1. Gestational PM2.5 exposure may increase the risk of small for gestational age through maternal blood pressure and hemoglobin: A mediation analysis based on a prospective cohort in China, 2014–2018.
- Author
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Zhu, Zhenghong, Hu, Huanqing, Benmarhnia, Tarik, Ren, Zhoupeng, Luo, Jiajun, Zhao, Wei, Chen, Sidi, Wu, Kaipu, Zhang, Xiaoxin, Wang, Liyun, Di, Jiangli, Huang, Cunrui, and Wang, Qiong
- Subjects
SMALL for gestational age ,HEMOGLOBINS ,MATERNAL age ,SECOND trimester of pregnancy ,PRENATAL care ,BLOOD pressure ,BLOOD pressure measurement - Abstract
Maternal gestational PM 2.5 exposure was associated with small for gestational age (SGA). Identifying potential mediating factors may help design preventive strategies to reduce this risk. This study aimed to explore the roles of maternal blood pressure and hemoglobin may play in the PM 2.5 exposure and SGA relationship among 117,162 births in 16 counties across China during 2014–2018. Daily PM 2.5 concentration was collected from China National Environmental Monitoring Center. According to maternal residency during pregnancy, the PM 2.5 exposure for each trimester and the whole pregnancy was assessed using an inverse-distance weighting approach. Repeated measurements of maternal blood pressure and hemoglobin during pregnancy were collected for each woman. We estimated the total effect of gestational PM 2.5 exposure on SGA, and further tested the mediation effects of maternal blood pressure and hemoglobin concentration during pregnancy. Of 117,162 included mother-infant pairs, 11,361 (9.7 %) were SGA. The odds ratios of SGA associated with PM 2.5 exposure (per 10 μg/m
3 increase) in the second trimester and the whole pregnancy were 1.023 (95 % CI: 1.009, 1.037) and 1.024 (1.001, 1.048), respectively. We identified the independent mediating effect of blood pressure and hemoglobin in the second and third trimesters, with the proportion of mediation ranging from 1.64 % to 5.78 % and 2.40 % to 8.70 %, respectively. When considering the mediators jointly, we found a stronger mediating effect with a proportion of mediation ranging from 3.93 % to 13.69 %. Increases in maternal blood pressure and hemoglobin in the second and third trimesters can independently and jointly mediate the effects of gestational PM 2.5 exposure on SGA. Monitoring and managing maternal blood pressure and hemoglobin during prenatal care may constitute a promising avenue to reducing SGA risk associated with gestational PM 2.5 exposure. • This is a prospective cohort study in 16 counties across China during 2014–2018. • PM 2.5 exposure in the second trimester and the whole pregnancy increased SGA risk. • Maternal blood pressure and hemoglobin mediated the PM 2.5 and SGA relationship. • Mediation proportion ranged from 3.93 % to 13.69 %. [ABSTRACT FROM AUTHOR]- Published
- 2022
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