Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort

Heejoo Jo, Sandrah P. Eckel, Jiu Chiuan Chen, Myles Cockburn, Mayra P. Martinez, Ting Chow, Fred Lurmann, William E. Funk, Rob McConnell, Anny H. Xiang*

*Corresponding author for this work

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish (US)
Article number104933
JournalEnvironment International
Volume130
DOIs
StatePublished - Sep 2019

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pollution exposure
diabetes
pregnancy
atmospheric pollution
confidence interval
pollutant
household income
nitrogen dioxide
ethnicity
health care
aerodynamics
particulate matter
census
ozone
education
exposure
air

Keywords

  • Air pollution
  • Gestational diabetes mellitus
  • Preconception
  • Pregnancy

ASJC Scopus subject areas

  • Environmental Science(all)

Cite this

Jo, Heejoo ; Eckel, Sandrah P. ; Chen, Jiu Chiuan ; Cockburn, Myles ; Martinez, Mayra P. ; Chow, Ting ; Lurmann, Fred ; Funk, William E. ; McConnell, Rob ; Xiang, Anny H. / Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. In: Environment International. 2019 ; Vol. 130.
@article{0a8d0f38a0424910acf0749621e4c7c3,
title = "Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort",
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.",
keywords = "Air pollution, Gestational diabetes mellitus, Preconception, Pregnancy",
author = "Heejoo Jo and Eckel, {Sandrah P.} and Chen, {Jiu Chiuan} and Myles Cockburn and Martinez, {Mayra P.} and Ting Chow and Fred Lurmann and Funk, {William E.} and Rob McConnell and Xiang, {Anny H.}",
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doi = "10.1016/j.envint.2019.104933",
language = "English (US)",
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journal = "Environmental International",
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Associations of gestational diabetes mellitus with residential air pollution exposure in a large Southern California pregnancy cohort. / Jo, Heejoo; Eckel, Sandrah P.; Chen, Jiu Chiuan; Cockburn, Myles; Martinez, Mayra P.; Chow, Ting; Lurmann, Fred; Funk, William E.; McConnell, Rob; Xiang, Anny H.

In: Environment International, Vol. 130, 104933, 09.2019.

Research output: Contribution to journalArticle

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.

PY - 2019/9

Y1 - 2019/9

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.

AB - 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.

KW - Air pollution

KW - Gestational diabetes mellitus

KW - Preconception

KW - Pregnancy

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