Key Lab of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), China; Key Laboratory of Public Health Safety, Ministry of Education, School of Public Health, Fudan University, Shanghai, 200032, China.
The Maternal and Child Healthcare Hospital of Songjiang District, Shanghai, China.
Environ Pollut. 2019 Jul;250:346-356. doi: 10.1016/j.envpol.2019.04.024. Epub 2019 Apr 11.
Ambient fine particulate matter (PM) pollution has been implicated in the development of hypertensive disorders of pregnancy. However, evidence on the effects of PM-derived chemical constituents on gestational blood pressure (BP) is limited, and the potential mechanisms underlying the association remain unclear. In this study, we repeated three consecutive 72-h personal air sampling and BP measurements in 215 pregnant women for 590 visits during pregnancy. Individual PM exposure level was assessed by gravimetric method and 28 PM chemical constituents were analyzed by ED-XRF method. Plasma biomarkers of endothelial function and inflammation were measured using multiplexed immunoassays. Robust multiple linear regression models were used to estimate the associations among personal PM exposure and chemical constituents, BP changes (compared with pre-pregnancy BP) and plasma biomarkers. Mediation analyses were performed to evaluate underlying potential pathways. Result showed that exposure to PM was significantly associated with increases in systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in the early second trimester. Meanwhile, elevated concentration of lead (Pb) constituent in PM was significant associated with increases in DBP and MAP after adjusting for PM total mass. PM and Pb constituent also presented positive associations with plasma biomarkers of endothelial function (ET-1, E-selectin, ICAM-1) and inflammation (IL-1β, IL-6, TNFα) significantly. After multiple adjustment, elevated ET-1 and IL-6 were significantly correlated with increased gestational BP, and respectively mediated 1.24%-25.06% and 7.01%-10.69% of the increased BP due to PM and Pb constituent exposure. In conclusion, our results suggested that personal exposure to PM and Pb constituent were significantly associated with increased BP during pregnancy, and the early second trimester might be the sensitive window of PM exposure. The endothelial dysfunction and elevated inflammation partially mediated the effect of PM and Pb constituent on BP during pregnancy.
环境细颗粒物（PM）污染已被认为与妊娠高血压疾病的发展有关。然而，关于 PM 衍生化学成分对妊娠期间血压（BP）的影响的证据有限，并且关联的潜在机制仍不清楚。在这项研究中，我们在 215 名孕妇中重复了三次连续的 72 小时个人空气采样和 BP 测量，共进行了 590 次妊娠期间的访问。通过重量法评估个体 PM 暴露水平，并通过 ED-XRF 法分析 28 种 PM 化学成分。使用多重免疫分析测量血浆内皮功能和炎症的生物标志物。使用稳健的多元线性回归模型来估计个人 PM 暴露和化学成分、BP 变化（与妊娠前的 BP 相比）和血浆生物标志物之间的关联。进行中介分析以评估潜在的潜在途径。结果表明，PM 暴露与孕早期中期收缩压（SBP）、舒张压（DBP）和平均动脉压（MAP）的升高显著相关。同时，在调整 PM 总质量后，PM 中铅（Pb）成分的浓度升高与 DBP 和 MAP 的升高显著相关。PM 和 Pb 成分也与内皮功能（ET-1、E-选择素、ICAM-1）和炎症（IL-1β、IL-6、TNFα）的血浆生物标志物呈显著正相关。经过多次调整后，升高的 ET-1 和 IL-6 与妊娠期间的 BP 升高显著相关，分别介导了由于 PM 和 Pb 成分暴露而导致的 BP 升高的 1.24%-25.06%和 7.01%-10.69%。总之，我们的研究结果表明，个体 PM 暴露和 Pb 成分与妊娠期间血压升高显著相关，孕早期中期可能是 PM 暴露的敏感窗口。内皮功能障碍和炎症升高部分介导了 PM 和 Pb 成分对妊娠期间血压的影响。
