title: Air pollution exposure and gestational diabetes mellitus among pregnant women in Massachusetts: a cohort study.
abstract: BACKGROUND
  Rodent and human studies suggest an association between air pollution exposure and type 2 diabetes mellitus, but the extent to which air pollution is associated with gestational diabetes mellitus (GDM) is less clear.
  
  
  METHODS
  We used the Massachusetts Registry of Vital Records to study primiparous women pregnant from 2003-2008 without pre-existing diabetes. We used satellite-based spatiotemporal models to estimate first and second trimester residential particulate (PM2.5) exposure and geographic information systems to estimate neighborhood traffic density. We obtained GDM status from birth records. We performed logistic regression analyses adjusted for sociodemographics on the full cohort and after stratification by maternal age and smoking habits.
  
  
  RESULTS
  Of 159,373 women, 5,381 (3.4 %) developed GDM. Residential PM2.5 exposure ranged 1.3-19.3 μg/m(3) over the second trimester. None of the exposures were associated with GDM in the full cohort [e.g. OR 0.99 (95 % CI: 0.95, 1.03) for each interquartile range (IQR) increment in second trimester PM2.5]. There were also no consistent associations after stratification by smoking habits. When the cohort was stratified by maternal age, women less than 20 years had 1.36 higher odds of GDM (95 % CI: 1.08, 1.70) for each IQR increment in second trimester PM2.5 exposure.
  
  
  CONCLUSIONS
  Although we found no evidence of an association between air pollution exposure and GDM among all women in our study, greater exposure to PM2.5 during the second trimester was associated with GDM in the youngest age stratum.
authors.affiliation: Division of Endocrinology, Boston Children's Hospital, 300 Longwood Ave., Boston, MA, 02115, USA. abby.fleisch@childrens.harvard.edu.
authors.forename: Abby F
authors.initials: AF
authors.lastname: Fleisch
authors.affiliation: Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel.
authors.forename: Itai
authors.initials: I
authors.lastname: Kloog
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Heike
authors.initials: H
authors.lastname: Luttmann-Gibson
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.|Channing Laboratory, Brigham and Women's Hospital, Boston, MA, USA.
authors.forename: Diane R
authors.initials: DR
authors.lastname: Gold
authors.affiliation: Obesity Prevention Program, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA.|Department of Nutrition, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Oken
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Schwartz
mesh_terms: D000328:Adult; D000367:Age Factors; D000393:Air Pollutants / Q000009:adverse effects / Q000032:analysis; D000397:Air Pollution / Q000009:adverse effects* / Q000032:analysis; D015331:Cohort Studies; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008404:Massachusetts / Q000453:epidemiology; D018811:Maternal Exposure / Q000009:adverse effects*; D052638:Particulate Matter / Q000009:adverse effects / Q000032:analysis; D011247:Pregnancy; D011262:Pregnancy Trimester, Second; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D052638:Particulate Matter