Air Pollution, Residential Greenness and Metabolic Dysfunction during Early Pregnancy in the INfancia y Medio Ambiente (INMA) Cohort.

Amal Rammah,Martine Vrijheid,Jesús Ibarluzea,Christopher I Amos,Mikel Subiza-Pérez,Marisa Estarlich,Carmen Iñiguez,Kristina W Whitworth,Mònica Guxens,Elaine Symanski

doi:10.3390/ijerph18179354

Abstract

Despite extensive study, 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. We used data from mothers 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 m buffers surrounding the mother’s residence. We applied logistic regression models to evaluate associations between each of the three exposures of interest and (a) glucose intolerance and (b) abnormal lipid levels. We found limited evidence of associations between increases in PM2.5 and NO2 exposures and the metabolic outcomes. Though not statistically significant, high PM2.5 exposure (≥25 µg/m3) was associated with increased odds of glucose intolerance (OR = 1.16, 95% CI: 0.82, 1.63) and high cholesterol (OR = 1.14, 95% CI: 0.90, 1.44). High NO2 exposure (≥39.8 µg/m3) was inversely associated with odds of high triglycerides (OR = 0.70, 95% CI: 0.45, 1.08). Whereas NDVI was not associated with glucose intolerance, odds of high triglycerides were increased, although the results were highly imprecise. Results were unchanged when the air pollutant variables were included in the regression models. Given the equivocal findings in our study, additional investigations are needed to assess effects of air pollution and residential greenness on metabolic dysfunction during pregnancy.

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

Introduction

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]

Objectives

Methods

Results

Discussion

Conclusion