Associations between Prenatal Exposure to Air Pollutants and Cord-Blood Thyroid Hormones Levels: A Cross-Sectional Study in Isfahan

Golverdi, Elahe; Hashemipour, Mahin; Hovsepian, Silva; Khoshhali, Mehri; Kelishadi, Roya

doi:10.22038/ijp.2024.79827.5454

Associations between Prenatal Exposure to Air Pollutants and Cord-Blood Thyroid Hormones Levels: A Cross-Sectional Study in Isfahan

Document Type : original article

Authors

Elahe Golverdi ¹

Mahin Hashemipour ¹^{, 2}

Silva Hovsepian ¹

Mehri Khoshhali ²

Roya Kelishadi ²

¹ Metabolic Liver Diseases Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.

² Child Growth and Development Research Center, Research Institute for Primordial Prevention of NonCommunicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran.

10.22038/ijp.2024.79827.5454

Abstract

Background: Air pollution as a major health concern in the world can adversely affect pregnant women and their newborns' thyroid function. We evaluated the association between prenatal exposure to air pollutants and cord-blood thyroid hormone levels.
Method: This cross-sectional study was conducted as a sub-study of the PERSIAN birth cohort on mothers and their newborns from October 2019 to September 2021. All participants, related data, and cord blood samples were gathered from the Isfahan. The air quality index (AQI), extracted from its official website, and was used to assess overall air quality during pregnancy. The association between mean levels of AQI in the three trimesters with cord blood thyroid hormone levels was evaluated.
Results: In 195 mothers with a mean age of 29.79(5.46), the mean of TSH and free T4 was 6.96 IU/L and 1ng/dl, respectively. The total days with moderate AQI (51-100) were higher than other AQI categories over the three trimesters. This study found no significant association between the mean cord-blood TSH and AQI>100, (P>0.05). The mean cord-blood FT4 had a negative association with total unhealthy days for sensitive groups in the first trimester and total very unhealthy days in the third trimester. The mean cord-blood FT4 was positively associated with unhealthy days in the second trimester.
Conclusion: The cord-blood FT4 levels were associated with prenatal exposure to AQI higher than 100. These results highlight the need for air pollution management to minimize neonatal thyroid hormone alteration and its critical sequelae.

Keywords

Air pollution

Air quality

Maternal exposure

Thyroid stimulating hormone

TSH

Cord blood, Birth cohort

De Escobar, G. M., M. J. Obregón and F. E. Del Rey (2004). "Role of thyroid hormone during early brain development." European journal of endocrinology 151(Suppl_3): U25-U37.
Schmaltz, C. (2012). "Thyroid hormones in the neonate: an overview of physiology and clinical correlation." Advances in Neonatal Care 12(4): 217-222.
Prezioso, G., C. Giannini and F. Chiarelli (2018). "Effect of thyroid hormones on neurons and neurodevelopment." Hormone research in paediatrics 90(2): 73-81.
Wassie, M. M., L. G. Smithers, L. N. Yelland, M. Makrides and S. J. Zhou (2021). "Associations between newborn thyroid-stimulating hormone concentration and neurodevelopment and growth of children at 18 months." British Journal of Nutrition 126(10): 1478-1488.
Shields, B. M., B. A. Knight, A. Hill, A. T. Hattersley and B. Vaidya (2011). "Fetal thyroid hormone level at birth is associated with fetal growth." The Journal of Clinical Endocrinology & Metabolism 96(6): E934-E938.
Medici, M., S. Timmermans, W. Visser, S. M. de Muinck Keizer-Schrama, V. W. Jaddoe, A. Hofman, et al (2013). "Maternal thyroid hormone parameters during early pregnancy and birth weight: the Generation R Study." J Clin Endocrinol Metab 98(1): 59-66.
Fisher, D. A. (2008). Thyroid system immaturities in very low birth weight premature infants. Seminars in perinatology, Elsevier.
Yordam, N. and A. Ozon (2003). "Neonatal thyroid screening: methods-efficiency-failures." PEDIATRIC ENDOCRINOLOGY REVIEWS 1: 177.
Kampa, M. and E. Castanas (2008). "Human health effects of air pollution." Environmental pollution 151(2): 362-367.
Darbre, P. D. (2018). "Overview of air pollution and endocrine disorders." International journal of general medicine 11: 191.
Soldin, O. P., B. E. Goughenour, S. Z. Gilbert, H. J. Landy and S. J. Soldin (2009). "Thyroid hormone levels associated with active and passive cigarette smoking." Thyroid 19(8): 817-823.
Iijima, K., T. Otake, J. Yoshinaga, M. Ikegami, E. Suzuki, H. Naruse, et al (2007). "Cadmium, lead, and selenium in cord blood and thyroid hormone status of newborns." Biological trace element research 119(1): 10-18.
Maervoet, J., G. Vermeir, A. Covaci, N. Van Larebeke, G. Koppen, G. Schoeters, et al (2007). "Association of thyroid hormone concentrations with levels of organochlorine compounds in cord blood of neonates." Environmental health perspectives 115(12): 1780-1786.
Abdelouahab, N., M.-F. Langlois, L. Lavoie, F. Corbin, J.-C. Pasquier and L. Takser (2013). "Maternal and cord-blood thyroid hormone levels and exposure to polybrominated diphenyl ethers and polychlorinated biphenyls during early pregnancy." American journal of epidemiology 178(5): 701-713.
Shang, L., L. Huang, W. Yang, C. Qi, L. Yang, J. Xin, et al (2019). "Maternal exposure to PM2. 5 may increase the risk of congenital hypothyroidism in the offspring: a national database based study in China." BMC Public Health 19(1): 1-9.
Janssen, B. G., N. D. Saenen, H. A. Roels, N. Madhloum, W. Gyselaers, W. Lefebvre, et al (2017). "Fetal thyroid function, birth weight, and in utero exposure to fine particle air pollution: a birth cohort study." Environmental health perspectives 125(4): 699-705.
Howe, C. G., S. P. Eckel, R. Habre, M. S. Girguis, L. Gao, F. W. Lurmann, et al (2018). "Association of prenatal exposure to ambient and traffic-related air pollution with newborn thyroid function: findings from the Children’s Health Study." JAMA network open 1(5): e182172-e182172.
Wang, X., C. Liu, M. Zhang, Y. Han, H. Aase, G. D. Villanger, O. Myhre, et al (2019). "Evaluation of maternal exposure to PM2. 5 and its components on maternal and neonatal thyroid function and birth weight: a cohort study." Thyroid 29(8): 1147-1157.
Zhao, Y., Z. Cao, H. Li, X. Su, Y. Yang, C. Liu and J. Hua (2019). "Air pollution exposure in association with maternal thyroid function during early pregnancy." Journal of hazardous materials 367: 188-193.
Zare Sakhvidi, M. J., N. Danaei, P. Dadvand, A. H. Mehrparvar, M. Heidari-Beni, S. Nouripour, et al (2021). "The prospective epidemiological research studies in IrAN (PERSIAN) birth cohort protocol: Rationale, design and methodology." Longitudinal and Life Course Studies 12(2): 241-262.
Montanelli, L., S. Benvenga, L. Hegedüs, P. Vitti, F. Latrofa and L. H. Duntas (2018). "Drugs and other substances interfering with thyroid function." Thyroid Diseases: Pathogenesis, Diagnosis, and Treatment: 733-761.
Gadekar, M. C. S. "Air Quality Index (AQI) Basics." Journal homepage: www. ijrpr. com ISSN 2582: 7421.
Wassie, M. M., L. G. Smithers and S. J. Zhou (2021). "Association between newborn thyroid-stimulating-hormone concentration and neurodevelopment and growth: a systematic review." Biological Trace Element Research: 1-15.
Zhang, X., A. Huels, R. Makuch, A. Zhou, T. Zheng, W. Xia, et al (2022). "Association of exposure to ambient particulate matter with maternal thyroid function in early pregnancy." Environ Res 214(Pt 2): 113942.
Zhou, Y., Q. Zhu, P. Wang, J. Li, R. Luo, W. Zhao, et al (2022). "Early pregnancy PM(2.5) exposure and its inorganic constituents affect fetal growth by interrupting maternal thyroid function." Environ Pollut 307: 119481.
Ghassabian, A., L. Pierotti, M. Basterrechea, L. Chatzi, M. Estarlich, A. Fernández-Somoano, et al (2019). "Association of exposure to ambient air pollution with thyroid function during pregnancy." JAMA network open 2(10): e1912902-e1912902.
Ilias, I., I. Kakoulidis, S. Togias, S. Stergiotis, A. Michou, A. Lekkou, et al (2020). "Atmospheric Pollution and Thyroid Function of Pregnant Women in Athens, Greece: A Pilot Study." Medical Sciences 8(2): 19.
Neven, K. Y., C. Wang, B. G. Janssen, H. A. Roels, C. Vanpoucke, A. Ruttens and T. S. Nawrot (2021). "Ambient air pollution exposure during the late gestational period is linked with lower placental iodine load in a Belgian birth cohort." Environ Int 147: 106334.
Dong, X., W. Wu, S. Yao, H. Li, Z. Li, L. Zhang, et al (2021). "PM2.5 disrupts thyroid hormone homeostasis through activation of the hypothalamic-pituitary-thyroid (HPT) axis and induction of hepatic transthyretin in female rats 2.5." Ecotoxicology and Environmental Safety 208: 111720.
Saenen, N. D., E. B. Provost, M. K. Viaene, C. Vanpoucke, W. Lefebvre, K. Vrijens, et al (2016). "Recent versus chronic exposure to particulate matter air pollution in association with neurobehavioral performance in a panel study of primary schoolchildren." Environ Int 95: 112-119.
Gangwar, R. S., G. H. Bevan, R. Palanivel, L. Das and S. Rajagopalan (2020). "Oxidative stress pathways of air pollution mediated toxicity: Recent insights." Redox Biol 34: 101545.
Xu, M. X., C. X. Ge, Y. T. Qin, T. T. Gu, D. S. Lou, Q. Li, et al (2019). "Prolonged PM2.5 exposure elevates risk of oxidative stress-driven nonalcoholic fatty liver disease by triggering increase of dyslipidemia." Free Radic Biol Med 130: 542-556.
St Germain, D. L., V. A. Galton and A. Hernandez (2009). "Minireview: Defining the roles of the iodothyronine deiodinases: current concepts and challenges." Endocrinology 150(3): 1097-1107.
Winkler, R., S. Griebenow and W. Wonisch (2000). "Effect of iodide on total antioxidant status of human serum." Cell Biochem Funct 18(2): 143-146.
Küpper, F. C., L. J. Carpenter, G. B. McFiggans, C. J. Palmer, T. J. Waite, E. M. Boneberg, et al (2008). "Iodide accumulation provides kelp with an inorganic antioxidant impacting atmospheric chemistry." Proc Natl Acad Sci U S A 105(19): 6954-6958.
Soriguer, F., C. Gutiérrez-Repiso, E. Rubio-Martin, F. Linares, I. Cardona, J. López-Ojeda, et al (2011). "Iodine intakes of 100-300 μg/d do not modify thyroid function and have modest anti-inflammatory effects." Br J Nutr 105(12): 1783-1790.
Korevaar, T. I., L. Chaker, V. W. Jaddoe, T. J. Visser, M. Medici and R. P. Peeters (2016). "Maternal and Birth Characteristics Are Determinants of Offspring Thyroid Function." J Clin Endocrinol Metab 101(1): 206-213.
Girguis, M. S., M. J. Strickland, X. Hu, Y. Liu, S. M. Bartell and V. M. Vieira (2016). "Maternal exposure to traffic-related air pollution and birth defects in Massachusetts." Environmental research 146: 1-9.
Yoshimura Noh, J., N. Momotani, S. Fukada, K. Ito, A. Miyauchi and N. Amino (2005). "Ratio of serum free triiodothyronine to free thyroxine in Graves' hyperthyroidism and thyrotoxicosis caused by painless thyroiditis." Endocr J 52(5): 537-542.