Abstract
BACKGROUND AND AIM: Despite being studied extensively, the role of air pollution in gestational diabetes remains unclear, and there is limited evidence of the beneficial impact of residential greenness on metabolic dysfunction during pregnancy. Our objective was to examine associations of both air pollution and residential greenness on glucose intolerance and abnormal serum lipids among pregnant women. METHODS: We used data from more than 2,200 mothers from Gipuzkoa, Sabadell and Valencia who were enrolled in the Spanish INfancia y Medio Ambiente (INMA) Project from 2003—2008. We obtained spatiotemporally resolved estimates of fine particulate matter (PM₂.₅) and nitrogen dioxide (NO₂) exposures in early pregnancy and estimated residential greenness using satellite-based Normal Difference Vegetation Index (NDVI) within 100-, 300- and 500-meter buffers surrounding the mother’s residence. We applied mixed models with random effect for cohort to separately evaluate associations between each of the three exposures of interest (PM₂.₅, NO₂, or NDVI) and a) glucose intolerance (defined as either impaired glucose tolerance (IGT) or gestational diabetes mellitus (GDM)) and b) abnormal lipid levels. RESULTS:No associations were observed between a 5 µg/m³ increase in first trimester PM₂.₅ exposure and glucose intolerance (OR = 1.0, 95% CI: 0.9, 1.2), high cholesterol (OR = 1.0, 95% CI: 0.9, 1.2), or high triglycerides (OR= 1.0, 95% CI: 0.9, 1.2). Null associations were also observed for a 10 µg/m³ increase in NO₂ exposure. We also observed no association between NDVI and any of the metabolic outcomes and results were similar irrespective of buffer size. CONCLUSIONS:Given the lack of evidence in our study, other investigations are needed to assess effects of air pollution and residential greenness on metabolic dysfunction during pregnancy. KEYWORDS: Particulate matter, oxides of nitrogen, green space, pregnancy outcomes
Highlights
Metabolic disorders of pregnancy, such as impaired glucose intolerance (IGT) or gestational diabetes mellitus (GDM), are associated with an increased risk of cardiovascular diseases [1] and type 2 diabetes post pregnancy [2]
A 0.19 interquartile range (IQR) increase in 300 m Normalized Difference Vegetation Index (NDVI) was associated with increased odds of high triglycerides (OR = 1.44, 95% CI: 0.98, 2.12); odds ratios (OR) were closer to the null value for glucose intolerance and high total cholesterol
Sometimes conflicting, evidence of associations between air pollution and glucose intolerance and non-fasting serum lipids among women during their pregnancy
Summary
Metabolic disorders of pregnancy, such as impaired glucose intolerance (IGT) or gestational diabetes mellitus (GDM), are associated with an increased risk of cardiovascular diseases [1] and type 2 diabetes post pregnancy [2]. Women with pregnancies complicated by glucose intolerance have abnormal serum lipid levels, which are markers of metabolic dysfunction [3] and increase mothers’ risks for cardiovascular disease [4]. Metabolic dysfunction in early pregnancy is associated with increased risk of several adverse birth outcomes [5,6,7,8] and places the infant at risk for cardiometabolic consequences later in life [9]. Exposure to ambient air pollution, including fine particulate matter (PM2.5 ) and nitrogen dioxide (NO2 ), has been linked to oxidative stress and systemic inflammation [10,11,12], and inflammatory mediators are associated with levels of glucose during pregnancy [13]. Some constituents of particulate matter are endocrine disruptors, which may have potentially adverse effects on pregnancy, including metabolic diseases [15]
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