Association Between Atmospheric Fine Particle Exposure And Blood Pressure Changes In Pregnant Women During Pregnancy

Pregnancy is a critical period in the development of women and the fetus.The circulatory system of pregnant women undergoes physiological changes during pregnancy to adapt to this particular physiological period,ensuring that pregnant women and fetuses have adequate oxygen supply.Abnormal changes in blood pressure during pregnancy are associated with the occurrence of adverse health outcomes in pregnant women and neonates.Fine particulate matter(PM_2.5)refers to particulate matter with aerodynamic diameter?2.5?m.Due to its small particle size,PM_2.5.5 has a relatively large surface area,making it easier to enrich various toxic and hazardous substances such as heavy metals,chemicals,bacteria and viruses in the air.Atmospheric PM_2.5 pollution poses a serious threat to population health.According to a report published by Lancet on the latest Global Burden of Diseases Study,atmospheric PM_2.5 pollution is directly or indirectly global in 2015.This caused the death of 4.2 million people and a loss of 103.1million Disability-adjusted life-years DALYs.Because pregnant women are in a special physiological period,the health of mothers and fetuses is more susceptible to PM_2.5exposure.In recent years,more and more researchers have been concerned about the correlation between atmospheric PM_2.5.5 exposure and pregnancy-induced hypertension and gestational blood pressure changes,but the results of the current study are not consistent.However,there are few studies using longitudinal data to analyze the factors affecting the abnormal changes in blood pressure and the variance of PM_2.5 exposure.Therefore,more research is needed on the influencing factors of blood pressure changes during pregnancy.This study is based on a large prospective birth cohort,using longitudinal data of pregnancy blood pressure to explore the trends of pregnancy blood pressure with gestational age and related factors related to changes in blood pressure during pregnancy.At the same time,this study is based on the atmospheric PM_2.5 concentration data provided by Wuhan Environmental Monitoring Center to explore the relationship between exposure to atmospheric PM_2.5 during pregnancy and hypertensive disorders of pregnancy and blood pressure during pregnancy,in order to prevent and control the atmosphere during pregnancy.PM_2.5 exposure provides epidemiological evidence.Part 1:Analysis of factors influencing blood pressure changes during pregnancyObjectiveAnalysis of trends in blood pressure during pregnancy and factors associated with changes in blood pressure during pregnancy.To investigate whether there is a difference in blood pressure during pregnancy between pregnant hypertensive patients and normal pregnant womenMethodsThe study was conducted in a large prospective birth cohort study from Wuhan.This study collected basic information about pregnant women and husbands through questionnaires and electronic medical record systems and collected blood pressure of pregnant women at various time points throughout pregnancy.Measurements.According to the inclusion and exclusion criteria,2332 subjects were finalized,including a total of13699 gestational blood pressure measurements.In this study,a mixed model was used to construct a model of blood pressure during pregnancy,and the model with the best goodness of fit was selected.The model was used to analyze the influencing factors related to blood pressure changes during pregnancy.Finally,the model was used to analyze the difference in blood pressure during pregnancy between pregnant hypertensive patients and normal pregnant women.ResultsThe trend of blood pressure during pregnancy can be explained by the function of gestational blood pressure as a function of gestational age?pregnancy regression coefficient is between-1.62-0.93;P<0.05?.This study found a correlation between pre-pregnancy BMI,pregnancy,maternal age,parity and changes in maternal blood pressure during pregnancy?regression coefficient between-1.62-0.93;P<0.05?.The blood pressure level in pregnant women with hypertensive disorder complicating pregnancy is higher than that of normal pregnant women?regression coefficient is between 4.99-10.63;P<0.05?.The systolic blood pressure in pregnant women with hypertensive disorder is10mmHg higher than that of normal pregnant women,and the blood pressure during pregnancy There is a difference in the trend of change:compared with normal pregnant women,the blood pressure fluctuation range is higher in the second trimester of pregnancy,and the blood pressure rises faster in the third trimester;the blood pressure of the preeclampsia patients keeps rising during pregnancy.ConclusionsIn normal pregnant women,blood pressure during pregnancy increases first in the first trimester of pregnancy,and gradually rises to the lowest point in the second trimester,and gradually increases in the third trimester.Patients with hypertensive disorder complicating pregnancy have different trends in blood pressure,which are manifested in the absence of decreased blood pressure,increased volatility,and rapid rise in blood pressure during the third trimester.Pre-pregnancy BMI,pregnancy weight gain,pregnancy,mother's age and changes in blood pressure during pregnancy.Part 2:Effect of PM_2.5 exposure during pregnancy on blood pressure changes during pregnancyObjectiveTo explore the association between PM_2.5 during pregnancy and hypertensive disorders in pregnancy and blood pressure during pregnancy.MethodsUsing the data provided by the Wuhan Environmental Monitoring Center,this study used the land use regression model to assess the atmospheric PM_2.5 exposure concentration of each subject per day,and further calculated the PM_2.5 exposure of each subject during pregnancy.This part of the study used logistic regression to analyze the association between PM_2.5 exposure during pregnancy and hypertensive disorder complicating pregnancy.At the same time,in order to accurately describe the PM_2.5exposure of pregnant women throughout pregnancy.In this part of the study,the study population was clustered according to PM_2.5 exposure during pregnancy,and the PM_2.5exposure category in pregnancy was included in the first part of the pregnancy blood pressure change model,and the PM_2.5 exposure during pregnancy was analyzed.Correlation with changes in blood pressure during pregnancy.ResultsThis study did not find a correlation between the average PM_2.5 exposure during pregnancy and the prevalence of hypertensive disorder complicating pregnancy?OR1.0395%CI-1.53,3.44?and changes in blood pressure during pregnancy?systolic blood pressure?=-0.75?,95%CI:-8.12,6.63;diastolic blood pressure?=0.38,95%CI:-6.04,6.79).The results of cluster analysis showed that the whole study population could be divided into five categories according to the change of PM_2.5 exposure concentration during the whole pregnancy.Including the PM_2.5 exposure during pregnancy,the results showed that pregnant women in the first trimester of pregnancy were exposed to high concentrations of PM_2.5,and had higher levels of blood pressure?regression coefficient of control group-18.82;P<0.05?,and blood pressure It continued to rise throughout the pregnancy?regression coefficient of 2.32 with gestational age;P<0.05?.Pregnant women exposed to high concentrations of PM_2.5 in the third trimester had higher levels of systolic blood pressure?regression coefficient 11.85;P<0.05?,and blood pressure increased earlier and more rapidly in the third trimester of pregnancy?regression coefficient with gestational age interaction-Between 1.86-0.09;P<0.05?.In order to investigate whether the high-concentration exposure in the second trimester has an effect on blood pressure,this study compared pregnant women with high PM_2.5 exposure in the early and middle trimesters and only pregnant women with early exposure to PM_2.5 and found that pregnant women exposed to high concentrations,if they are exposed to high concentrations of PM_2.5 during the second trimester,the systolic blood pressure decreases?the regression coefficient with the gestational age is between 0.09-0;P<0.05?.ConclusionsThere was no association between the average exposure concentration of PM_2.5throughout pregnancy and the prevalence of hypertensive disorders during pregnancy and changes in blood pressure during pregnancy.PM_2.5 high concentration exposure has a“lifting”effect on blood pressure during pregnancy;if it is exposed to PM_2.5 high concentration during the second trimester,the blood pressure value will return to normal;high pregnancy in late pregnancy can make blood pressure earlier in pregnancy.Faster rise.