Air pollution exposure during preconception and first trimester of pregnancy and gestational diabetes mellitus in a large pregnancy cohort, Hebei Province, China

Abstract

Objective: To explore the relationship between the exposure level of particulate matter 2.5 (PM2.5) and particulate matter 10 (PM10) in the air of pregnant women during preconception and first trimester of pregnancy and the risk of gestational diabetes mellitus (GDM).

Methods: The data of pregnant women delivered in 22 monitoring hospitals in Hebei Province from 2019 to 2021 were collected, and the daily air quality data of their cities were used to calculate the exposure levels of PM2.5 and PM10 in different pregnancy stages, and logistic regression model was used to analyze the impact of exposure levels of PM2.5 and PM10 on GDM during preconception and first trimester of pregnancy.

Results: 108,429 singleton live deliveries were included in the study, of which 12,967 (12.0%) women had a GDM diagnosis. The prevalence of GDM increased over the course of the study from 10.2% (2019) to 14.9% (2021). From 2019 to 2021, the average exposure of PM2.5 and PM10 was relatively 56.67 and 103.08μg/m3 during the period of preconception and first trimester of pregnancy in Hebei Province. Handan, Shijiazhuang, and Xingtai regions had the most severe exposure to PM2.5 and PM10, while Zhangjiakou, Chengde, and Qinhuangdao had significantly lower exposure levels than other regions. The GDM group had statistically higher exposure concentrations of PM2.5 and PM10 during the period of preconception, first trimester, preconception and first trimester (P<0.05). Multivariate logistic regression analysis showed that the risk of GDM increases by 4.5%, 6.0%, and 10.6% for every 10ug/m3 increase in the average exposure value of PM2.5 in preconception, first trimester, preconception and first trimester, and 1.7%, 2.1%, and 3.9% for PM10. Moreover, High exposure to PM2.5 in the first, second, and third months of preconception and first trimester is associated with the risk of GDM. And high exposure to PM10 in the first, second, and third months of first trimester and the first, and third months of preconception is associated with the risk of GDM.

Conclusion: Exposure to high concentrations of PM2.5 and PM10 during preconception and first trimester of pregnancy can significantly increase the risk of GDM. It is important to take precautions to prevent exposure to pollutants, reduce the risk of GDM, and improve maternal and fetal outcomes.

Keywords: Hebei; PM10; PM2.5; air pollution; gestational diabetes mellitus.