The relationship between hot spots of air pollution and the incidence of gestational diabetes based on spatial analysis: A study on one of the most air-polluted metropolis of Iran

Background: Despite the serious impacts of air pollution on human health, few studies have focused on the adverse effects of air pollution on pregnancy outcomes based on the geographic information system (GIS) approach. Therefore, adopting the GIS approach, this study aimed to determine the extent to which of overlap of air pollution hotspots overlap with gestational diabetes density in Ahvaz, an airpolluted metropolis in Iran. Methods: Data from an ongoing population-based cohort study was used for gestational diabetes mapping. Three methods were used for air pollution assessment. The inverse distance weighting (IDW) technique was used for spatial interpolation. ArcGIS10.8 was used for preparing maps. Results: The lowest rate of gestational diabetes was estimated in District One (2.4%) while the highest rate was observed in Districts Six and Four (20.6% and 20.2%, respectively). As far as air pollution was concerned, 32.6% of mothers with gestational diabetes were residents in low-risk areas whereas 67.4% lived in high-risk areas. A higher density of gestational diabetes was estimated in high-risk air-polluted districts based on any method of air pollution assessment. Conclusion: The density of gestational diabetes incidence increased with residence in air-polluted areas. Residence in more polluted areas is a higher risk factor for developing gestational diabetes and its complications. Providing preventive services in these areas is a priority.