Air pollution exposure and gestational diabetes mellitus among pregnant women in Massachusetts: A cohort study

Background: Rodent and human studies suggest an association between air pollution exposure and type 2 diabetes mellitus, but the extent to which air pollution is associated with gestational diabetes mellitus (GDM) is less clear. Methods: We used the Massachusetts Registry of Vital Records to study primiparous women pregnant from 2003-2008 without pre-existing diabetes. We used satellite-based spatiotemporal models to estimate first and second trimester residential particulate (PM_2.5) exposure and geographic information systems to estimate neighborhood traffic density. We obtained GDM status from birth records. We performed logistic regression analyses adjusted for sociodemographics on the full cohort and after stratification by maternal age and smoking habits. Results: Of 159,373 women, 5,381 (3.4 %) developed GDM. Residential PM_2.5 exposure ranged 1.3-19.3 μg/m³ over the second trimester. None of the exposures were associated with GDM in the full cohort [e.g. OR 0.99 (95 % CI: 0.95, 1.03) for each interquartile range (IQR) increment in second trimester PM_2.5]. There were also no consistent associations after stratification by smoking habits. When the cohort was stratified by maternal age, women less than 20 years had 1.36 higher odds of GDM (95 % CI: 1.08, 1.70) for each IQR increment in second trimester PM_2.5 exposure. Conclusions: Although we found no evidence of an association between air pollution exposure and GDM among all women in our study, greater exposure to PM_2.5 during the second trimester was associated with GDM in the youngest age stratum.