Prohypertensive effect of gestational personal exposure to fine particulate matter. Prospective cohort study in non-smoking and non-obese pregnant women.
Exposure to fine particulate matter (PM) is a recognized risk factor for elevated blood pressure (BP) and cardiovascular disease in adults, and this prospective cohort study was undertaken to evaluate whether gestational exposure to PM(2.5) has a prohypertensive effect. We measured personal exposure to fine particulate matter (PM(2.5)) by personal air monitoring in the second trimester of pregnancy among 431 women, and BP values in the third trimester were obtained from medical records of prenatal care clinics. In the general estimating equation model, the effect of PM(2.5) on BP was adjusted for relevant covariates such as maternal age, education, parity, gestational weight gain (GWG), prepregnancy BMI, environmental tobacco smoke (ETS), and blood lead level. Systolic blood pressure (SBP) increased in a linear fashion across a dosage of PM(2.5) and on average augmented by 6.1 mm Hg (95% CI, 0.6-11.6) with log unit of PM(2.5) concentration. Effects of age, maternal education, prepregnancy BMI, blood lead level, and ETS were insignificant. Women with excessive gestational weight gain (>18 kg) had higher mean SBP parameters by 5.5 mmHg (95% CI, 2.7-8.3). In contrast, multiparous women had significantly lower SBP values (coeff. = -4.2 mm Hg; 95% CI, -6.8 to -1.6). Similar analysis performed for diastolic blood pressure (DBP) has demonstrated that PM(2.5) also affected DBP parameters (coeff. = 4.1; 95% CI, -0.02 to 8.2), but at the border significance level. DBP values were positively associated with the excessive GWG (coeff. = 2.3; 95% CI, 0.3-4.4) but were inversely related to parity (coeff. = -2.7; 95% CI, -4.6 to -0.73). In the observed cohort, the exposure to fine particulate matter during pregnancy was associated with increased maternal blood pressure.
Epidemiology and Preventive Medicine, Jagiellonian University Medical College, 7, Kopernika Street, Krakòw, Poland. myjedryc@cyf-kr.edu.pl
Wieslaw A
WA
Jedrychowski
Frederica P
FP
Perera
Umberto
U
Maugeri
John
J
Spengler
Elzbieta
E
Mroz
Elzbieta
E
Flak
Laura
L
Stigter
Renata
R
Majewska
Irena
I
Kaim
Agata
A
Sowa
Ryszard
R
Jacek
D000293:Adolescent; D000328:Adult; D000393:Air Pollutants / Q000009:adverse effects* / Q000032:analysis; D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D001823:Body Composition; D003367:Cotinine / Q000097:blood; D005260:Female; D005865:Gestational Age; D006801:Humans; D046110:Hypertension, Pregnancy-Induced / Q000097:blood / Q000139:chemically induced* / Q000503:physiopathology; D007854:Lead / Q000097:blood; D018811:Maternal Exposure / Q000009:adverse effects*; D009765:Obesity / Q000503:physiopathology*; D052638:Particulate Matter / Q000009:adverse effects* / Q000032:analysis; D011247:Pregnancy; D011446:Prospective Studies; D012907:Smoking / Q000503:physiopathology*; D015430:Weight Gain; D055815:Young Adult
D000393:Air Pollutants; D052638:Particulate Matter; D007854:Lead; D003367:Cotinine