TY - JOUR

T1 - Ambient air pollution and pregnancy-induced hypertensive disorders

T2 - a systematic review and meta-analysis

AU - Pedersen, Marie

AU - Stayner, Leslie

AU - Slama, Rémy

AU - Sørensen, Mette

AU - Figueras, Francesc

AU - Nieuwenhuijsen, Mark J

AU - Raaschou-Nielsen, Ole

AU - Dadvand, Payam

N1 - © 2014 American Heart Association, Inc.

PY - 2014

Y1 - 2014

N2 - Pregnancy-induced hypertensive disorders can lead to maternal and perinatal morbidity and mortality, but the cause of these conditions is not well understood. We have systematically reviewed and performed a meta-analysis of epidemiological studies investigating the association between exposure to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December 2009 and December 2013. Combined risk estimates were calculated using random-effect models for each exposure that had been examined in ≥4 studies. Heterogeneity and publication bias were evaluated. A total of 17 articles evaluating the impact of nitrogen oxides (NO2, NOX), particulate matter (PM10, PM2.5), carbon monoxide (CO), ozone (O3), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Meta-analyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta-analysis combined odds ratio associated with a 5-μg/m3 increase in PM2.5 was 1.57 (95% confidence interval, 1.26-1.96) for combined pregnancy-induced hypertensive disorders and 1.31 (95%confidence interval, 1.14-1.50) for preeclampsia [corrected]. Our results suggest that exposure to air pollution increases the risk of pregnancy-induced hypertensive disorders.

AB - Pregnancy-induced hypertensive disorders can lead to maternal and perinatal morbidity and mortality, but the cause of these conditions is not well understood. We have systematically reviewed and performed a meta-analysis of epidemiological studies investigating the association between exposure to ambient air pollution and pregnancy-induced hypertensive disorders including gestational hypertension and preeclampsia. We searched electronic databases for English language studies reporting associations between ambient air pollution and pregnancy-induced hypertensive disorders published between December 2009 and December 2013. Combined risk estimates were calculated using random-effect models for each exposure that had been examined in ≥4 studies. Heterogeneity and publication bias were evaluated. A total of 17 articles evaluating the impact of nitrogen oxides (NO2, NOX), particulate matter (PM10, PM2.5), carbon monoxide (CO), ozone (O3), proximity to major roads, and traffic density met our inclusion criteria. Most studies reported that air pollution increased risk for pregnancy-induced hypertensive disorders. There was significant heterogeneity in meta-analysis, which included 16 studies reporting on gestational hypertension and preeclampsia as separate or combined outcomes; there was less heterogeneity in findings of the 10 studies reporting solely on preeclampsia. Meta-analyses showed increased risks of hypertensive disorders in pregnancy for all pollutants except CO. Random-effect meta-analysis combined odds ratio associated with a 5-μg/m3 increase in PM2.5 was 1.57 (95% confidence interval, 1.26-1.96) for combined pregnancy-induced hypertensive disorders and 1.31 (95%confidence interval, 1.14-1.50) for preeclampsia [corrected]. Our results suggest that exposure to air pollution increases the risk of pregnancy-induced hypertensive disorders.

KW - Adult

KW - Air Pollution/adverse effects

KW - Carbon Monoxide/adverse effects

KW - Female

KW - Humans

KW - Hypertension, Pregnancy-Induced/epidemiology

KW - Nitrogen Oxides/adverse effects

KW - Ozone/adverse effects

KW - Particulate Matter/adverse effects

KW - Pre-Eclampsia/epidemiology

KW - Pregnancy

KW - Risk Factors

U2 - 10.1161/HYPERTENSIONAHA.114.03545

DO - 10.1161/HYPERTENSIONAHA.114.03545

M3 - Review

C2 - 24935943

VL - 64

SP - 494

EP - 500

JO - Hypertension

JF - Hypertension

SN - 0194-911X

IS - 3

ER -