College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China; Department of Clinical Laboratory, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, Shanxi 030032, PR China; Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
College of Environment and Resource, Research Center of Environment and Health, Shanxi University, Taiyuan, Shanxi 030006, PR China.
Sci Total Environ. 2023 Jun 1;875:162515. doi: 10.1016/j.scitotenv.2023.162515. Epub 2023 Mar 1.
The effect of air pollution on human health has been a major concern, especially the association between air pollution and gestational diabetes mellitus (GDM).
In this study, we conducted a retrospective cohort study in Taiyuan, a typical energy production base in China. This study included 28,977 pairs of mothers and infants between January 2018 and December 2020. To screen for GDM, oral glucose tolerance test (OGTT) was performed in pregnant women at 24-28 weeks of gestation. Logistic regression was used to assess the trimester-specific association between 5 common air pollutants (PM, PM, NO, SO, and O) and GDM, and the weekly-based association was also assessed using distributed lag non-linear models (DLNMs). Odds ratios (ORs) with 95 % confidence intervals (CIs) were calculated for the association between GDM and each air pollutant.
The overall incidence of GDM was 3.29 %. PM was positively associated with GDM over the second trimester (OR [95 % CI], 1.105 [1.021, 1.196]). O was positively associated with GDM in the preconception period (OR [95 % CI], 1.125 [1.024, 1.236]), the first trimester (OR [95 % CI], 1.088 [1.019, 1.161]) and the 1st + 2nd trimester (OR [95 % CI], 1.643 [1.387, 1.945]). For the weekly-based association, PM was positively associated with GDM at 19-24 weeks of gestation, with the strongest association at week 24 (OR [95 % CI], 1.044 [1.021, 1.067]). PM was positively associated with GDM at 18-24 weeks of gestation, with the strongest association at week 24 (OR [95 % CI], 1.016 [1.003, 1.030]). O was positively associated with GDM during the 3rd week before conception to the 8th gestational week, with the strongest association at week 3 of gestation (OR [95 % CI], 1.054 [1.032, 1.077]).
The findings are important for the development of effective air quality policies and the optimization of preventive strategies for preconception and prenatal care.
空气污染对人类健康的影响一直是一个主要关注点，尤其是空气污染与妊娠糖尿病（GDM）之间的关联。
本研究在太原市进行了一项回顾性队列研究，太原市是中国典型的能源生产基地。这项研究纳入了 2018 年 1 月至 2020 年 12 月期间的 28977 对母婴。在妊娠 24-28 周时，对孕妇进行口服葡萄糖耐量试验（OGTT）以筛查 GDM。采用 logistic 回归评估 5 种常见空气污染物（PM、PM、NO、SO 和 O）与 GDM 的 trimester 特异性关联，并使用分布滞后非线性模型（DLNMs）评估每周关联。计算 GDM 与每种空气污染物之间关联的比值比（OR）及其 95%置信区间（CI）。
GDM 的总发生率为 3.29%。PM 在孕中期与 GDM 呈正相关（OR [95%CI]，1.105 [1.021, 1.196]）。O 与受孕前（OR [95%CI]，1.125 [1.024, 1.236]）、孕早期（OR [95%CI]，1.088 [1.019, 1.161]）和 1 期+2 期（OR [95%CI]，1.643 [1.387, 1.945]）与 GDM 呈正相关。对于每周关联，PM 与妊娠 19-24 周的 GDM 呈正相关，在妊娠 24 周时相关性最强（OR [95%CI]，1.044 [1.021, 1.067]）。PM 与妊娠 18-24 周的 GDM 呈正相关，在妊娠 24 周时相关性最强（OR [95%CI]，1.016 [1.003, 1.030]）。O 与受孕前 3 周到妊娠第 8 周与 GDM 呈正相关，在妊娠第 3 周时相关性最强（OR [95%CI]，1.054 [1.032, 1.077]）。
这些发现对于制定有效的空气质量政策和优化孕前及产前保健的预防策略具有重要意义。
