Department of Population and Public Health Sciences, Keck School of Medicine (Z.N., R.H, T.Y., X.C., M.V., C.M.T.-C., J.J., G.F.D., S.P.E., C.V.B., T.M.B., S.F.F.), University of Southern California, Los Angeles.
Department of Health Sciences, California State University, Northridge (K.B., C.M.T.-C.).
Hypertension. 2024 Jun;81(6):1285-1295. doi: 10.1161/HYPERTENSIONAHA.123.22272. Epub 2024 Mar 27.
Air pollution has been associated with gestational hypertension (GH) and preeclampsia, but susceptible windows of exposure and potential vulnerability by comorbidities, such as prenatal depression, remain unclear.
We ascertained GH and preeclampsia cases in a prospective pregnancy cohort in Los Angeles, CA. Daily levels of ambient particulate matters (with a diameter of ≤10 μm [PM] or ≤2.5 μm [PM]), nitrogen dioxide, and ozone were averaged for each week from 12 weeks preconception to 20 gestational weeks. We used distributed lag models to identify susceptible exposure windows, adjusting for potential confounders. Analyses were additionally stratified by probable prenatal depression to explore population vulnerability.
Among 619 participants, 60 developed preeclampsia and 42 developed GH. We identified a susceptible window for exposure to PM from 1 week preconception to 11 weeks postconception: higher exposure (5 µg/m) within this window was associated with an average of 8% (95% CI, 1%-15%) higher risk of GH. Among participants with probable prenatal depression (n=179; 32%), overlapping sensitive windows were observed for all pollutants from 8 weeks before to 10 weeks postconception with increased risk of GH (PM, 16% [95% CI, 3%-31%]; PM, 39% [95% CI, 13%-72%]; nitrogen dioxide, 65% [95% CI, 17%-134%]; and ozone, 45% [95% CI, 9%-93%]), while the associations were close to null among those without prenatal depression. Air pollutants were not associated with preeclampsia in any analyses.
We identified periconception through early pregnancy as a susceptible window of air pollution exposure with an increased risk of GH. Prenatal depression increases vulnerability to air pollution exposure and GH.
空气污染与妊娠高血压（GH）和子痫前期有关，但暴露的易感窗口和潜在的脆弱性，如产前抑郁等，仍不清楚。
我们在加利福尼亚州洛杉矶的一项前瞻性妊娠队列中确定了 GH 和子痫前期病例。从受孕前 12 周至妊娠 20 周，每周平均计算环境颗粒物（直径≤10μm[PM]或≤2.5μm[PM]）、二氧化氮和臭氧的日水平。我们使用分布式滞后模型来识别易感暴露窗口，并调整潜在的混杂因素。分析还按产前抑郁的可能性进行分层，以探索人群的脆弱性。
在 619 名参与者中，有 60 人发生子痫前期，42 人发生 GH。我们确定了受孕前 1 周至受孕后 11 周 PM 暴露的易感窗口：在此窗口内，较高的暴露（5μg/m）与 GH 风险增加 8%（95%CI，1%-15%）相关。在有产前抑郁可能的参与者中（n=179；32%），从受孕前 8 周到受孕后 10 周，所有污染物都观察到重叠的敏感窗口，与 GH 风险增加相关（PM，16%[95%CI，3%-31%]；PM，39%[95%CI，13%-72%]；二氧化氮，65%[95%CI，17%-134%]；臭氧，45%[95%CI，9%-93%]），而在没有产前抑郁的参与者中，相关性接近零。在任何分析中，空气污染物都与子痫前期无关。
我们确定了受孕前到孕早期是空气污染暴露增加 GH 风险的易感窗口。产前抑郁增加了对空气污染暴露和 GH 的脆弱性。
