Abstract
Anemia has been a public health issue evoking global concern, and the low hemoglobin (Hb) concentration links to adverse pregnancy outcomes. However, the associations of PM2.5 and its constituents with Hb and anemia in pregnant women remain unclear. In this retrospective birth cohort study, 7932 pregnant women who delivered in the First Affiliated Hospital of Xi’an Jiaotong University from 2015 to 2018 were included. The Hb during the third trimester in pregnant women was assessed before delivery. PM2.5 and its constituents (BC, NH4+, NO3−, OM, SO42−, and Dust) during pregnancy were retrieved from the V4.CH.03 product constructed by the Atmospheric Composition Analysis Group. Generalized linear regression model was applied to investigate the effects of PM2.5 and its constituents on Hb and anemia during the third trimester in pregnant women. The means and standard deviations of PM2.5, BC, NH4+, NO3−, OM, SO42−, and Dust were 69.56 (15.24), 10.02 (2.72), 8.11 (1.77), 14.96 (5.42), 15.36 (4.11), 10.08 (1.20), and 10.98 (1.85) μg/m3, respectively. Per IQR increase (μg/m3) of PM2.5, BC, NO3−, and OM linked to − 0.75 (− 1.50, − 0.01), − 0.85 (− 1.65, − 0.04), − 0.79 (− 1.56, − 0.03), and − 0.73 (− 1.44, − 0.03) g/L decrease of Hb during the third trimester in multiparous pregnant women, but not for NH4+, SO42−, Dust, and primiparous pregnant women. PM2.5 and its constituents had no significant association with anemia, except for Dust (OR: 0.90, 95% CI: 0.82, 0.99, per IQR increase) in primiparous pregnant women. Besides, SO42− was of lag effects on Hb and anemia in multiparous pregnant women. Moreover, non-linear associations were found among PM2.5 and its constituents, Hb, and anemia. Therefore, exposure to PM2.5 and some constituents of PM2.5 was associated with reduced Hb level during the third trimester in multiparous pregnant women. Related departments and pregnant women should take targeted actions to eliminate the detrimental effects of PM2.5 and its constituents on pregnancy outcomes.Supplementary InformationThe online version contains supplementary material available at 10.1007/s11356-022-18693-2.
Highlights
Nutritional status during pregnancy has influence on the health of pregnant women, and the growth and development of infant
We comprehensively explored the effects of PM2.5 and its constituents on Hb and anemia during the third trimester in pregnant women
A study revealed that Hb concentration increased with the rise of daily average concentration of PM2.5 (β: 9.923%, 95% CI: 8.741%, 11.264%, g/L, per 10 μg/m3 increase of PM2.5) (Wang et al 2021) and one study for pregnant women illuminated that prenatal exposure to P M2.5 linked to higher concentration of Hb (β: 0.929, 95% CI: 0.068, 1.789, g/L, per interquartile range (IQR) increase of P M2.5) (Liao et al 2019)
Summary
Nutritional status during pregnancy has influence on the health of pregnant women, and the growth and development of infant. The Developmental Origin of Health and Disease (DOHaD) concept holds that maternal nutritional status links to birth outcomes of infants and the risks of chronic diseases in adulthood via epigenetic regulation, and the health impacts even remain in multiple generations (Gluckman et al 2016). Anemia is characterized by the decreased concentration of Hb, which could lead to placental dysfunction through influencing the perfusion of placenta and restricting the oxygen exchange between pregnant women and fetus, so as to result in adverse pregnancy outcomes. A growing body of epidemiologic studies confirmed that P M2.5 had detrimental health impacts on pregnant women and fetuses (Ghassabian et al 2019; Shang et al 2019; Xie et al 2021). A growing body of epidemiologic studies confirmed that P M2.5 had detrimental health impacts on pregnant women and fetuses (Ghassabian et al 2019; Shang et al 2019; Xie et al 2021). PM2.5 can be inhaled into alveoli and enter circulatory system by lung ventilation, and induce inflammatory stress, immune response, and alteration of iron homeostasis, change Hb level (Badman & Jaffé 1996; Ganz 2019; Seaton et al 1999; Weiss et al 2019)
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