Epidemiologic studies have reported inconsistent findings for the association between air pollution levels and blood pressure (BP), which has been studied mainly in elderly subjects. Short-term air pollution effects on BP have not been investigated in pregnant women, who may constitute a vulnerable population.
Between 2002 and 2006, 1500 pregnant women from a mother-child cohort study conducted in Nancy and Poitiers, France, underwent 11,220 repeated BP measurements (average, 7.5 measurements/woman). Nitrogen dioxide (NO2), particulate matter with an aerodynamic diameter below 10 μm (PM10), and meteorologic variables were measured on an hourly basis at permanent monitoring sites. We studied changes of BP in relation to short-term variations of air pollution and temperature with mixed models adjusted for meteorologic and personal characteristics.
A 10°C decrease in temperature led to an increase in systolic BP of 0.5% (95% confidence interval = 0.1% to 1.0%). Elevated NO2-levels 1 day, 5 days and averaged over 7 days before the BP measurement were associated with reduced systolic BP. The strongest decrease was observed for the 7-day NO2 average (−0.4% [−0.7% to −0.2%] change for an 11 μg/m3 increase in NO2). PM10 effects on systolic BP differed according to pregnancy trimester: PM10 concentration was associated with systolic BP increases during the first trimester and systolic BP decreases later in pregnancy.
We observed short-term associations of air pollution and of temperature with BP in pregnant women. Whether such changes in BP have clinical implications remains to be investigated.
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From the aHelmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Neuherberg, Germany; bInserm, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institut Albert Bonniot (U823), BP170, Grenoble, France; cGrenoble University, Institut Albert Bonniot, Grenoble, France; dINSERM, U1018, CESP Centre for research in Epidemiology and Population Health, Team “Epidemiology of obesity, diabetes and renal disease: lifelong approach” Villejuif, France; eUniversité Paris Sud 11, UMRS 1018, F-94807, Villejuif, France; and fINSERM Villejuif, France.
Submitted 16 November 2010; accepted 6 April 2011; posted 6 July 2011.
Supported by a grant from ANSES (French Agency for food, environment and occupation health safety, call EST-Environment Santé Travail, Eden-Air Plus project). The Eden cohort is funded by the Foundation for Medical Research (FRM), Inserm, IReSP, Nestlé, French Ministry of Health, National Research Agency (ANR), Univ. Paris-Sud, Institute of Health Monitoring (InVS), ANSES, MGEN, AFSSA. The team of Environmental Epidemiology (Inserm U823) is supported by an AVENIR grant from Inserm.
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Correspondence: Regina Hampel, Helmholtz Zentrum München, German Research Center for Environmental Health, Institute of Epidemiology II, Ingolstädter Landstr. 1, 85764 Neuherberg, Germany. E-mail: email@example.com.