester was associated with higher odds of GDM and higher blood glucose levels. Avoiding exposure to high air pollution levels during the sensitive windows might prevent women from developing GDM.

Keywords: Ambient PM(2.5) exposure; Blood glucose levels; DLNM; GDM.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Air Pollutants* / analysis
Air Pollutants* / toxicity
Air Pollution* / adverse effects
Air Pollution* / analysis
Blood Glucose
Cohort Studies
Diabetes, Gestational* / chemically induced
Diabetes, Gestational* / epidemiology
Female
Humans
Maternal Exposure / adverse effects
Particulate Matter / analysis
Particulate Matter / toxicity
Pregnancy

Substances

Air Pollutants
Blood Glucose
Particulate Matter