First School of Clinical Medicine, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Department of Occupational Health and Environmental Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, 230032, Anhui, China.
Environ Sci Pollut Res Int. 2022 Sep;29(45):68615-68635. doi: 10.1007/s11356-022-20594-3. Epub 2022 May 11.
Numerous studies have evaluated the association between air pollution and gestational diabetes mellitus (GDM), but the findings were inconsistent. This meta-analysis aimed to provide higher grade evidence on the association of air pollution with GDM based on previous studies. PubMed, Web of science, China National Knowledge Infrastructure (CNKI), and Wanfang Data Knowledge Service Platform (Wanfang) were searched comprehensively up to September 2021. Totally, 20 eligible cohort studies were finally included, for which the pooled RR and 95% CIs were estimated. Stratified analyses by study regions and units of pollutant increase were conducted for further investigation. Sensitivity analyses were also performed to assess the robustness. The finding showed that PM, PM, NO, and SO exposure increased the risk of GDM, while O exposure reduced GDM risk. Specifically, PM exposure in the first and second trimesters, NO and SO exposure in the first trimester significantly increased the risk of GDM, with the RR ranging from 1.015 to 1.032. In addition, the elevation of GDM risk induced by PM, PM, and O exposure was more pronounced in Asian subjects than in American subjects. The meta-analysis provides high-quality evidence on the effect of maternal air pollution exposure on GDM in each exposure period.
大量研究评估了空气污染与妊娠糖尿病（GDM）之间的关联，但结果不一致。本荟萃分析旨在基于以往研究为空气污染与 GDM 之间的关联提供更高质量的证据。全面检索了 PubMed、Web of science、中国知网（CNKI）和万方数据知识服务平台（Wanfang），截至 2021 年 9 月。最终共纳入 20 项符合条件的队列研究，估计了汇总 RR 和 95%CI。进一步进行了按研究区域和污染物增量单位的分层分析。还进行了敏感性分析以评估稳健性。结果表明，PM、PM、NO 和 SO 暴露增加了 GDM 的风险，而 O 暴露降低了 GDM 的风险。具体而言，第一和第二孕期 PM 暴露、第一孕期 NO 和 SO 暴露显著增加了 GDM 的风险，RR 范围为 1.015 至 1.032。此外，PM、PM 和 O 暴露引起的 GDM 风险增加在亚洲人群中比在美国人群中更为明显。荟萃分析为每个暴露期内母体空气污染暴露对 GDM 的影响提供了高质量的证据。
