Individual exposure to urban air pollution and its correlation with placental angiogenic markers in the first trimester of pregnancy, in São Paulo, Brazil

Abstract

Pollution of the atmosphere is known that may lead to adverse obstetric outcomes, including fetal growth restriction, gestational hypertension, and preeclampsia. Such disorders are correlated with imbalances in angiogenic factors, which may also be involved in the pathological mechanism as the pollutants impact placental and maternal physiology. In the first trimester of gestation, this study assessed the outcomes of personal maternal short period exposure to air pollution on soluble fms-like tyrosine kinase 1 (sFlt1) and placental growth factor (PLGF) of pregnant women blood concentrations. This was a cross-sectional study, held in the city of São Paulo, Brazil, and conducted with low-risk pregnant women, who carried personal passive nitrogen dioxide (NO2) and ozone (O3) monitors for about a few days preceding the ultrasound evaluation, and on this day, the venous blood sample was collected to measure the angiogenic factors sFlt1 and PLGF and their ratio (sFlt1/PLGF) by enzyme-linked immunosorbent assay (ELISA). By means of multiple regression models, the effect of the studied pollutants on the log-transformed concentrations of the angiogenic factors was evaluated. One hundred thirty-one patients were included. The log of the sFlt1/PLGF ratio increased with rising NO2 levels (p = 0.021 and beta = 0.206), and the log of the PLGF concentration showed a negative correlation with NO2 (p = 0.008 and beta = − 0.234). NO2, an indicator of the levels of primary air pollutants, presented significant positive correlation with an increased sFlt1/PLGF ratio and diminished PLGF levels, which may reflect an antiangiogenic state generated by air pollution exposure.

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Fig. 1

Data availability

The datasets used and analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

The authors acknowledge Companhia Ambiental do Estado de São Paulo (CETESB).

Funding

This work was financed by grants 2008/57717-6, Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP), and part of notice 15 CNPq/Fapesp – (Instituto Nacional de Análise de Risco Ambiental) INAIRA, case number 2009/17315-9. Both were for financial support.

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Authors

Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by Karen Hettfleisch, Mariana Azevedo Carvalho, Mara Sandra Hoshida, Luciana Duzolina Manfré Pastro, Silvia R D M Saldiva, Sandra Elisabete Vieira, Rossana Pulcineli Vieira Francisco, Paulo Hilário Nascimento Saldiva, and Lisandra Stein Bernardes. The first draft of the manuscript was written by Karen Hettfleisch and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Lisandra Stein Bernardes.

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Ethics approval and consent to participate

The research project was approved by the Ethics and Research Committee of the São Paulo University Medical School, São Paulo, Brazil, under reference number 132/10 and by the Ethics and Research Committee of the Municipal Health Secretariat of the City of São Paulo under CAAE number: 0205.0.162.162-10, reference number 430/10. Pregnant women were invited to participate in the study and those who accepted signed an Informed Consent Form.

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Not applicable.

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The authors declare that they have no competing interests.

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Hettfleisch, K., Carvalho, M.A., Hoshida, M.S. et al. Individual exposure to urban air pollution and its correlation with placental angiogenic markers in the first trimester of pregnancy, in São Paulo, Brazil. Environ Sci Pollut Res (2021). https://doi.org/10.1007/s11356-021-12353-7

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Keywords

  • Air pollution
  • Placental growth factor (PLGF)
  • Pregnancy
  • Angiogenic factors
  • Soluble fms-like tyrosine kinase 1 (sFlt1)
  • First trimester