Can air pollution also cause high blood pressure in pregnancy?

With the liberalization of the two-child policy, our outpatient clinic visits, the number of patients with gestational hypertension has increased, due to the special characteristics of gestational hypertension, so the diagnosis and treatment is relatively complex, so what is gestational hypertension? Hypertensive disorders in pregnancy include gestational hypertension, preeclampsia, eclampsia, primary hypertension and pregnancy, and secondary hypertension and pregnancy due to renal disease, adrenal disease and so on. In China, pre-eclampsia and eclampsia were collectively called hypertensive syndrome of pregnancy (referred to as hyperemesis gravidarum). After 20 weeks of pregnancy, with hypertension, proteinuria as the main characteristics, can be accompanied by multi-organ functional damage or functional failure. This disease has become more common clinically and is a major cause of maternal and perinatal mortality because of the frequent combination of obstetric hemorrhage, infection, and convulsions. There are many factors associated with the development of this disease and a brief statement is made on the study of air pollution and hypertension in pregnancy. A previous large-scale study showed that air pollution may increase the risk of hypertension in pregnant women. The study was based on an analysis of 22,000 pregnant women, and after excluding women with a history of high blood pressure, a history of preterm labor, and a history of delivery complications, 4.7 percent of the remaining pregnant women developed hypertension. The researchers conducted a comparative analysis using air pollution data collected by the U.S. Environmental Protection Agency and found an association between exposure to air pollutants such as fine particulate matter, NO2, and SO2, and high blood pressure in pregnant women. This correlation was even stronger when exposed to several high levels of pollutants at the same time. A systematic review and meta-analysis of air pollution and hypertensive disorders in pregnancy similarly showed that exposure to air pollution can increase the risk of developing hypertensive disorders in pregnancy. This study was a systematic review and meta-analysis of epidemiologic investigations related to the association between exposure to air pollution and hypertensive disorders of pregnancy, including gestational hypertension and pre-eclampsia. English electronic databases were searched for English-language literature reporting the association between ambient air pollution and hypertensive disorders in pregnancy between December 2009 and December 2013. Random-effects models were used to calculate the joint risk of various pollutant exposure levels observed in ≥4 studies, and heterogeneity and publication bias were assessed. The results showed that 17 papers assessing the role of nitrogen oxides (NO2, NOx), suspended particulates (PM10, PM2.5), CO, O3, residential proximity to major roadways, and traffic density on hypertension in pregnancy met the inclusion requirements. Most of the literature reported that air pollution increases the risk of developing hypertensive disorders in pregnancy. Meta-analysis showed that all pollutants except CO increased the risk of developing hypertensive disorders in pregnancy. The results of the random-effects pooled analysis showed that for every 5-μg/m3 increase in PM2.5, the risk ratio for the development of hypertensive disorders in pregnancy was 1.47 (95% CI; 1.27-1.68), with a risk ratio for the development of preeclampsia of 1.30 (95% CI; 1.11-1.48). The results of this study confirm that exposure to air pollution can increase the risk of developing hypertensive disorders during pregnancy. Therefore, pregnant women should avoid air pollution as much as possible, especially in winter in the north of China, when the haze is heavy, avoid going out, or take appropriate measures to prevent haze when going out.