Association of Atmospheric Particulate Matter and Ozone with Gestational Diabetes Mellitus

Environ Health Perspect. 2015 Sep;123(9):853-9. doi: 10.1289/ehp.1408456. Epub 2015 Mar 20.


Background: Ambient air pollution has been linked to the development of gestational diabetes mellitus (GDM). However, evidence of the association is very limited, and no study has estimated the effects of ozone.

Objective: Our aim was to determine the association of prenatal exposures to particulate matter ≤ 2.5 μm (PM2.5) and ozone (O3) with GDM.

Methods: We used Florida birth vital statistics records to investigate the association between the risk of GDM and two air pollutants (PM2.5 and O3) among 410,267 women who gave birth in Florida between 2004 and 2005. Individual air pollution exposure was assessed at the woman's home address at time of delivery using the hierarchical Bayesian space-time statistical model. We further estimated associations between air pollution exposures during different trimesters and GDM.

Results: After controlling for nine covariates, we observed increased odds of GDM with per 5-μg/m3 increase in PM2.5 (ORTrimester1 = 1.16; 95% CI: 1.11, 1.21; ORTrimester2 = 1.15; 95% CI: 1.10, 1.20; ORPregnancy = 1.20; 95% CI: 1.13, 1.26) and per 5-ppb increase in O3 (ORTrimester1 = 1.09; 95% CI: 1.07, 1.11; ORTrimester2 = 1.12; 95% CI: 1.10, 1.14; ORPregnancy = 1.18; 95% CI: 1.15, 1.21) during both the first trimester and second trimester as well as the full pregnancy in single-pollutant models. Compared with the single-pollutant model, the ORs for O3 were almost identical in the co-pollutant model. However, the ORs for PM2.5 during the first trimester and the full pregnancy were attenuated, and no association was observed for PM2.5 during the second trimester in the co-pollutant model (OR = 1.02; 95% CI: 0.98, 1.07).

Conclusion: This population-based study suggests that exposure to air pollution during pregnancy is associated with increased risk of GDM in Florida, USA.

Citation: Hu H, Ha S, Henderson BH, Warner TD, Roth J, Kan H, Xu X. 2015. Association of atmospheric particulate matter and ozone with gestational diabetes mellitus. Environ Health Perspect 123:853-859;

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Adult
  • Air Pollution / adverse effects*
  • Bayes Theorem
  • Diabetes, Gestational / chemically induced
  • Diabetes, Gestational / epidemiology*
  • Female
  • Florida / epidemiology
  • Humans
  • Ozone / adverse effects*
  • Particulate Matter / toxicity*
  • Pregnancy
  • Pregnancy Trimester, First
  • Pregnancy Trimester, Second
  • Retrospective Studies
  • Young Adult


  • Particulate Matter
  • Ozone