Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea

<i>Background and Objectives</i>: Air pollutants have been shown to affect hypertensive disorders and placental hypoxia due to vasoconstriction, inflammation, and oxidative stress. The objective of this study was to evaluate whether high levels of maternal exposure to heavy metals during...

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Main Authors: Kuen Su Lee, Won Kee Min, Yoon Ji Choi, Jeongun Cho, Sang Hun Kim, Hye Won Shin
Format: Article
Language:English
Published: MDPI AG 2025-06-01
Series:Medicina
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Online Access:https://www.mdpi.com/1648-9144/61/7/1146
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author Kuen Su Lee
Won Kee Min
Yoon Ji Choi
Jeongun Cho
Sang Hun Kim
Hye Won Shin
author_facet Kuen Su Lee
Won Kee Min
Yoon Ji Choi
Jeongun Cho
Sang Hun Kim
Hye Won Shin
author_sort Kuen Su Lee
collection DOAJ
description <i>Background and Objectives</i>: Air pollutants have been shown to affect hypertensive disorders and placental hypoxia due to vasoconstriction, inflammation, and oxidative stress. The objective of this study was to evaluate whether high levels of maternal exposure to heavy metals during the second trimester of pregnancy are associated with an increased risk of preeclampsia and eclampsia, using national health insurance claim data from South Korea. <i>Methods:</i> Data on mothers and their newborns from 2016 to 2020, provided by the National Health Insurance Service, were used (<i>n</i> = 1,274,671). Exposure data for ambient air pollutants (PM2.5, CO, SO<sub>2</sub>, NO<sub>2</sub>, and O<sub>3</sub>) and heavy metals (Pb, Cd, Cr, Cu, Mn, Fe, Ni, and As) during the second trimester of pregnancy were retrieved from the Korea Environment Corporation. Atmospheric condition data based on the mother’s registration area were matched. A logistic regression model was adjusted for maternal age, infant sex, season of conception, and household income. <i>Results:</i> In total, 16,920 cases of preeclampsia and 592 cases of eclampsia were identified. In the multivariate model, copper exposure remained significantly associated with an increased risk of preeclampsia (odds ratio: 1.011; 95% confidence interval: 1.001–1.023), and higher ozone exposure during pregnancy was associated with an elevated risk of eclampsia. <i>Conclusions:</i> Increased copper exposure during the second trimester of pregnancy was associated with a high incidence of preeclampsia.
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spelling doaj-art-413ed6dfd1d8422695c6ea47d0f47f312025-08-20T03:07:55ZengMDPI AGMedicina1010-660X1648-91442025-06-01617114610.3390/medicina61071146Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South KoreaKuen Su Lee0Won Kee Min1Yoon Ji Choi2Jeongun Cho3Sang Hun Kim4Hye Won Shin5Department of Anesthesiology and Pain Medicine, Eulji University Uijeongbu Eulji Medical Center, Eulji University School of Medicine, Uijeongbu 11759, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Korea University Ansan Hospital, Korea University College of Medicine, Ansan 15355, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, Chosun University, Chosun University Hospital, Gwangju 61453, Republic of KoreaDepartment of Anesthesiology and Pain Medicine, College of Medicine, Korea University Anam Hospital, Seoul 02841, Republic of Korea<i>Background and Objectives</i>: Air pollutants have been shown to affect hypertensive disorders and placental hypoxia due to vasoconstriction, inflammation, and oxidative stress. The objective of this study was to evaluate whether high levels of maternal exposure to heavy metals during the second trimester of pregnancy are associated with an increased risk of preeclampsia and eclampsia, using national health insurance claim data from South Korea. <i>Methods:</i> Data on mothers and their newborns from 2016 to 2020, provided by the National Health Insurance Service, were used (<i>n</i> = 1,274,671). Exposure data for ambient air pollutants (PM2.5, CO, SO<sub>2</sub>, NO<sub>2</sub>, and O<sub>3</sub>) and heavy metals (Pb, Cd, Cr, Cu, Mn, Fe, Ni, and As) during the second trimester of pregnancy were retrieved from the Korea Environment Corporation. Atmospheric condition data based on the mother’s registration area were matched. A logistic regression model was adjusted for maternal age, infant sex, season of conception, and household income. <i>Results:</i> In total, 16,920 cases of preeclampsia and 592 cases of eclampsia were identified. In the multivariate model, copper exposure remained significantly associated with an increased risk of preeclampsia (odds ratio: 1.011; 95% confidence interval: 1.001–1.023), and higher ozone exposure during pregnancy was associated with an elevated risk of eclampsia. <i>Conclusions:</i> Increased copper exposure during the second trimester of pregnancy was associated with a high incidence of preeclampsia.https://www.mdpi.com/1648-9144/61/7/1146air pollutantsheavy metalspreeclampsia
spellingShingle Kuen Su Lee
Won Kee Min
Yoon Ji Choi
Jeongun Cho
Sang Hun Kim
Hye Won Shin
Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
Medicina
air pollutants
heavy metals
preeclampsia
title Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
title_full Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
title_fullStr Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
title_full_unstemmed Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
title_short Exposure to Fine Particulate Matter (PM2.5) and Heavy Metals During the Second Trimester of Pregnancy Increases the Risk of Preeclampsia and Eclampsia: An Analysis of National Health Insurance Claims Data from South Korea
title_sort exposure to fine particulate matter pm2 5 and heavy metals during the second trimester of pregnancy increases the risk of preeclampsia and eclampsia an analysis of national health insurance claims data from south korea
topic air pollutants
heavy metals
preeclampsia
url https://www.mdpi.com/1648-9144/61/7/1146
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