Air pollution tied to high blood pressure in pregnancy

Pregnant women who live in neighborhoods with lots of air pollution may be slightly more likely to develop high blood pressure, a new study says.

Past research suggests people with high blood pressure have often been exposed to more air pollution in the past than those with normal blood pressure. But few studies have looked to see whether that’s the case for pregnant women.

Women develop high blood pressure during about one in ten pregnancies. Having so-called gestational hypertension makes it more likely that a woman will need a cesarean section, that she will give birth early and that her baby will be born small.

“Our results suggest air pollution does have some impact on the risk of gestational hypertension,” said epidemiologist Dr. Xiaohui Xu. He led the study at the University of Florida in Gainesville.

“This could have some subsequent effects on both maternal and fetal health,” Xu told Reuters Health.

However, he said, “This was a pilot study, meaning it was meant to test for any potential impact of pollution on blood pressure.” Researchers said the results still leave many questions unanswered.

Air pollution tied to high blood pressure in preGnancy Xu and his colleagues used data on about 22,000 women who gave birth in Jacksonville, Florida, in 2004 and 2005. Birth records showed just over 1,000 women - close to five percent - developed high blood pressure during pregnancy.

The researchers linked each woman’s home address to data from the nearest U.S. Environmental Protection Agency air quality monitor. Monitors record how much nitrogen dioxide, carbon monoxide and other pollutants are in the air each day.

Women who lived near monitors that recorded high levels of four pollutants, including nitrogen dioxide and fine particle pollution, throughout pregnancy had 12 percent to 24 percent higher odds of getting hypertension than women with less exposure.

The patterns were similar when the researchers looked only at exposure to air pollution during the first trimester or second trimester, they reported in the Journal of Epidemiology and Community Health.

Air pollution tied to high blood pressure in preGnancy “The study is provocative without being definitive in any way,” said Dr. Jodi Abbott, an associate professor of maternal-fetal medicine at the Boston University School of Medicine.

Abbott, who was not involved in the research, said it had some key limitations. For example, some factors that affect a woman’s risk of getting high blood pressure, such as her weight, were not taken into account.

In addition, the study did not look at whether any women moved to a different neighborhood while pregnant or spent most of their time away from home, where pollution was measured.

For those reasons, Abbott told Reuters Health, more research is needed to determine whether there are any blood pressure-related benefits to moving to an area with less pollution, or to staying indoors on high-pollution days while pregnant.

“I would not make any recommendations to my patients based on this research,” she said.

The author is a student at the Boston University School of Medicine, and Abbott is a former professor of hers.

SOURCE: Journal of Epidemiology and Community Health, online September 10, 2013


Ambient air pollution and hypertensive disorder of pregnancy

Background Ambient air pollution has been implicated in the development of hypertensive disorders of pregnancy (HDP). However, evidence of the association between air pollution and HDP is still limited, and the effects of gaseous air pollutants on HDP and their time windows of exposure have not been well studied.

Methods We used the Florida birth registry data to investigate the associations between air pollutants (NO2, SO2, PM2.5, O3 and CO) and the risks of HDP in 22 041 pregnant women in Jacksonville, Florida, USA from 2004 to 2005. Further, we examined whether air pollution exposure during different time windows defined by trimesters and the entire pregnancy had different effects on HDP.

Results The single-pollutant logistic regression model showed that exposure to four pollutants during the full pregnancy period was significantly associated with prevalence of HDP after adjusting for covariates: NO2 (OR=1.21, 95% CI 1.09 to 1.35), PM2.5 (OR=1.24, 95% CI 1.08 to 1.43), SO2 (OR=1.13, 95% CI 1.01 to 1.25) and CO (OR=1.12, 95% CI 1.03 to 1.22) per IQR increase. Similar effects were observed when first trimester exposure to NO2, SO2 and CO, and second trimester exposures to PM2.5 were examined. Consistent results were confirmed in multiple-pollutant models.

Conclusions This study suggests that exposure to high levels of air pollution during early pregnancy and the full gestational period was associated with increased prevalence of HDP in Florida, USA.

  Xiaohui Xu1,
  Hui Hu1,
  Sandie Ha1,
  Jeffrey Roth2

  1Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, Gainesville, Florida, USA
  2Department of Pediatrics, College of Medicine, University of Florida, Gainesville, Florida, USA

  Correspondence to Dr Xiaohui Xu, Department of Epidemiology, College of Public Health and Health Professional and College of Medicine, University of Florida, PO Box 100231, Gainesville, FL 32610, USA; .(JavaScript must be enabled to view this email address)

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