Hypertensive disorders of pregnancy (HDP) are major causes of maternal death worldwide and the risk factors are not fully understood. Few studies have investigated the risk factors for HDP among ...Chinese women. A cohort study involving 84,656 women was conducted to investigate pre-pregnancy BMI, total gestational weight gain (GWG), and GWG during early pregnancy as risk factors for HDP among Chinese women.
The study was conducted between 2011-2013 in Wuhan, China, utilizing data from the Maternal and Children Healthcare Information Tracking System of Wuhan. A total of 84,656 women with a live singleton pregnancy were included. Multiple unconditional logistic regression was conducted to evaluate associations between putative risk factors and HDP.
Women who were overweight or obese before pregnancy had an elevated risk of developing HDP (overweight: OR = 2.66, 95% CI = 2.32-3.05; obese: OR = 5.53, 95% CI = 4.28-7.13) compared to their normal weight counterparts. Women with total GWG above the Institute of Medicine (IOM) recommendation had an adjusted OR of 1.72 (95% CI = 1.54-1.93) for HDP compared to women who had GWG within the IOM recommendation. Women with gestational BMI gain >10 kg/m2 during pregnancy had an adjusted OR of 3.35 (95% CI = 2.89-3.89) for HDP, compared to women with a gestational BMI gain <5 kg/m2. The increased risk of HDP was also observed among women with higher early pregnancy (up to 18 weeks of pregnancy) GWG (>600g/wk: adjusted OR = 1.48, 95% CI = 1.19-1.84).
The results from this study show that maternal pre-pregnancy BMI, early GWG, and total GWG are positively associated with the risk of HDP. Weight control efforts before and during pregnancy may help to reduce the risk of HDP.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Abstract Background The effects of green tea intake on risk of cardiovascular disease (CVD) have not been well-defined. The aim of this meta-analysis was to evaluate the association between green tea ...consumption, CVD, and ischemic related diseases. Methods All observational studies and randomized trials that were published through October 2014 and that examined the association between green tea consumption and risk of cardiovascular and ischemic related diseases as the primary outcome were included in this meta-analysis. The quality of the included studies was evaluated according to the Cochrane Handbook 5.0.2 quality evaluation criteria. Results A total of 9 studies including 259,267 individuals were included in the meta-analysis. The results showed that those who didn't consume green tea had higher risks of CVD (OR = 1.19, 95% CI: 1.09–1.29), intracerebral hemorrhage (OR = 1.24, 95% CI: 1.03–1.49), and cerebral infarction (OR = 1.15, 95% CI: 1.01–1.30) compared to < 1 cup green tea per day. Those who drank 1–3 cups of green tea per day had a reduced risk of myocardial infarction (OR = 0.81, 95% CI: 0.67–0.98) and stroke (OR = 0.64, 95% CI: 0.47–0.86) compared to those who drank < 1 cup/day. Similarly, those who drank ≥ 4 cups/day had a reduced risk of myocardial infarction compared to those who drank < 1 cup/day (OR = 0.68, 95% CI: 0.56–0.84). Those who consumed ≥ 10 cups/day of green tea were also shown to have lower LDL compared to the < 3 cups/day group (MD = − 0.90, 95% CI: − 0.95 to − 0.85). Conclusions Our meta-analysis provides evidence that consumption of green tea is associated with favorable outcomes with respect to risk of cardiovascular and ischemic related diseases.
Delayed fetal growth and adverse birth outcomes are some of the greatest public health threats to this generation of children worldwide because these conditions are major determinants of mortality, ...morbidity, and disability in infancy and childhood and are also associated with diseases in adult life. A number of studies have investigated the impacts of a range of environmental conditions during pregnancy (including air pollution, endocrine disruptors, persistent organic pollutants, heavy metals) on fetal and child development. The results, while provocative, have been largely inconsistent. This review summarizes up to date epidemiologic studies linking major environmental pollutants to fetal and child development and suggested future directions for further investigation.
Maternal exposure to ambient air pollution has increasingly been linked to congenital heart defects (CHDs). The objective of this study was to evaluate whether high levels of maternal exposure to ...PM2.5 and PM10 are related to increased risk of CHDs in Wuhan, China. We conducted a cohort study with a total of 105,988 live-born infants, stillbirths, and fetal deaths. The study included mothers living in the urban district of Wuhan during pregnancy over the 2-year period from 10 June 2011 to 9 June 2013. For each study participant, we assigned 1-month and 1-week averages of PM10 and PM2.5 exposure based on measurements obtained from the nearest exposure monitor to the living residence of mothers during their early pregnancy period. Logistic regression analyses were conducted to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association between exposure to these ambient air pollutants during early pregnancy and CHDs. We observed an increased risk of CHDs, particularly ventricular septal defect (VSD), with increasing PM2.5 exposure. Using 1-week averages, we also observed significant monotonically increasing associations between PM2.5 exposure during weeks 7-10 of pregnancy and risk of VSD, with aORs ranging from 1.11 to 1.17 (95% CI: 1.02-1.20, 1.03-1.22, 1.05-1.24, and 1.08-1.26 separately) per a 10 μg/m(3) change in PM2.5 concentration. Our study contributes to the small body of knowledge regarding the association between in utero exposure to air pollution and CHDs, but confirmation of these associations will be needed in future studies.
The deteriorating air quality in Chinese cities is attracting growing public concern. We conducted analyses to quantify the associations between daily changes in ambient air pollution and mortality ...in Nanjing, China. Daily mortality, air pollution, and meteorological data from 1 January 2009 to 31 December 2013 were collected. Over-dispersed Poisson regression models were used to evaluate the risk of daily non-accidental mortality and years of life lost (YLL) from exposure to respirable particulate matter (PM10) and gaseous pollutants (NO2, SO2). Stratified analysis was conducted to indentify the modifying effect of individual-level factors on the association between air pollutants and mortality. We found that interquartile range (IQR) increases in the two-day average of PM10, NO2 and SO2 were significantly associated with 1.6% 95% confidence interval (CI):0.7%-2.6%, 2.9% (95% CI: 1.7%-4.2%) and 2.4% (95% CI: 1.2%-3.6%) higher rates of non-accidental mortality; and related to YLL increases of 20.5 (95% CI: 6.3-34.8), 34.9 (95% CI: 16.9-52.9) and 30.3 (95% CI: 12.2-48.4) years, respectively; Associations between air pollution and mortality were more pronounced in the warm season than in the cool season. We conclude that the risks of mortality and YLL were elevated corresponding to an increase in current ambient concentrations of the air pollutants, and season may modify the effects of outdoor air pollution in Nanjing.
With the exception of lung cancer, the health effects associated with diesel exhaust for other cancers and nonmalignant health outcomes are not well understood.
We extended the mortality follow-up of ...the Diesel Exhaust in Miners Study, a cohort study of 12,315 workers, by 18 y (ending 31 December 2015), more than doubling the number of observed deaths to
, to evaluate associations between mortality and diesel exhaust exposure.
Quantitative estimates of historical exposure to respirable elemental carbon (REC), a surrogate for diesel exhaust, were created for all jobs, by year and facility, using measurements collected from each mine, as well as historical measurements. Standardized mortality ratios (SMRs) and hazard ratios (HRs) were estimated for the entire cohort and by worker location (surface, underground).
We observed an excess of death for cancers of the lung, trachea, and bronchus (
;
; 95% CI: 1.13, 1.37). Among workers who ever worked underground, where the majority of diesel exposure occurred, excess deaths were evident for lung, trachea, and bronchus cancers (
;
; 95% CI: 1.11, 1.42). Several nonmalignant diseases were associated with excess mortality among workers ever-employed underground, including ischemic heart disease (
; 95% CI: 1.00, 1.16), cerebrovascular disease (
; 95% CI: 1.04, 1.43), and nonmalignant diseases of the respiratory system (
; 95% CI: 1.01, 1.26). Continuous 15-y lagged cumulative REC exposure
was associated with increased lung cancer risk (
; 95% CI: 1.24, 3.03), but the risk declined at the highest exposures (
; 95% CI: 0.74, 2.26). We also observed a significant trend in non-Hodgkin lymphoma (NHL) risk with increasing 20-y lagged cumulative REC (
; 95% CI: 1.00, 9.79;
).
Increased risks of lung cancer mortality observed in the original study were sustained. Observed associations between diesel exposure and risk of death from NHL and the excesses in deaths for diseases of the respiratory and cardiovascular system, including ischemic heart disease and cerebrovascular disease, warrant further study and provide evidence of the potential widespread public health impact of diesel exposure. https://doi.org/10.1289/EHP12840.
Celotno besedilo
Dostopno za:
CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
•Traffic-related air pollution (TRAP) is a complex mixture that includes carcinogens.•Commuting is a major source of TRAP exposure for millions of people worldwide.•Public transportation users have ...higher lung cancer risk vs. automobile users.•Our findings may inform policies pertaining to urban planning and development.
Commuting exposes millions of people to carcinogens from traffic-related air pollution (TRAP) but is seldomly considered in epidemiologic studies of lung cancer. In the prospective United Kingdom (UK) Biobank cohort study, we investigated associations between commute patterns, residential nitrogen dioxide concentrations (NO2; a surrogate for TRAP), and lung cancer risk.
We analyzed 234,124 employed participants at baseline (2006–2010). There were 493 incident lung cancer cases diagnosed over an average 7-year follow-up. Subjects were cross-classified into exclusive categories of commute mode (automobile, public transportation, walking, cycling, active mixture, and other mixture) and frequency (regular: 1–4, often: ≥5 work-bound trips/week). Annual average residential NO2 concentrations in 2005–2007 were estimated with land use regression. Multivariable Cox regression was used to estimate associations between commute patterns, NO2 quartiles, and incident lung cancer. We conducted analyses stratified by NO2 (>, ≤median = 28.3 µg/m3) and potential confounders such as sex and smoking.
Compared to regular automobile use, commuting often by public transportation was associated with increased lung cancer risk (hazard ratio (HR) = 1.58, 95% confidence intervals (CI):1.08–2.33). Additionally, we found a positive exposure–response relationship with residential NO2 (HRQ2 = 1.21, 95 %CI: 0.90–1.62; HRQ3 = 1.48, 95 %CI: 1.10–1.99; HRQ4 = 1.58, 95 %CI: 1.13–2.23; p-trend = 3.1 × 10−3).
The public transportation association was observed among those with higher NO2 (p-interaction = 0.02). Other commute categories were not associated with risk.
Commuters residing in high-NO2 areas who often use public transportation could have elevated lung cancer risk compared to regular automobile users. These results warrant investigations into which component(s) of public transportation contribute to the observed association with increased lung cancer risk.
•In utero exposure to organochlorine pesticides was shown to affect fetal growth.•Serum levels of 18 major OCPs were measured in 81 mother–infant pairs.•p,p′-DDE, β-BHC, and HCB were the main OCPs in ...maternal and cord serum in China.•Cord serum p,p′-DDE, β-BHC, and HCB were associated with decreased birth weight.
In utero exposure to organochlorine pesticides (OCPs) is thought to be potentially harmful to fetal development. We aimed to investigate the associations of maternal and cord serum OCPs levels with infant birth weight in China. In this study, we measured serum levels of 18 OCPs in 81 mother–infant pairs, including DDT, hexachlorocyclohexanes (BHC), hexachlorobenzene (HCB), heptachlors, chlordanes, endosulfan-I, and mirex using a high-resolution-gas-chromatography with high-resolution-mass-spectrometry method. We found that p,p′-DDE and β-BHC had the highest detection rate in both maternal and cord blood serum (97.2% and 96.7%, respectively), followed by HCB (93.0%, 51.7%), p,p′-DDT (88.7%, 36.7%), and p,p′-DDD (83.1%, 60.0%). Among all OCPs, the concentration of p,p′-DDE was the highest (mothers geometric mean (GM): 203.54ngg−1, newborns GM: 116.14ngg−1), followed by HCB (70.62ngg−1, 65.16ngg−1), and β-BHC (67.67ngg−1, 33.39ngg−1). Multiple linear regression analyses showed that each 1ngg−1 increment of cord serum p,p′-DDE, total DDT, and β-BHC was associated with a 0.10g, 0.10g, and 0.92g decrease in infant birth weight, respectively, and as the cord serum concentrations of p,p′-DDT, p,p′-DDD, HCB and mirex increased, the infant birth weight was also decreased, although the associations were not statistically significant due to the relatively small sample size. These results suggest that p,p′-DDE, β-BHC, and HCB were the predominant OCPs in the serum of Chinese pregnant women and cord blood of their newborns. Prenatal exposure to DDT, β-BHC, HCB, and mirex were associated with a decrease in birth weight, but these results need validation in larger sample-sized studies.
We investigated the relationship between telomere length and lung cancer in a pooled analysis from three prospective cohort studies: the Prostate, Lung, Colorectal and Ovarian (PLCO) Cancer Screening ...Trial, conducted among men and women in the United States, and previously published data from the Alpha-Tocopherol, Beta-Carotene Cancer Prevention (ATBC) Trial conducted among male smokers in Finland, and the Shanghai Women's Health Study (SWHS), which is comprised primarily of never-smokers. The pooled population included 847 cases and 847 controls matched by study, age, and sex. Leukocyte telomere length was measured by a monochrome multiplex qPCR assay. We used conditional logistic regression models to calculate ORs and their 95% confidence intervals (CI) for the association between telomere length and lung cancer risk, adjusted for age and pack-years of smoking. Longer telomere length was associated with increased lung cancer risk in the pooled analysis OR (95% CI) by quartile: 1.00; 1.24 (0.90-1.71); 1.27 (0.91-1.78); and 1.86 (1.33-2.62); P trend = 0.000022. Findings were consistent across the three cohorts and strongest for subjects with very long telomere length, i.e., lung cancer risks for telomere length OR (95% CI) in the upper half of the fourth quartile were 2.41 (1.28-4.52), 2.16 (1.11-4.23), and 3.02(1.39-6.58) for the PLCO trial, the ATBC trial, and the SWHS, respectively. In addition, the association persisted among cases diagnosed more than 6 years after blood collection and was particularly evident for female adenocarcinoma cases. Telomere length in white blood cell DNA may be a biomarker of future increased risk of lung cancer in diverse populations.
To prospectively investigate whether diversity in oral microbiota is associated with risk of lung cancer among never-smokers.
A nested case-control study within two prospective cohort studies, the ...Shanghai Women's Health Study (n=74 941) and the Shanghai Men's Health Study (n=61 480).
Lifetime never-smokers who had no cancer at baseline. Cases were subjects who were diagnosed with incident lung cancer (n=114) and were matched 1:1 with controls on sex, age (≤2 years), date (≤30 days) and time (morning/afternoon) of sample collection, antibiotic use during the week before sample collection (yes/no) and menopausal status (for women).
Metagenomic shotgun sequencing was used to measure the community structure and abundance of the oral microbiome in pre-diagnostic oral rinse samples of each case and control. Multivariable logistic regression models were used to estimate the association of lung cancer risk with alpha diversity metrics and relative abundance of taxa. The Microbiome Regression-Based Kernel Association Test (MiRKAT) evaluated the association between risk and the microbiome beta diversity.
Subjects with lower microbiota alpha diversity had an increased risk of lung cancer compared with those with higher microbial alpha diversity (Shannon: p
=0.05; Simpson: p
=0.04; Observed Species: p
=0.64). No case-control differences were apparent for beta diversity (p
=0.30). After accounting for multiple comparisons, a greater abundance of Spirochaetia (OR
1.00 (reference), OR
0.61 (95% CI 0.32 to 1.18), OR
0.42 (95% CI 0.21 to 0.85)) and Bacteroidetes (OR
1.00 (reference), OR
0.66 (95% CI 0.35 to 1.25), OR
0.31 (95% CI 0.15 to 0.64)) was associated with a decreased risk of lung cancer, while a greater abundance of the Bacilli class (OR
1.00 (reference), OR
1.49 (95% CI 0.73 to 3.08), OR
2.40 (95% CI 1.18 to 4.87)) and Lactobacillales order (OR
1.00 (reference), OR
2.15 (95% CI 1.03 to 4.47), OR
3.26 (95% CI 1.58 to 6.70)) was associated with an increased risk of lung cancer.
Our prospective study of never-smokers suggests that lower alpha diversity was associated with a greater risk of lung cancer and the abundance of certain specific taxa was associated with altered risk, providing further insight into the aetiology of lung cancer in the absence of active tobacco smoking.
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