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Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study
BACKGROUND: Particulate matter (PM) is detrimental to the respiratory and circulatory systems. However, no study has evaluated the lag effects of weekly exposure to fine PM during the period from preconception to delivery on the risk of hypertensive disorders of pregnancy (HDPs). OBJECTIVE: We set o...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903185/ https://www.ncbi.nlm.nih.gov/pubmed/36689262 http://dx.doi.org/10.2196/41442 |
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author | Yuan, Zhichao Wang, Hai-Jun Li, Qin Su, Tao Yang, Jie Chen, Junjun Peng, Yuanzhou Zhou, Shuang Bao, Heling Luo, Shusheng Wang, Hui Liu, Jue Han, Na Guo, Yuming Ji, Yuelong |
author_facet | Yuan, Zhichao Wang, Hai-Jun Li, Qin Su, Tao Yang, Jie Chen, Junjun Peng, Yuanzhou Zhou, Shuang Bao, Heling Luo, Shusheng Wang, Hui Liu, Jue Han, Na Guo, Yuming Ji, Yuelong |
author_sort | Yuan, Zhichao |
collection | PubMed |
description | BACKGROUND: Particulate matter (PM) is detrimental to the respiratory and circulatory systems. However, no study has evaluated the lag effects of weekly exposure to fine PM during the period from preconception to delivery on the risk of hypertensive disorders of pregnancy (HDPs). OBJECTIVE: We set out to investigate the lag effect windows of PM on the risk of HDPs on a weekly scale. METHODS: Data from women with de novo HDPs and normotensive pregnant women who were part of the Peking University Retrospective Birth Cohort, based on the hospital information system of Tongzhou district, were obtained for this study. Meteorological data and data on exposure to fine PM were predicted by satellite remote sensing data based on maternal residential address. The de novo HDP group consisted of pregnant women who were diagnosed with gestational hypertension or preeclampsia. Fine PM was defined as PM(2.5) and PM(1). The gestational stage of participants was from preconception (starting 12 weeks before gestation) to delivery (before the 42nd gestational week). A distributed-lag nonlinear model (DLNM) was nested in a Cox regression model to evaluate the lag effects of weekly PM exposure on de novo HDP hazard by controlling the nonlinear relationship of exposure–reaction. Stratified analyses by employment status (employed or unemployed), education level (higher or lower), and parity (primiparity or multiparity) were performed. RESULTS: A total of 22,570 pregnant women (mean age 29.1 years) for whom data were available between 2013 and 2017 were included in this study. The prevalence of de novo HDPs was 6.7% (1520/22,570). Our findings showed that PM(1) and PM(2.5) were significantly associated with an elevated hazard of HDPs. Exposure to PM(1) during the 5th week before gestation to the 6th gestational week increased the hazard of HDPs. A significant lag effect of PM(2.5) was observed from the 1st week before gestation to the 6th gestational week. The strongest lag effects of PM(1) and PM(2.5) on de novo HDPs were observed at week 2 and week 6 (hazard ratio [HR] 1.024, 95% CI 1.007-1.042; HR 1.007, 95% CI 1.000-1.015, respectively, per 10 μg/m(3) increase). The stratified analyses indicated that pregnant women who were employed, had low education, and were primiparous were more vulnerable to PM exposure for de novo HDPs. CONCLUSIONS: Exposure to PM(1) and PM(2.5) was associated with the risk of de novo HDPs. There were significant lag windows between the preconception period and the first trimester. Women who were employed, had low education, and were primiparous were more vulnerable to the effects of PM exposure; more attention should be paid to these groups for early prevention of de novo HDPs. |
format | Online Article Text |
id | pubmed-9903185 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-99031852023-02-08 Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study Yuan, Zhichao Wang, Hai-Jun Li, Qin Su, Tao Yang, Jie Chen, Junjun Peng, Yuanzhou Zhou, Shuang Bao, Heling Luo, Shusheng Wang, Hui Liu, Jue Han, Na Guo, Yuming Ji, Yuelong JMIR Public Health Surveill Original Paper BACKGROUND: Particulate matter (PM) is detrimental to the respiratory and circulatory systems. However, no study has evaluated the lag effects of weekly exposure to fine PM during the period from preconception to delivery on the risk of hypertensive disorders of pregnancy (HDPs). OBJECTIVE: We set out to investigate the lag effect windows of PM on the risk of HDPs on a weekly scale. METHODS: Data from women with de novo HDPs and normotensive pregnant women who were part of the Peking University Retrospective Birth Cohort, based on the hospital information system of Tongzhou district, were obtained for this study. Meteorological data and data on exposure to fine PM were predicted by satellite remote sensing data based on maternal residential address. The de novo HDP group consisted of pregnant women who were diagnosed with gestational hypertension or preeclampsia. Fine PM was defined as PM(2.5) and PM(1). The gestational stage of participants was from preconception (starting 12 weeks before gestation) to delivery (before the 42nd gestational week). A distributed-lag nonlinear model (DLNM) was nested in a Cox regression model to evaluate the lag effects of weekly PM exposure on de novo HDP hazard by controlling the nonlinear relationship of exposure–reaction. Stratified analyses by employment status (employed or unemployed), education level (higher or lower), and parity (primiparity or multiparity) were performed. RESULTS: A total of 22,570 pregnant women (mean age 29.1 years) for whom data were available between 2013 and 2017 were included in this study. The prevalence of de novo HDPs was 6.7% (1520/22,570). Our findings showed that PM(1) and PM(2.5) were significantly associated with an elevated hazard of HDPs. Exposure to PM(1) during the 5th week before gestation to the 6th gestational week increased the hazard of HDPs. A significant lag effect of PM(2.5) was observed from the 1st week before gestation to the 6th gestational week. The strongest lag effects of PM(1) and PM(2.5) on de novo HDPs were observed at week 2 and week 6 (hazard ratio [HR] 1.024, 95% CI 1.007-1.042; HR 1.007, 95% CI 1.000-1.015, respectively, per 10 μg/m(3) increase). The stratified analyses indicated that pregnant women who were employed, had low education, and were primiparous were more vulnerable to PM exposure for de novo HDPs. CONCLUSIONS: Exposure to PM(1) and PM(2.5) was associated with the risk of de novo HDPs. There were significant lag windows between the preconception period and the first trimester. Women who were employed, had low education, and were primiparous were more vulnerable to the effects of PM exposure; more attention should be paid to these groups for early prevention of de novo HDPs. JMIR Publications 2023-01-23 /pmc/articles/PMC9903185/ /pubmed/36689262 http://dx.doi.org/10.2196/41442 Text en ©Zhichao Yuan, Hai-Jun Wang, Qin Li, Tao Su, Jie Yang, Junjun Chen, Yuanzhou Peng, Shuang Zhou, Heling Bao, Shusheng Luo, Hui Wang, Jue Liu, Na Han, Yuming Guo, Yuelong Ji. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 23.01.2023. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Original Paper Yuan, Zhichao Wang, Hai-Jun Li, Qin Su, Tao Yang, Jie Chen, Junjun Peng, Yuanzhou Zhou, Shuang Bao, Heling Luo, Shusheng Wang, Hui Liu, Jue Han, Na Guo, Yuming Ji, Yuelong Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title | Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title_full | Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title_fullStr | Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title_full_unstemmed | Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title_short | Risk of De Novo Hypertensive Disorders of Pregnancy After Exposure to PM1 and PM2.5 During the Period From Preconception to Delivery: Birth Cohort Study |
title_sort | risk of de novo hypertensive disorders of pregnancy after exposure to pm1 and pm2.5 during the period from preconception to delivery: birth cohort study |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9903185/ https://www.ncbi.nlm.nih.gov/pubmed/36689262 http://dx.doi.org/10.2196/41442 |
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