Clinical Reserch Center, Shengjing Hospital of China Medical University, Huaxiang Road No. 39, Tiexi District, China.
Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Sanhao Street, No. 36, Heping District, China.
Environ Sci Pollut Res Int. 2021 Feb;28(7):7806-7814. doi: 10.1007/s11356-020-11143-x. Epub 2020 Oct 10.
The prevalence of gestational diabetes mellitus (GDM) is increasing worldwide. Reports of the association between air pollution exposure and GDM have been inconsistent in previous studies. We conducted a cohort study to investigate the associations between air pollution exposure and GDM in the city of Shenyang in Northeast China for the first time. We studied interactions with different air pollutant exposures and conducted a stratified analysis according to folic acid intake, age, body mass index (BMI), primiparity, and sleep quality. We found significant associations between prenatal exposure to NO and SO and the development of GDM during the second trimester: the largest effect on GDM was exposure to SO (odds ratio (OR): 1.77, 95% confidence interval (CI): 1.23-2.56) in the largest quartile compared with the lowest quartile. Significant interactions between age, BMI, parity, sleep quality, and air pollution exposures were observed; stratified analysis showed stronger associations between GDM and high air pollutant exposure in pregnant women with older age, larger BMI, poorer sleep quality, and more parity. We found that air pollution exposure during the second trimester was significantly associated with GDM in a prospective birth cohort study in Northeast China. SO, oxynitride (NOX, NO, NO), CO, and O all showed a linear trend effect on GDM. Interactions between prenatal air pollution exposure and other factors, such as age at pregnancy, BMI before pregnancy, primiparity, folic acid intake, and sleep quality, during the second trimester might exist.
妊娠期糖尿病（GDM）的患病率在全球范围内呈上升趋势。先前的研究报告表明，空气污染暴露与 GDM 之间存在关联，但结果并不一致。我们首次在我国东北地区的沈阳市进行了一项队列研究，以调查空气污染暴露与 GDM 之间的关联。我们研究了不同空气污染物暴露之间的相互作用，并根据叶酸摄入、年龄、体重指数（BMI）、初产情况和睡眠质量进行了分层分析。我们发现，产前暴露于 NO 和 SO 与 GDM 在孕中期的发生存在显著关联：与最低四分位数相比，最大四分位数 SO 暴露对 GDM 的影响最大（比值比（OR）：1.77，95%置信区间（CI）：1.23-2.56）。我们观察到年龄、BMI、初产情况、睡眠质量和空气污染暴露之间存在显著的相互作用；分层分析显示，在年龄较大、BMI 较大、睡眠质量较差和初产情况较多的孕妇中，空气污染暴露与 GDM 之间存在更强的关联。我们发现，在我国东北地区的一项前瞻性出生队列研究中，孕中期的空气污染暴露与 GDM 显著相关。SO、氮氧化物（NOX、NO、NO）、CO 和 O 对 GDM 均显示出线性趋势效应。产前空气污染暴露与其他因素（如孕期年龄、孕前 BMI、初产情况、叶酸摄入和睡眠质量）之间可能存在相互作用。
