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The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis

  • Systematic Review and Meta-analysis
  • Published:
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Abstract

Purpose

Air pollution is an environmental stimulus that may predispose pregnant women to gestational diabetes mellitus (GDM). This systematic review and meta-analysis were conducted to investigate the relationship between air pollutants and GDM.

Methods

PubMed, Web of Science, and Scopus were systematically searched for retrieving English articles published from January 2020 to September 2021, investigating the relationship of exposure to ambient air pollution or levels of air pollutants with GDM and related parameters, including fasting plasma glucose (FPG), insulin resistance, and impaired glucose tolerance. Heterogeneity and publication bias were evaluated using I-squared (I2), and Begg’s statistics, respectively. We also performed the subgroup analysis for particulate matters (PM2.5, PM10), Ozone (O3), and sulfur dioxide (SO2) in the different exposure periods.

Results

A total of 13 studies examining 2,826,544 patients were included in this meta-analysis. Compared to non-exposed women, exposure to PM2.5 increases the odds (likelihood of occurrence outcome) of GDM by 1.09 times (95% CI 1.06, 1.12), whereas exposure to PM10 has more effect by OR of 1.17 (95% CI 1.04, 1.32). Exposure to O3 and SO2 increases the odds of GDM by 1.10 times (95% CI 1.03, 1.18) and 1.10 times (95% CI 1.01, 1.19), respectively.

Conclusions

The results of the study show a relationship between air pollutants PM2.5, PM10, O3, and SO2 and the risk of GDM. Although evidence from various studies can provide insights into the linkage between maternal exposure to air pollution and GDM, more well-designed longitudinal studies are recommended for precise interpretation of the association between GDM and air pollution by adjusting all potential confounders.

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Data availability

All data relevant to the study are included in the article or uploaded as supplementary information.

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Acknowledgements

The authors would like to thank all authors of the primary studies included in this review. They also acknowledge Niusha Bakhtyari for designing the graphic abstract.

Funding

No funding was received to conduct this research.

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Authors and Affiliations

  1. Reproductive Endocrinology Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, 24 Parvaneh, Yaman Street, Velenjak, P.O. Box: 19395-4763, Tehran, 1985717413, Islamic Republic of Iran

    S. Nazarpour, F. Ramezani Tehrani & M. Amiri

  2. Department of Epidemiology, School of Public Health, Iran University of Medical Sciences, Tehran, Iran

    R. Valizadeh

  3. Department of Midwifery, Varamin-Pishva Branch, Islamic Azad University, Tehran, Iran

    S. Nazarpour

  4. Minimally Invasive Surgery Research Center, Hazrat-e Rasool General Hospital, Iran University of Medical Sciences, Tehran, Iran

    R. Valizadeh

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  1. S. Nazarpour
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  4. M. Amiri
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Contributions

Research idea and study design: SN and FRT; data acquisition: SN; data analysis/interpretation: SN, MA and RV; statistical analysis: RV; supervision: FRT; Writing—original draft, SN, MA; Writing—review and editing, FRT, RV had equal contribution with corresponding author. All authors have read and approved the final version for submission.

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Correspondence to F. Ramezani Tehrani or R. Valizadeh.

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The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Ethical approval

The study was approved by the ethical committee of the School of Pharmacy and Nursing & Midwifery- Shahid Beheshti University of Medical Sciences (approval ID: IR.SBMU.ENDOCRINE.REC.1401.005).

Research involving human participants and/or animals

All procedures performed in the study involved human participants in accordance with the ethical standards of the Institutional and National Research Committee. This article does not contain any animal studies conducted by any of the authors.

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Nazarpour, S., Ramezani Tehrani, F., Valizadeh, R. et al. The relationship between air pollutants and gestational diabetes: an updated systematic review and meta-analysis. J Endocrinol Invest 46, 1317–1332 (2023). https://doi.org/10.1007/s40618-023-02037-z

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