Effects of indoor air pollution from household solid fuel use on the risk of gastrointestinal and liver diseases in middle aged and elderly adults.

Solid fuels are widely used in China and increase the concentrations of indoor air pollutants. Nevertheless, there is limited longitudinal evidence linking solid fuel use and Gastrointestinal (GI) and liver diseases. This study aimed to prospectively investigate the association between household solid fuel use and the risk of GI and liver diseases in middle aged and elderly adults. This work was based on the China Health and Retirement Longitudinal Study (CHARLS). Longitudinal data incorporate with cross-sectional data were analyzed. Compared with individuals using clean fuel for cooking, solid fuel users were observed to have higher risk of GI diseases (OR in 2011, 2013, 2015, 2018 wave separately: 1.37, 95 % CI: 1.24-1.50, P < 0.001; 1.24, 95 % CI: 1.11-1.39, P < 0.001; 1.18, 95 % CI: 1.06-1.33, P < 0.001; 1.23, 95 % CI: 1.04-1.45, P < 0.05). The associations between solid fuel use and liver diseases were not significant in most of the groups. Participants transforming from solid to clean cooking fuels had lower risk of GI and liver diseases than persistent solid fuel users. Moreover, biomass cooking fuel users were at a significant higher risk of both liver and GI diseases compared with clean fuel users. Overall, household solid fuel use, especially for cooking, was related to higher risk of GI and liver diseases, while switching from solid to clean fuels could reduce this risk. Using biomass for cooking was identified to be more associated with the increasing risk of GI and liver diseases than cooking with coal.

Sodium alginate hydrogelation mediated paper-based POCT sensor for visual distance reading and smartphone-assisted colorimetric dual-signal determination of L-lactate.

Herein, we present a paper-based POCT sensor based on lactate dehydrogenase-mediated alginate gelation combined with visual distance reading and smartphone-assisted colorimetric dual-signal analysis to determine the concentration of L-lactate in yogurt samples. In this research, L-lactate was transformed into pyruvate by lactate dehydrogenase. Pyruvate then triggered the gelation of a sol mixture, increasing the viscosity (ηs) of the mixture, which was shown as a decrease in the diffusion diameter on the paper-based sensor. In addition, protons from pyruvate accelerated the degradation of Rhodamine B, causing color fading of the mixture, which was analyzed using RGB analysis application software. Under optimal experimental conditions, the linear ranges of visual distance reading and smartphone-assisted colorimetric analysis were 0.1-15 µM and 0.3-15 µM and the detection limits were 0.03 µM and 0.07 µM, respectively. As a proof-of-concept application, we exploited the paper-based sensor to determine the concentration of L-lactate in yogurt samples. The results from the dual-signal paper-based sensor were consistent with the ones from HPLC analysis. In short, this study developed a simple, convenient, cost-effective, and feasible method for the quantitative detection of L-lactate in real samples.

Residential energy transition and chronic respiratory diseases.

Obtaining clean energy is of prime importance for planetary health and sustainable development. We aimed to assess the association between residential energy transition and the risk of chronic respiratory diseases. Using data from the Global Health Observatory and Global Burden of Diseases, Injuries, and Risk Factors Study, we delineated the spatial distribution and temporal trends of the population using clean fuels for cooking at a global scale. In the China Health and Retirement Longitudinal Study, we performed rigorous and well-structured multistage analyses incorporating both cross-sectional and prospective data analyses to examine the associations between solid fuel use, residential energy transition, duration of solid fuel use, and the risk of chronic respiratory diseases. Despite great progress, huge disparities in access to clean energy persist globally. Residential energy transition was associated with a lower risk of chronic respiratory diseases. In the period of 2011-2013, compared with persistent solid fuel users, both participants who switched from solid to clean fuels (adjusted risk ratio [RR] 0.78, 95% confidence interval [CI] 0.62-0.98) and persistent clean fuel users (adjusted RR 0.71, 95% CI 0.57-0.89) had significantly lower risk of chronic respiratory diseases (p < 0.001 for trend). Consistent associations were observed in the period of 2011-2015 and 2011-2018. Household energy transition from solid to clean fuels could reduce the risk of chronic respiratory diseases. This is a valuable lesson for policy-makers and the general public to accelerate energy switching to alleviate the burden of chronic respiratory diseases and achieve health benefits, particularly in low- and middle-income countries.

Effect of prenatal exposure to phthalates on birth weight of offspring: A meta-analysis.

Prenatal exposure to phthalates is common. However, its effect on birth weight has always been met with conflicting conclusions. To explore the effects of prenatal phthalate exposure on neonatal weight, we searched PubMed, Web of Science (WOS), Cochrane Library, and Embase databases for articles published up to October 24, 2023. Observational studies with 95% confidence intervals (CI) were included. Our findings indicate no significant association between either mixed exposure effects or single phthalate metabolites and offspring birth weight when monitoring maternal urine phthalate metabolites. When stratified by sex, ΣHMWPs and MMP significantly reduced the birth weight of female offspring (ΣHMWPs: Pooled ß = -62.08, 95%CI: -123.11 to -1.05, P = 0.046; MMP: Pooled ß = -10.77, 95%CI: -18.74 to -2.80, P = 0.008). The results of subgroup analysis showed that ΣPAEs and ΣDEHP significantly decreased birth weight in the specific gravity correction group (ΣPAEs: Pooled estimates = -29.31, 95%CI: -58.52 to -0.10, P = 0.049; ΣDEHP: Pooled estimates = -18.25, 95%CI: -33.03 to -3.47, P = 0.016), and MECPP showed a positive correlation in the creatinine correction group (MECPP: Pooled estimates = 18.45, 95%CI: 0.13 to 36.77, P = 0.048). MEP and MBzP were negatively associated with birth weight in the no adjustment for gestational age group (MEP: Pooled estimates = -7.70, 95%CI: -14.19 to -1.21, P = 0.020; MBzP: Pooled estimates = -9.55, 95%CI: -16.08 to -3.03, P = 0.004). To make the results more convincing, more high-quality studies with large samples are urgently required.

Associations between maternal exposure to perfluoroalkylated substances (PFASs) and infant birth weight: a meta-analysis.

The objective of this study was to determine the associations between maternal exposure to PFASs and infant birth weight and to explore evidence for a possible dose-response relationship. Four databases including PubMed, Embase, Web of Science, and Medline before 20 September 2022 were systematically searched. A fixed-effect model was used to estimate the change in infant birth weight (g) associated with PFAS concentrations increasing by 10-fold. Dose-response meta-analyses were also conducted when possible. The study follows the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A total of 21 studies were included. Among these studies, 18 studies examined the associations between PFOA and birth weight, 17 studies reported PFOS, and 11 studies discussed PFHxS. Associations between PFHxS (ES = -5.67, 95% CI: -33.92 to 22.59, P = 0.694) were weaker than those for PFOA and PFOS (ES = -58.62, 95% CI: -85.23 to -32.01, P < 0.001 for PFOA; ES = -54.75, 95% CI: -84.48 to -25.02, P < 0.001 for PFOS). The association was significantly stronger in the high median PFOS concentration group (ES = -107.23, 95% CI: -171.07 to -43.39, P < 0.001) than the lower one (ES = -29.15, 95% CI: -63.60 to -5.30, P = 0.097; meta-regression, P = 0.045). Limited evidence of a dose-response relationship was found. This study showed negative associations between maternal exposure to PFASs and infant birth weight. Limited evidence of a dose-response relationship between exposure to PFOS and infant birth weight was found. Further studies are needed to find more evidence.

The correlation between prenatal maternal active smoking and neurodevelopmental disorders in children: a systematic review and meta-analysis.

OBJECTIVE: To systematically evaluate the association between maternal active smoking during pregnancy and Tourette syndrome (TS), chronic tic disorder (CTD), and developmental coordination disorder (DCD) in children, and to provide evidence-based medical references to reduce the incidence of neurodevelopmental disorders in children. METHOD: We searched PubMed, Web of Science, Embase, and Cochrane Library to obtain relevant articles published before 4 August 2021. Two reviewers independently assessed the articles for eligibility and extracted data. RESULTS: We included eight studies involving a total of 50,317 participants (3 cohort, 3 case-control, and 2 cross-sectional studies). The pooled effect estimates suggested that prenatal maternal active smoking is related to an increased risk of neurodevelopmental disorders (OR = 1.91, 95% CI: 1.30-2.80), especially DCD (OR = 2.25, 95% CI: 1.35-3.75). Maternal active smoking during pregnancy is not associated with TS (OR = 1.07, 95% CI: 0.66-1.73) in children. CONCLUSION: In this meta-analysis, we found evidence for a correlation between active smoking exposure in pregnant women and neurodevelopmental disorders in children. Owing to the differences in sample size, smoking categories and diagnostic methods, further research is needed to validate our results.

Prenatal exposure to pesticides and domain-specific neurodevelopment at age 12 and 18 months in Nanjing, China.

BACKGROUND: The extensive usage of pesticides has led to a ubiquitous exposure in the Chinese general population. Previous studies have demonstrated developmental neurotoxicity associated with prenatal exposure to pesticides. OBJECTIVES: We aimed to delineate the landscape of internal pesticides exposure levels from pregnant women's blood serum samples, and to identify the specific pesticides associated with the domain-specific neuropsychological development. METHODS: Participants included 710 mother-child pairs in a prospective cohort study initiated and maintained in Nanjing Maternity and Child Health Care Hospital. Maternal spot blood samples were collected at enrollment. Leveraging on an accurate, sensitive and reproducible analysis method for 88 pesticides, a total of 49 pesticides were measured simultaneously using gas chromatography-triple quadrupole tandem mass spectrometry (GC-MS/MS). After implementing a strict quality control (QC) management, 29 pesticides were reported. We assessed neuropsychological development in 12-month-old (n = 172) and 18-month-old (n = 138) children using the Ages and Stages Questionnaire (ASQ), Third Edition. Negative binomial regression models were used to investigate the associations between prenatal exposure to pesticides and ASQ domain-specific scores at age 12 and 18 months. Restricted cubic spline (RCS) analysis and generalized additive models (GAMs) were fitted to evaluate non-linear patterns. Longitudinal models with generalized estimating equations (GEE) were conducted to account for correlations among repeated observations. Weighted quantile sum (WQS) regression and Bayesian kernel machine regression (BKMR) were applied to examining the joint effect of the mixture of pesticides. Several sensitivity analyses were performed to assess the robustness of the results. RESULTS: We observed that prenatal exposure to chlorpyrifos was significantly associated with a 4 % decrease in the ASQ communication scores both at age 12 months (RR, 0.96; 95 % CI, 0.94-0.98; P < 0.001) and 18 months (RR, 0.96; 95 % CI, 0.93-0.99; P < 0.01). In the ASQ gross motor domain, higher concentrations of mirex (RR, 0.96; 95 % CI, 0.94-0.99, P < 0.01 for 12-month-old children; RR, 0.98; 95 % CI, 0.97-1.00, P = 0.01 for 18-month-old children), and atrazine (RR, 0.97; 95 % CI, 0.95-0.99, P < 0.01 for 12-month-old children; RR, 0.99; 95 % CI, 0.97-1.00, P = 0.03 for 18-month-old children) were associated with decreased scores. In the ASQ fine motor domain, higher concentrations of mirex (RR, 0.98; 95 % CI, 0.96-1.00, P = 0.04 for 12-month-old children; RR, 0.98; 95 % CI, 0.96-0.99, P < 0.01 for 18-month-old children), atrazine (RR, 0.97; 95 % CI, 0.95-0.99, P < 0.001 for 12-month-old children; RR, 0.98; 95 % CI, 0.97-1.00, P = 0.01 for 18-month-old children), and dimethipin (RR, 0.94; 95 % CI, 0.89-1.00, P = 0.04 for 12-month-old children; RR, 0.93; 95 % CI, 0.88-0.98, P < 0.01 for 18-month-old children) were associated with decreased scores. The associations were not modified by child sex. There was no evidence of statistically significant nonlinear relationships between pesticides exposure and RRs of delayed neurodevelopment (Pnonlinearity > 0.05). Longitudinal analyses implicated the consistent findings. CONCLUSION: This study gave an integrated picture of pesticides exposure in Chinese pregnant women. We found significant inverse associations between prenatal exposure to chlorpyrifos, mirex, atrazine, dimethipin and the domain-specific neuropsychological development (i.e., communication, gross motor and fine motor) of children at 12 and 18 months of age. These findings identified specific pesticides with high risk of neurotoxicity, and highlighted the need for priority regulation of them.

Maternal exposure to pesticides and autism or attention-deficit/hyperactivity disorders in offspring: A meta-analysis.

OBJECTIVE: To analyze the association between maternal pesticide exposure and autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorders (ADHD) in offspring. METHOD: Five databases including PubMed, Embase, Web of Science, Medline, as well as PsycINFO were systematically retrieved for the records related to pesticide exposure during pregnancy and ASD and ADHD in offspring before August 30, 2022. The pesticide category, maternal age and window of exposure as the main subgroups were presented. RESULTS: 949 studies were initially identified, and 19 studies were eventually included. Eleven were on ASD, seven were on ADHD, and one was on both disorders. Maternal pesticide exposure was positively related to ASD (pooled OR = 1.19 (95%CI: 1.04 to 1.36)) and ADHD (pooled OR = 1.20 (95%CI: 1.04 to 1.38)) in offspring. In the subgroup analysis, organophosphorus pesticides (OPs) (pooled OR = 1.14 (95%CI: 1.04 to 1.24)), pyrethroid (pooled OR = 1.40 (95%CI: 1.09 to 1.80)), and maternal age ≥30 years old (pooled OR = 1.24 (95%CI: 1.10 to 1.40)) increased the risk of ASD in offspring. Maternal organochlorine pesticides (OCPs) exposure was a risk factor for ADHD in offspring (pooled OR = 1.22 (95%CI: 1.03 to 1.45)). CONCLUSION: Maternal pesticide exposure increased the risk of ASD and ADHD in offspring. Moreover, OPs, pyrethroid, and maternal age ≥30 years old were found to be risk factors affecting children's ASD. Maternal exposure to OCPs increased the risk of ADHD in offspring. Our findings contribute to our understanding of health risks related to maternal pesticide exposure and indicate that the in utero developmental period is a vulnerable window-of-susceptibility for ASD and ADHD risk in offspring. These findings should guide policies that limit maternal exposure to pesticides, especially for pregnant women living in agricultural areas.

Statin shapes inflamed tumor microenvironment and enhances immune checkpoint blockade in non-small cell lung cancer.

Immune checkpoint blockade (ICB) therapy has achieved breakthroughs in the treatment of advanced non-small cell lung cancer (NSCLC). Nevertheless, the low response due to immuno-cold (i.e., tumors with limited tumor-infiltrating lymphocytes) tumor microenvironment (TME) largely limits the application of ICB therapy. Based on the glycolytic/cholesterol synthesis axis, a stratification framework for EGFR-WT NSCLC was developed to summarize the metabolic features of immuno-cold and immuno-hot tumors. The cholesterol subgroup displays the worst prognosis in immuno-cold NSCLC, with significant enrichment of the cholesterol gene signature, indicating that targeting cholesterol synthesis is essential for the therapy for immuno-cold NSCLC. Statin, the inhibitor for cholesterol synthesis, can suppress the aggressiveness of NSCLC in vitro and in vivo and can also drastically reverse the phenotype of immuno-cold to an inflamed phenotype in vivo. This change led to a higher response to ICB therapy. Moreover, both our in-house data and meta-analysis further support that statin can significantly enhance ICB efficacy. In terms of preliminary mechanisms, statin could transcriptionally inhibit PD-L1 expression and induce ferroptosis in NSCLC cells. Overall, we reveal the significance of cholesterol synthesis in NSCLC and demonstrate the improved therapeutic efficacy of ICB in combination with statin. These findings could provide a clinical insight to treat NSCLC patients with immuno-cold tumors.

Severity of Hospitalized Children with Anti-NMDAR Autoimmune Encephalitis.

Background: Information on the clinical characteristics and severity of autoimmune encephalitis with antibodies against the N-methyl-d-aspartate receptor (NMDAR) in children is attracting more and more attention in the field of pediatric research. Methods: In this retrospective cohort study, all cases (n = 67) were enrolled from a tertiary children's hospital, from 2017 to 2020. We compared severe cases that received intensive care unit (ICU) care with nonsevere cases that did not receive ICU care and used machine learning algorithm to predict the severity of children, as well as using immunologic and viral nucleic acid tests to identify possible pathogenic triggers. Results: Mean age of children was 8.29 (standard deviation 4.09) years, and 41 (61.19%) were girls. Eleven (16.42%) were admitted to the ICU, and 56 (83.58%) were admitted to neurology ward. Ten individual parameters were statistically significant differences between severe cases and nonsevere cases (P < .05), including headache, abnormal mental behavior or cognitive impairment, seizures, concomitant tumors, sputum/blood pathogens, blood globulin, blood urea nitrogen, blood immunoglobulin G, blood immunoglobulin M, and number of polynucleated cells in cerebrospinal fluid. Random forest regression model presented that the overall prediction power of severity reached 0.806, among which the number of polynucleated cells in cerebrospinal fluid contributed the most. Potential pathogenic causes exhibited that the proportion of mycoplasma was the highest, followed by Epstein-Barr virus. Conclusion: Our findings provided evidence for early identification of autoimmune encephalitis in children, especially in severe cases.

Effect of Maternal Triclosan Exposure on Neonatal Birth Weight and Children Triclosan Exposure on Children's BMI: A Meta-Analysis.

Background: Triclosan (TCS) is an environmental chemical with endocrine disrupting effects and can enter the body through the skin or oral mucosa. Human data about the effect of TCS exposure during pregnancy on neonatal birth weight and TCS exposure during childhood on children's growth are scarce. Objectives: To investigate the association between maternal urinary TCS level and neonatal birth weight, as well as children's urinary TCS level and children's body mass index (BMI). Methods: A systematic literature search was conducted using PubMed, Cochrane Library, and Web of Science. Finally, seven epidemiological articles with 5,006 participants from September 25, 2014 to August 10, 2018 were included in the meta-analysis to identify the relationship between maternal exposure to TCS and neonatal birth weight. On the other hand, three epidemiological articles with 5,213 participants from July 22, 2014 to September 1, 2017 were included in another meta-analysis to identify the relationship between children's exposure to TCS and children's BMI. We used Stata 16.0 to test the heterogeneity among the studies and calculating the combined effect value 95% confidence interval (CI) of the selected corresponding models. Results: TCS exposure during pregnancy was not significant associated with neonatal birth weight. The results of forest plots were as follows: ES (Estimate) = 0.41 (95% CI: -11.97-12.78). Children's urinary TCS level was also irrelevant associated with children's BMI: ES = 0.03 (95% CI: -0.54-0.60). Conclusions: This meta-analysis demonstrated that there was no significant association between maternal TCS level and neonatal birth weight, also there has no relationship between children's urinary TCS level and children's BMI.

Comparison of Continuous Subcutaneous Insulin Infusion and Multiple Daily Injections in Pediatric Type 1 Diabetes: A Meta-Analysis and Prospective Cohort Study.

Background: The incidence of pediatric type 1 diabetes (T1D) is increasing worldwide, and the appropriate choice of therapy regimens is important for children, especially in developing countries with inadequate resources. Methods: We conducted a design combining meta-analysis and prospective cohort study. In meta-analysis, 14 studies involving 69,085 TID cases reported glycosylated hemoglobin (HbA1c) levels, including 48,363 multiple daily insulin injections therapy (MIT) and 20,722 continuous subcutaneous insulin infusion (CSII). In our prospective cohort study, TID cases were recruited from a tertiary children's hospital, and randomly divided into Group MIT and Group CSII. After the 4-year follow-up, the effects of MDI (n = 112) and CSII (n = 76) therapy on glycemic control, long-term complications, as well as the growth and pubertal development were explored. Results: Compared to CSII in TID, HbA1c levels in MDI (WMD = 0.21, 95% CI: 0.20 to 0.23) were increased significantly in meta-analysis. Among 188 clinical cases, mean age at recruitment was 7.55 (SD 2.91) years. Duration of TID was 4.23 (SD 2.61) years. 50.53% (n = 95) of them were boys. The 4-year follow-up showed that children's HbA1c was 0.67 (95% CI -1.28, -0.05) % lower in children with CSII compared to children with MDI in multivariable regression models with adjustment for potential confounders (children's age at follow-up, duration of TID, gender, birthweight, parity, and delivery method). CSII was associated with 2.31 kg higher in children's weight (95% CI 0.59, 4.04) in the adjusted model. No difference was found in peripheral nerve and fundus consequences as well as the status of obesity and thin and pubertal development between CSII and MIT. Conclusion: CSII might be associated with better glycemic control and better effect for children growth development. No higher risks of long-term complications and delayed pubertal development were observed in CSII. Our findings provided evidence for a better therapy regimen for T1D in children, nevertheless, they need to be validated by a larger sample size study.

Differences of blood cells, lymphocyte subsets and cytokines in COVID-19 patients with different clinical stages: a network meta-analysis.

BACKGROUND: Due to the rapid spread of coronavirus disease 2019 (COVID-19) worldwide, it is necessary to ascertain essential immune inflammatory parameters that describe the severity of the disease and provide guidance for treatment. We performed network meta-analyses to determine differences in blood cells, lymphocyte subsets, and cytokines in COVID-19 patients with different clinical stages. METHODS: Databases were systematically searched to May 2, 2020, and updated on June 1, 2020. Network meta-analyses were conducted via Stata 15.0, and the mean difference (MD) and its 95% CI were used as the effect values of the pooled analysis. RESULTS: Seventy-one studies were included involving 8647 COVID-19 patients, White blood cell (WBC), neutrophil (NEUT), IL-6, and IL-10 counts increased significantly with worsening of the COVID-19, while lymphocyte (LYM) counts decreased. The levels of platelet (PLT), CD3+, CD4+, CD8+, and CD19+ cells in severe and critical patients were significantly lower than those in mild patients. IL-1ß count was significantly elevated in critical patients. CONCLUSIONS: Immune suppression and inflammatory injury play crucial roles in the progression of COVID-19, and the identification of susceptible cells and cytokines provide guidance for the early and accurate treatment of COVID-19 patients.

Consumer health informatics approach for personalized cancer screening decisions using utility functions.

A consumer health informatics approach is used to investigate the development of a patient-centered decision support system (DSS) with individualized utility functions. It supports medical decisions that have uncertain benefits and potential harms. Its use for accepting or declining cancer screening is illustrated. The system's underlying optimization model incorporates two user-specific utility functions-one that quantifies life-saving benefits and one that quantifies harms, such as unnecessary follow-up tests, surgeries, or treatments. The system requires sound decision making. Therefore, the decision making process was studied using a decision aid in the form of a color-coded matrix with the potential outcomes randomly placed in proportion to their likelihoods. Data were collected from 48 study participants, based on a central composite experimental design. The results show that the DSS can be effective, but health consumers may not be rational decision makers.

Associations of Prenatal Exposure to Triclosan and Maternal Thyroid Hormone Levels: A Systematic Review and Meta-Analysis.

Objective: To quantitatively evaluate associations between exposure to triclosan during pregnancy and maternal thyroid hormone levels. Method: The databases of PubMed, Embase, Web of Science and Cochrane Library were systematically searched to identify relevant studies on the relationship between prenatal exposure to triclosan and maternal levels of serum thyroid hormone published before October 22, 2019. Stata 12.0 was used to examine the heterogeneity among the eligible studies. Results: Seven studies involving a total of 4,136 participants were included. Overall, descriptive analysis provided no indication that exposure to TCS during pregnancy was related to either maternal FT4 levels (ES = 0.01, 95% CI: -0.03 to 0.05, P = 0.00) or TSH levels (ES = -0.03, 95% CI: -0.13 to 0.07, P = 0.412). Although the results were statistically insignificant, with the increase of urine TCS concentration, maternal FT4 levels exhibited a tendency to increase while TSH levels had a tendency to decrease during pregnancy. Conclusion: The results indicated that exposure to triclosan during pregnancy has no significant influence on maternal levels of thyroid hormone. On account of the inconsistency of existing research designs and study locations, further studies and replication are necessary to confirm these findings.

The correlation between PM2.5 exposure and hypertensive disorders in pregnancy: A Meta-analysis.

OBJECTIVE: To find the correlation between exposure to PM2.5 (fine particulate matter) and hypertensive disorders in pregnancy (HDP), and provide medical evidence for decreasing the incidence of hypertensive disorders in pregnancy. METHOD: A combination of computer and manual retrieval was used to search for keywords in PubMed (385 records), Cochrane Library (20 records), Web of Science (419 records) and Embase (325 records). Finally, ten epidemiological articles were considered in this meta-analysis. Stata 13.0 was used to examine the heterogeneity among the studies and to calculate the combined effect value (OR, odds ratio) by selecting the corresponding models. Sensitivity analysis and publication bias test were also performed. RESULTS: Meta-analysis indicated that there was an association between PM2.5 exposure (per 10 µg/m3 increase) and hypertensive disorders in pregnancy (OR = 1.52, 95% CI: 1.24-1.87). Exposure to PM2.5 (per 10 µg/m3 increase) enhanced the risk of pre-eclampsia (OR = 1.31, 95% CI: 1.07-1.61), but there was no evidence relating exposure to PM2.5 to gestational hypertension (OR = 1.35, 95% CI: 0.98-1.87). CONCLUSION: There is a significant link between exposure to PM2.5 and hypertensive disorders in pregnancy. The first and the third trimester were more susceptible to PM2.5 exposure. It is recommended to further strengthen protective measures against PM2.5 during pregnancy.