Abstract

BackgroundPreconception exposure to air pollution has been associated with glucose tolerance during pregnancy. However, the evidence in low and middle-income countries (LMICs) is under debate yet. Therefore, this study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019).MethodsTwo-hundred and fifty healthy pregnant women with singleton pregnancies and 24–26 weeks of gestations participated in our study. Land use regression (LUR) models were applied to estimate the annual mean of PM1, PM2.5 and PM10 at the residential address. Traffic indicators, including proximity of women to major roads as well as total streets length in 100, 300 and 500 m buffers around the home were calculated using the street map of Sabzevar. The oral glucose tolerance test (OGTT) was used to assess glucose tolerance during pregnancy. Multiple linear regression adjusted for relevant covariates was used to estimate the association of fasting blood glucose (FBG), 1-h and 2-h post-load glucose with PMs and traffic indicators.ResultsExposure to PM1, PM2.5 and PM10 was significantly associated with higher FBG concentration. Higher total streets length in a 100 m buffer was associated with higher FBG and 1-h glucose concentrations. An interquartile range (IQR) increase in proximity to major roads was associated with a decrease of − 3.29 mg/dL (95% confidence interval (CI): − 4.35, − 2.23, P-value < 0.01) in FBG level and − 3.65 mg/dL (95% CI, − 7.01, − 0.28, P-value = 0.03) decrease in 1-h post-load glucose.ConclusionWe found that higher preconception exposure to air pollution was associated with higher FBG and 1-h glucose concentrations during pregnancy.

Highlights

  • Gestational diabetes mellitus (GDM) has been associated with pregnancy complications, including macrosomia, hypertension, preeclampsia and premature birth and stillbirth [1]

  • We developed linear regression models (MLR) to estimate the change in the fasting blood glucose (FBG), 1-h and 2-h glucose concentrations associated with an interquartile range (IQR) increase in traffic indicators and particulate matter (PM) exposure

  • To the best of our knowledge, this study is one of the first to evaluate the association of preconception exposure to traffic indicators and air pollution with the glucose concentration obtained in oral glucose tolerance test (OGTT) of healthy pregnant women in a middle-income country

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Summary

Introduction

Gestational diabetes mellitus (GDM) has been associated with pregnancy complications, including macrosomia, hypertension, preeclampsia and premature birth and stillbirth [1]. The results of these studies are inconsistent Some of these studies reported a significant relationship between exposure to particulate matter (PM) with impaired glucose tolerance (IGT) [7, 16, 17] and increased risk of GDM [8, 18, 19]; other evidence reported opposing results [9, 12, 16]. These studies used different diagnostic criteria and had limitations in the timing of GDM development [18]. This study aimed to assess the relationship between exposure to ambient particulate matter (PM) and traffic indicators with glucose tolerance in healthy pregnant women in Sabzevar, Iran (2019)

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