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Int. J. Environ. Res. Public Health 2017, 14(12), 1604; https://doi.org/10.3390/ijerph14121604

Maternal Exposure to Air Pollutants and Risk of Gestational Diabetes Mellitus in Taiwan

1
Department of Intensive Care Medicine, Chi Mei Medical Center, Yong-Kang District, Tainan City, Taiwan
2
Department of Public Health, College of Medicine, National Cheng Kung University, Tainan City, Taiwan
3
Department of Dentistry, An Nan Hospital, China Medical University, Tainan City, Taiwan
4
Department of Public Health, College of Public Health, China Medical University, Taichung City, Taiwan
These authors contributed equally to this work.
*
Authors to whom correspondence should be addressed.
Received: 22 October 2017 / Revised: 26 November 2017 / Accepted: 15 December 2017 / Published: 20 December 2017
(This article belongs to the Section Environmental Health)
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Abstract

Mounting evidence has shown an increased risk of gestational diabetes mellitus (GDM) in association with elevated exposure to air pollution. However, limited evidence is available concerning the effect of specific air pollutant(s) on GDM incidence. We conducted this case-control study on 6717 mothers with GDM diagnosed in 2006–2013 and 6717 age- and year of delivery-matched controls to further address the risk of GDM in relation to specific air pollutant. Both cases and controls were selected from a cohort of 1-million beneficiaries of Taiwan’s National Health Insurance program registered in 2005. Maternal exposures to mean daily air pollutant concentration, derived from 76 fixed air quality monitoring stations within the 12-week period prior to pregnancy and during the 1st and 2nd trimesters, were assessed by the spatial analyst method (i.e., ordinary kriging) with the ArcGIS software. After controlling for potential confounders and other air pollutants, an increase in pre-pregnancy exposure of 1 inter-quartile range (IQR) for PM2.5 and SO2 was found to associate with a significantly elevated odds ratio (OR) of GDM at 1.10 (95% confidence interval (CI) 1.03–1.18 and 1.37 (95% CI 1.30–1.45), respectively. Exposures to PM2.5 and SO2 during the 1st and 2nd trimesters were also associated with significantly increased ORs, which were 1.09 (95% CI 1.02–1.17) and 1.07 (95% CI 1.01–1.14) for PM2.5, and 1.37 (95% CI 1.30–1.45) and 1.38 (95% CI 1.31–1.46) for SO2. It was concluded that higher pre- and post-pregnancy exposures to PM2.5 and SO2 for mothers were associated with a significantly but modestly elevated risk of GDM. View Full-Text
Keywords: air pollution; gestational diabetes mellitus; nested case-control study; dose-response relationship air pollution; gestational diabetes mellitus; nested case-control study; dose-response relationship
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Shen, H.-N.; Hua, S.-Y.; Chiu, C.-T.; Li, C.-Y. Maternal Exposure to Air Pollutants and Risk of Gestational Diabetes Mellitus in Taiwan. Int. J. Environ. Res. Public Health 2017, 14, 1604.

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