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Zhang H, Feng Y, Huang J, Zhang F, Zhuo S, Liu H. Identifying the critical windows of temperature extremes exposure and congenital heart diseases. INTERNATIONAL JOURNAL OF BIOMETEOROLOGY 2024:10.1007/s00484-024-02756-9. [PMID: 39167209 DOI: 10.1007/s00484-024-02756-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Accepted: 08/02/2024] [Indexed: 08/23/2024]
Abstract
The associations between atmospheric temperature and congenital heart disease (CHD) and its subtypes are still inconclusive. In this population-based retrospective case-control study, 643 CHD cases and 3,215 non-CHD controls were analyzed through distributed lag nonlinear model to estimate the effect of weekly temperature exposure on CHD risk and to identify potentially vulnerable windows. Through the binary logistic regression model, we found that elevated temperature in the first trimester was associated with an increased risk of overall CHD and ventricular septal defect (VSD) (OR: 1.059, 95% CI: 1.002-1.119; OR: 1.094, 95% CI: 1.005-1.190, respectively), while increased temperature in the second trimester was significantly positively correlated with atrial septal defect (ASD) risk. However, the results of the DLNM showed a nonlinear relationship between the weekly average temperature and the risk of total CHDs and the subtypes. Exposure to extremely, moderately, and mildly high temperatures significantly increased the risk of overall CHD, ASD and VSD, and the critical windows were mainly concentrated at the 5th-11th and 23rd-27th weeks of gestation. Low-temperature extreme exposure resulted in vulnerable windows for ASD only: 13th-14th gestational weeks. No significant positive associations were found between extreme temperature and patent ductus arteriosus or tetralogy of Fallot. In the current context of climate change, our results add new evidence to the present understanding of the effects of high- and low-temperature extreme exposure on CHD and its main subtypes.
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Affiliation(s)
- Huanhuan Zhang
- Department of Medical Genetics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Yang Feng
- Shanghai Pudong New Area Zhoupu Community Health Service Center, Pudong New Area, Shanghai, China
| | - Jia Huang
- Department of Medical Genetics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China
| | - Fenghua Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Sisi Zhuo
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Hongyan Liu
- Department of Medical Genetics, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, Zhengzhou, China.
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Klein JH, Cuneo B, Howley L, Kavanaugh-McHugh A, Taylor C, Chaves AH, Srivastava S, Donofrio MT, Gourishankar A, Krishnan A. Geospatial Distribution of Prenatally and Postnatally Diagnosed Congenital Heart Disease: Implications for Equitable Care from a Fetal Heart Society Research Collaborative Study. J Pediatr 2024; 273:114120. [PMID: 38815740 DOI: 10.1016/j.jpeds.2024.114120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/20/2024] [Accepted: 05/22/2024] [Indexed: 06/01/2024]
Abstract
OBJECTIVE To characterize patterns in the geospatial distribution of pre- and postnatally diagnosed congenital heart disease (CHD) across 6 surgical centers. STUDY DESIGN A retrospective, multicenter case series from the Fetal Heart Society identified patients at 6 centers from 2012 through 2016 with prenatally (PrND) or postnatally (PoND) diagnosed hypoplastic left heart syndrome (HLHS) or d-transposition of the great arteries (TGA). Geospatial analysis for clustering was done by the average nearest neighbor (ANN) tool or optimized hot spot tool, depending on spatial unit and data type. Both point location and county case rate per 10 000 live births were assessed for geographic clustering or dispersion. RESULTS Of the 453 CHD cases, 26% were PoND (n = 117), and 74% were PrND (n = 336). PrND cases, in all but one center, displayed significant geographic clustering by the ANN. Conversely, PoND cases tended toward geographic dispersion. Dispersion of PoND HLHS occurred in 2 centers (ANN = 1.59, P < .001; and 1.47, P = .016), and PoND TGA occurred in 2 centers (ANN = 1.22, P < .05; and ANN = 1.73, P < .001). Hot spot analysis of all CHD cases (TGA and HLHS combined) revealed clustering near areas of high population density and the tertiary surgical center. Hot spot analysis of county-level case rate, accounting for population density, found variable clustering patterns. CONCLUSION Geographic dispersion among postnatally detected CHD highlights the need for a wider reach of prenatal cardiac diagnosis tailored to the specific needs of a community. Geospatial analysis can support centers in improving the equitable delivery of prenatal care.
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Affiliation(s)
- Jennifer H Klein
- Division of Cardiology, Children's National Hospital, Washington, DC.
| | - Bettina Cuneo
- University of Arizona College of Medicine, Tuscon, AZ
| | | | | | - Carolyn Taylor
- Division of Cardiology, Medical University of South Carolina, Charleston, SC
| | - Alicia H Chaves
- Department of Pediatrics, University of Maryland School of Medicine, Baltimore, MD
| | | | - Mary T Donofrio
- Division of Cardiology, Children's National Hospital, Washington, DC
| | - Anand Gourishankar
- Division of Pediatric Hospital Medicine, Children's National Hospital, Washington, DC
| | - Anita Krishnan
- Division of Cardiology, Children's National Hospital, Washington, DC
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Feng Y, Liu X, Zhang X, Zhao X, Chang H, Ouyang F, Yu Z, Gao Z, Zhang H. Global air pollution exposure and congenital anomalies: an updated systematic review and meta-analysis of epidemiological studies. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2024; 34:2333-2352. [PMID: 37610216 DOI: 10.1080/09603123.2023.2246383] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023]
Abstract
A systematic review and meta-analysis was conducted to evaluate recent epidemiological evidence on the association of air pollution with congenital anomalies (CAs). Of 11,014 records, 49 were finally included in this meta-analysis. Per 10 μg/m3 increase in air pollutant, PM10 exposure during the 1st month of pregnancy and at the first trimester (T1) was associated with increased overall CAs. Further, exposure to PM10 was associated with congenital heart disease (OR = 1.055, 95% CI: 1.035, 1.074) and patent ductus arteriosus (OR = 1.094, 95% CI: 1.020, 1.168) at T1, with chromosomal anomalies during the entire pregnancy and with nervous system anomalies when exposure occurred 3 months prior to pregnancy, during the 1st, 2nd months of pregnancy and at T1. Besides, a significant association with overall CAs was observed for a combined exposure of PM10 and SO2 during the 1st month of gestation (OR: 1.101, 95% CI: 1.023, 1.180). A combined exposure of PM10 and CO was also associated with tetralogy of Fallot during 3-8 weeks of gestation (OR: 1.016, 95% CI: 1.005, 1.027). No significant associations were observed between PM2.5, NO2, and O3 exposure and CAs.
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Affiliation(s)
- Yang Feng
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xinxin Liu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Xiaoan Zhang
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- Clinical Nutrition Department, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Fan Ouyang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zengli Yu
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhan Gao
- Clinical Nutrition Department, The Fifth Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Huanhuan Zhang
- College of Public Health, Zhengzhou University, Zhengzhou, China
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Matias FR, Groves I, Durrans J, Herigstad M. Carbon monoxide affects early cardiac development in an avian model. Birth Defects Res 2024; 116:e2330. [PMID: 38488476 DOI: 10.1002/bdr2.2330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Revised: 02/21/2024] [Accepted: 02/28/2024] [Indexed: 03/19/2024]
Abstract
INTRODUCTION Carbon monoxide (CO) is a toxic gas that can be lethal in large doses and may also cause physiological damage in lower doses. Epidemiological studies suggest that CO in lower doses over time may impact on embryo development, in particular cardiac development, however other studies have not observed this association. METHODS Here, we exposed chick embryos in ovo to CO at three different concentrations (3, 9, 18 ppm) plus air control (4 protocols in total) for the first 9 days of development, at which point we assessed egg and embryo weight, ankle length, developmental stage, heart weight, ventricular wall thickness, ventricular-septal thickness and atrial wall thickness. RESULTS We found that heart weight was reduced for the low and moderate exposures compared to air, that atrial wall and ventricular wall thickness was increased for the moderate and high exposures compared to air and that ventricular septal thickness was increased for low, moderate and high exposures compared to air. Ventricular wall thickness was also significantly positively correlated with absolute CO exposures across all protocols. CONCLUSIONS This intervention study thus suggests that CO even at very low levels may have a significant impact on cardiac development.
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Affiliation(s)
- Filipa Rombo Matias
- Lisbon School of Health Technology, Polytechnic Institute of Lisbon, Lisbon, Portugal
| | - Ian Groves
- School of Mathematics and Statistics, The University of Sheffield, Sheffield, UK
- School of Biosciences, The University of Sheffield, Sheffield, UK
| | - Joshua Durrans
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
| | - Mari Herigstad
- Biomolecular Sciences Research Centre, Sheffield Hallam University, Sheffield, UK
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Robinson J, Sahai S, Pennacchio C, Sharew B, Chen L, Karamlou T. Effects of Sociodemographic Factors on Access to and Outcomes in Congenital Heart Disease in the United States. J Cardiovasc Dev Dis 2024; 11:67. [PMID: 38392282 PMCID: PMC10889660 DOI: 10.3390/jcdd11020067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 02/24/2024] Open
Abstract
Congenital heart defects (CHDs) are complex conditions affecting the heart and/or great vessels that are present at birth. These defects occur in approximately 9 in every 1000 live births. From diagnosis to intervention, care has dramatically improved over the last several decades. Patients with CHDs are now living well into adulthood. However, there are factors that have been associated with poor outcomes across the lifespan of these patients. These factors include sociodemographic and socioeconomic positions. This commentary examined the disparities and solutions within the evolution of CHD care in the United States.
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Affiliation(s)
- Justin Robinson
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Siddhartha Sahai
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
| | - Caroline Pennacchio
- Case Western Reserve University School of Medicine, Cleveland, OH 44195, USA
| | - Betemariam Sharew
- Cleveland Clinic Learner College of Medicine, Cleveland, OH 44195, USA
| | - Lin Chen
- Case Western Reserve University School of Medicine, Cleveland, OH 44195, USA
| | - Tara Karamlou
- Department of Thoracic and Cardiovascular Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic, Cleveland, OH 44195, USA
- Division of Pediatric Cardiac Surgery, Heart, Vascular and Thoracic Institute, Cleveland Clinic Children's Hospital, 9500 Euclid Avenue, Desk M41, Cleveland, OH 44195, USA
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Klein J, Ryan J, Dwivedi P, Leslie T, Vyas A, Krishnan A. Neighborhood location and nutritional resources as a risk factor for congenital heart disease in the fetus. Birth Defects Res 2023; 115:1556-1565. [PMID: 37589320 DOI: 10.1002/bdr2.2231] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 06/16/2023] [Accepted: 07/16/2023] [Indexed: 08/18/2023]
Abstract
BACKGROUND Congenital heart disease (CHD) is the most common birth defect, influenced by maternal health, environmental conditions, and genetics. Maternal health and nutrition, particularly maternal diabetes, is a modifiable risk factor for development of CHD in the fetus. However, the importance of food access during pregnancy on the development of CHD remains unknown. The objective of this study was to investigate the association between maternal neighborhood characteristics, particularly food access, and occurrence of prenatally diagnosed CHD. METHODS A retrospective case series studied maternal-fetal dyads with prenatally diagnosed CHD between 2019 and 2021 in Washington, DC. Moran's I of maternal addresses evaluated geographic clustering of disease. Negative binomial regression assessed association between census tract demographics and population-adjusted CHD rate. RESULTS A total of 307 dyads were analyzed. Global Moran's I showed significant CHD clustering (p-value = .004). However, degree of clustering was not clinically meaningful. After adjusting for neighborhood socioeconomic status, residing in food deserts was not a predictor for CHD. However, neighborhoods with a higher percentage of households receiving Supplemental Nutrition Assistance Program (SNAP) benefits were associated with higher rates of conotruncal heart defects (Incident Rate Ratio [IRR] = 1.04, CI = 1.01-1.08) and aggregate CHD (IRR = 1.03, CI = 1.01-1.05). CONCLUSIONS Neighborhood location and food access were not associated with CHD. However, increased enrollment in SNAP was associated with higher rates of CHD. The association between CHD and SNAP benefits warrants further exploration. Understanding food access and maternal nutrition may illuminate disparities in the burden of CHD.
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Affiliation(s)
- Jennifer Klein
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
| | - Julia Ryan
- The George Washington University School of Medicine and Health Sciences, George Washington University, Washington, DC, USA
| | - Pallavi Dwivedi
- Division of Biostatistics and Study Methodology, Children's National Hospital, Silver Spring, Maryland, USA
| | - Timothy Leslie
- Department of Geography and Geoinformation Sciences, George Mason University, Fairfax, Virginia, USA
| | - Amita Vyas
- Department of Prevention and Community Health, George Washington University, Milken Institute of Public Health, Washington, DC, USA
| | - Anita Krishnan
- Division of Cardiology, Children's National Hospital, Washington, DC, USA
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Buteau S, Veira P, Bilodeau-Bertrand M, Auger N. Association between First Trimester Exposure to Ambient PM2.5 and NO2 and Congenital Heart Defects: A Population-Based Cohort Study of 1,342,198 Live Births in Canada. ENVIRONMENTAL HEALTH PERSPECTIVES 2023; 131:67009. [PMID: 37339064 PMCID: PMC10281560 DOI: 10.1289/ehp11120] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 05/27/2023] [Accepted: 05/31/2023] [Indexed: 06/22/2023]
Abstract
BACKGROUND The extent to which ambient air pollution contributes to the pathogenesis of congenital heart defects remains uncertain. OBJECTIVE We investigated whether first trimester exposure to ambient fine particulate matter (PM2.5) and nitrogen dioxide (NO2) was associated with the risk of critical and noncritical heart defects in a large population-based cohort of births. METHODS We carried out a retrospective cohort study of children conceived between 2000 and 2016 in Quebec, Canada. Heart defects were identified via data from the Maintenance and Use of Data for the Study of Hospital Clientele registry. The main exposures were average concentration of PM2.5 and NO2 in a) the first trimester and b) the month of conception. Exposures were estimated at the residential postal code. Associations with critical and noncritical heart defects were assessed using logistic regression models, adjusted for maternal and infant characteristics. We considered single- and two-pollutant models and assessed modifying effects of maternal comorbidity, including preexisting hypertension, preeclampsia, anemia, and diabetes. RESULTS The cohort comprised 1,342,198 newborns, including 12,715 with heart defects. Exposure in the first trimester and month of conception yielded similar results; both were associated with a greater risk of heart defects. Adjusted odds ratios (OR) for any heart defect per interquartile range increase were 1.02 (95% CI: 1.00, 1.05) for PM2.5 and 1.10 (95% CI: 1.07, 1.13) for NO2. Associations with atrial septal defects were 1.08 (95% CI: 1.03, 1.14) for PM2.5 and 1.19 (95% CI: 1.12, 1.25) for NO2. Corresponding ORs for ventricular septal defects and individual critical heart defects were not significant. PM2.5 (OR=1.11; 95% CI: 1.06, 1.17) and NO2 (OR=1.23; 95% CI: 1.17, 1.31) exposure were associated with a greater risk of heart defects in mothers with comorbidity. DISCUSSION In this population-based cohort, prenatal exposure to ambient air pollution during the first trimester was associated with an increased risk of heart defects, particularly atrial septal defects. The association with heart defects was greater in mothers with comorbidity. https://doi.org/10.1289/EHP11120.
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Affiliation(s)
- Stéphane Buteau
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Environmental and Occupational Health, School of Public Health, University of Montreal, Montreal, Quebec, Canada
| | - Paige Veira
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada
| | | | - Nathalie Auger
- Institut national de santé publique du Québec, Montreal, Quebec, Canada
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Quebec, Canada
- University of Montreal Hospital Research Centre, University of Montreal, Montreal, Quebec, Canada
- Department of Social and Preventive Medicine, University of Montreal, Montreal, Quebec, Canada
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Zhang W, Yang Y, Liu Y, Zhou L, Yang Y, Pan L, Ba Y, Wang R, Huo Y, Ren X, Bai Y, Cheng N. Associations between congenital heart disease and air pollutants at different gestational weeks: a time-series analysis. ENVIRONMENTAL GEOCHEMISTRY AND HEALTH 2023; 45:2213-2228. [PMID: 35869374 DOI: 10.1007/s10653-022-01315-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 05/28/2022] [Indexed: 06/15/2023]
Abstract
Exposure to air pollution during pregnancy has been linked to birth defects. But the directions of studies on the associations between air pollutants exposure and effect on the incidence of congenital heart disease (CHDs) were inconsistent. To date, few studies were concentrated on the effects of both particulate matter and gaseous air pollutant exposure on CHDs across the full gestational week simultaneously. Our study aimed to investigate the critical exposure windows for each air pollutant throughout 40 gestational weeks. Data on CHDs, air pollution, and meteorological factors from 2013 to 2019 were collected in Lanzhou, China. A distributed lag nonlinear model combined with a quasi-Poisson regression model was applied to evaluate the weekly exposure-lag-response association between air pollutants levels and CHDs, and the subgroup analyses were conducted by gender (baby boy and baby girl). The study included 1607 mother-infant pairs. The results demonstrated that exposure of pregnant women to particulate matter ≤ 5 μm (PM2.5) at lag 1-4 weeks was significantly associated with the risk of CHDs, and the strongest effects were observed in the lag 1 week (1.150, 95%CI 1.059-1.248). For exposure to particulate matter ≤ 10 μm (PM10) at lag 1-3 weeks, the strongest effects were observed in the lag 1 week (1.075, 95% CI 1.026-1.128). For exposure to sulfur dioxide (SO2) at lag 1-4 weeks, the strongest effects were observed in the lag 1 week (1.154, 95% CI 1.025-1.299). For exposure to carbon monoxide (CO) at lag 1-3 weeks, the strongest effects were observed in the lag 1 week (1.089, 95% CI 1.002-1.183). For exposure to ozone (O3) concentration at lag 9-15 weeks, the strongest effects were observed in the lag 15 weeks (1.628, 95% CI 1.001-2.649). The cumulative effects of PM2.5, PM10, SO2, and CO along weeks with a maximum of 1.609 (95%CI 1.000-2.589), 1.286 (95%CI 1.007-1.641), 1.648 (95%CI 1.018-2.668), and 1.368 (95%CI 1.003, 1.865), respectively. The effects were obvious in the initial gestational weeks too. Through the gender stratification analysis, the air pollutants with significant effects were PM2.5 for baby boys and PM2.5, PM10, SO2, CO, NO2, and O3 for baby girl. For the relationship between CHDs and air pollution in Lanzhou, PM2.5, PM10, SO2, CO, and O3 played an important role in the initial gestational weeks, especially for baby girl.
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Affiliation(s)
- Wenling Zhang
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yanjun Yang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yanyan Liu
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Zhou
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yan Yang
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Li Pan
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yupei Ba
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ruijuan Wang
- Maternal and Child Health Care Hospital of Lanzhou, Lanzhou, 730050, Gansu, People's Republic of China
| | - Yanbei Huo
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Xiaoyu Ren
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Yana Bai
- School of Public Health, Institute of Epidemiology and Statistics, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China
| | - Ning Cheng
- Center for Reproductive Health and birth defects at Lanzhou University, Basic Medical College, Lanzhou University, Lanzhou, 730000, Gansu, People's Republic of China.
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Li B, Huang J, Zhang Y. The impacts of air pollution on immigrants' settlement intention in China. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2023; 30:46587-46603. [PMID: 36719576 DOI: 10.1007/s11356-023-25149-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Accepted: 01/02/2023] [Indexed: 06/18/2023]
Abstract
This paper investigates the impacts of air pollution on immigrants' willingness to settle in China. We construct a theoretical model that discusses how air pollution impacts immigrants' willingness to return home and move to other cities and illustrates how air pollution decreases the settlement intention of immigrants. The empirical results show that urban air pollution decreases immigrants' settlement intention. Robustness checks using multi-methods and multi-measures of settlement intention and air pollution support this conclusion. Air pollution has heterogeneous impacts on immigrants' settlement intentions. From the individual level, air pollution decreases the settlement intention for immigrants with 30-60 years old, middle-income migrants, and rural migrants. From the city level, air pollution decreases the settlement intention of immigrants in the eastern region, developed cities, and cities with high and low air pollution.
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Affiliation(s)
- Baoxi Li
- School of Business, Hubei University, Wuhan, 430062, China.
- Antai College of Economics and Management, Shanghai Jiao Tong University, Shanghai, China.
- Ant Group Research Institute, Shanghai, China.
| | - Jing Huang
- School of Business, Hubei University, Wuhan, 430062, China
- Research Center of Open Economy, Hubei University, Wuhan, China
| | - Yuan Zhang
- School of Business, Hubei University, Wuhan, 430062, China
- Research Center of Open Economy, Hubei University, Wuhan, China
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Cheng Y, Yin J, Yang L, Xu M, Lu X, Huang W, Dai G, Sun G. Ambient air pollutants in the first trimester of pregnancy and birth defects: an observational study. BMJ Open 2023; 13:e063712. [PMID: 36948563 PMCID: PMC10040071 DOI: 10.1136/bmjopen-2022-063712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/24/2023] Open
Abstract
OBJECTIVES As current studies on the relationships between air pollutants exposure during the first trimester and birth defects were not fully elucidated, this study aimed to assess the association between selected air pollutants and birth defects. DESIGN An observational study. PARTICIPANTS We obtained 70 854 singletons with gestational age <20 weeks who were delivered at a large maternal and child healthcare centre in Wuhan, China. OUTCOME MEASURES Birth defects data and daily average concentration of ambient particulate matter ≤10 µm diameter (PM10), PM ≤2.5 µm diameter (PM2.5), sulfur dioxide (SO2) and nitrogen dioxide (NO2) were obtained. Logistic regression analysis was applied to assess the association between maternal air pollutants exposure during first trimester and total birth defects, congenital heart defects (CHDs), limb defects and orofacial clefts with adjustments of potential covariates. RESULTS There were a total of 1352 birth defect cases included in this study, with a prevalence of 19.08‰. Maternal exposed to high concentrations of PM10, PM2.5, NO2 and SO2 in the first trimester were significantly associated with elevated ORs of birth defects (ORs ranged from 1.13 to 1.23). Additionally, for male fetuses, maternal exposed to high PM2.5 concentration was associated with an elevated odd of CHDs (OR 1.27, 95% CI 1.06 to 1.52). In the cold season, the ORs of birth defects were significantly increased among women exposed to PM2.5 (OR 1.64, 95% CI 1.41 to 1.91), NO2 (OR 1.22, 95% CI 1.08 to 1.38) and SO2 (OR 1.26, 95% CI 1.07 to 1.47). CONCLUSIONS This study showed unfavourable effects of air pollutants exposure during the first trimester on birth defects. Especially, the association between maternal PM2.5 exposure and CHDs was only observed among male fetuses, and stronger effects of PM2.5, NO2 and SO2 exposure on birth defects were observed in the cold season.
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Affiliation(s)
- Yao Cheng
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Jieyun Yin
- Department of Epidemiology and Health Statistics, Medical College of Soochow University, Suzhou, China
| | - Lijun Yang
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Man Xu
- School of Nursing, Hubei University of Chinese Medicine, Wuhan, China
| | - Xinfeng Lu
- Medical Record Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Wenting Huang
- Science and Education Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Guohong Dai
- Health Care Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
| | - Guoqiang Sun
- Obstetrics Department, Maternal and Child Health Hospital of Hubei Province, Wuhan, China
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Sun L, Wu Q, Wang H, Liu J, Shao Y, Xu R, Gong T, Peng X, Zhang B. Maternal exposure to ambient air pollution and risk of congenital heart defects in Suzhou, China. Front Public Health 2023; 10:1017644. [PMID: 36684928 PMCID: PMC9845866 DOI: 10.3389/fpubh.2022.1017644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 12/07/2022] [Indexed: 01/06/2023] Open
Abstract
Background More and more studies have investigated the association between maternal exposure to ambient air pollution during pregnancy and incidence of congenital heart defects (CHDs), but results are controversial. The aim of this study was to investigate whether maternal exposure to air pollutants (PM10, PM2.5, NO2, CO, SO2) are associated with an increased risk of congenital heart defects in Suzhou city, China. Methods Based on the birth defect monitoring system of Suzhou city and the Environmental Health Department of Suzhou CDC, the birth defect monitoring data and concentrations of five air pollutants (PM10, PM2.5, NO2, CO, SO2) in Suzhou city from 2015 to 2019 were obtained. The distribution of demographic characteristics of children with birth defects and exposure to air pollutant concentrations during different pregnancy periods were analyzed, Chi-square test was used to analyze whether there were statistical differences in the distribution of parturient woman age, pregnant weeks, times of pregnancy, as well as fetal sex and birth weight among children with congenital heart defects and other defects. Logistic regression model was further established to calculate the adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association between exposure to these ambient air pollutants during pregnancy and CHDs. Results A total of 5,213 infants with birth defects were recruited in this study from 2015 to 2019, the top five birth defects in Suzhou were syndactyly, congenital heart disease, ear malformation, cleft lip and palate, and hypospadias, and the proportion of congenital heart disease increased. The level of maternal exposures (mean ± sd) was highest in first trimester amongst pregnant women in Suzhou city. Compared to other birth defects, we observed significant increasing associations between PM2.5 exposure during second and third trimester with risk of CHDs, aORs were 1.228 and 1.236 (95% CI: 1.141-1.322, 1.154-1.324 separately) per a 10 μg/m3 change in PM2.5 concentration. Maternal NO2 exposure was significantly associated with CHDs in first trimester (aOR = 1.318; 95% CI: 1.210-1.435). Conclusions Our study contributes to explore the current state of Suzhou air quality and the association between maternal air pollution exposure and congenital heart defects. Exposure to PM2.5 and NO2 is thought to increase the risk of CHDs, but comprehensive description of these associations will be needed in future studies.
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Affiliation(s)
| | - Qianlan Wu
- Suzhou Maternal and Child Healthcare Center, Suzhou Municipal Hospital, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China
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Boyd R, McMullen H, Beqaj H, Kalfa D. Environmental Exposures and Congenital Heart Disease. Pediatrics 2022; 149:183839. [PMID: 34972224 DOI: 10.1542/peds.2021-052151] [Citation(s) in RCA: 33] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/19/2021] [Indexed: 12/16/2022] Open
Abstract
Congenital heart disease (CHD) is the most common congenital abnormality worldwide, affecting 8 to 12 infants per 1000 births globally and causing >40% of prenatal deaths. However, its causes remain mainly unknown, with only up to 15% of CHD cases having a determined genetic cause. Exploring the complex relationship between genetics and environmental exposures is key in understanding the multifactorial nature of the development of CHD. Multiple population-level association studies have been conducted on maternal environmental exposures and their association with CHD, including evaluating the effect of maternal disease, medication exposure, environmental pollution, and tobacco and alcohol use on the incidence of CHD. However, these studies have been done in a siloed manner, with few examining the interplay between multiple environmental exposures. Here, we broadly and qualitatively review the current literature on maternal and paternal prenatal exposures and their association with CHD. We propose using the framework of the emerging field of the exposome, the environmental complement to the genome, to review all internal and external prenatal environmental exposures and identify potentiating or alleviating synergy between exposures. Finally, we propose mechanistic pathways through which susceptibility to development of CHD may be induced via the totality of prenatal environmental exposures, including the interplay between placental and cardiac development and the internal vasculature and placental morphology in early stages of pregnancy.
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13
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Yu X, Miao H, Zeng Q, Wu H, Chen Y, Guo P, Zhu Y. Associations between ambient heat exposure early in pregnancy and risk of congenital heart defects: a large population-based study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2022; 29:7627-7638. [PMID: 34476711 DOI: 10.1007/s11356-021-16237-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/25/2021] [Indexed: 02/05/2023]
Abstract
Some epidemiological studies have confirmed the association between environmental factors and congenital heart defects (CHD). While the possibility that maternal ambient heat exposures are related to CHD has received little attention. Our study aims to investigate the association between maternal ambient extreme heat exposure early in pregnancy and the risk of CHD in offspring in China. We conducted a retrospective cohort study of 1,918,105 fetuses between 2 and 8 weeks after gestation from May to October in Guangdong, China, 2015-2019. The main heat exposure was defined as extreme heat events (EHE) by using the 90th (EHE90) or 95th (EHE95) percentile of the daily maximum temperature. For each EHE definition, we further defined four indicators: having EHE or not, frequency, duration, and cumulative days. We used the log-binomial regression models to calculate the prevalence ratios (PR) of CHD with 95% confidence intervals (CI) for the associations between CHD and EHE, adjusted for potentially confounding covariates. There are 1,918,105 infants included in the study, of which 9588 had CHD, with a prevalence rate of 499.9 per 100,000 (95% CI: 489.9, 509.8). We found that all EHE indicators were positively associated with the increased risks of overall CHD, some CHD classes (congenital malformations of cardiac septa, congenital malformations of great arteries, and congenital malformations of great arteries), and some CHD subtypes (atrial septal defect and patent ductus arteriosus). In addition, the PR yielded higher estimates when exposing to EHE95. For instance, the risk of suffering congenital malformations of great arteries was 1.548 (95% CI: 1.401, 1.712) for EHE90 exposure and 1.723 (95% CI: 1.565, 1.898) for EHE95 exposure, respectively. Our study demonstrated that EHE during 2-8 weeks postconception was associated with overall CHD in offspring, particularly atrial septal defects and patent ductus arteriosus. The associations strengthened with the extent and cumulative days of maternal exposure to EHE.
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Affiliation(s)
- Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Huazhang Miao
- Department of Healthcare, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511442, China
- School of Health Management, Southern Medical University, Guangzhou, 510515, Guangdong Province, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China
| | - Pi Guo
- Department of Preventive Medicine, Shantou University Medical College, Shantou, 515041, China.
- Guangdong Provincial Key Laboratory of Infectious Diseases and Molecular Immunopathology, Shantou, 515041, China
| | - Yingxian Zhu
- Department of Healthcare, Guangdong Women and Children Hospital, No. 521 Xingnan Road, Guangzhou, 511442, China
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14
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Klein J, Dwyer G, Donofrio MT, Krishnan A. Geographic Distribution of Congenital Heart Disease: A Single Surgical Center Experience. J Pediatr 2022; 240:117-121. [PMID: 34480916 DOI: 10.1016/j.jpeds.2021.08.080] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To determine presence of spatial clustering or dispersion of pre and postnatally detected hypoplastic left heart syndrome (HLHS) and d-transposition of the great arteries (TGA) cases. STUDY DESIGN This retrospective study examined all patients with a prenatal or postnatal diagnosis of HLHS or TGA who had an initial visit or hospitalization at our tertiary care center over a 5-year period from 2012 to 2016 (n = 105). Using geographic information systems software, the nearest neighbor ratio (NNR) tool was used to determine whether statistically significant clustering or dispersion occurred. RESULTS Geographic clustering was observed among prenatally diagnosed pooled cases of HLHS and TGA and all total cases (NNR = 0.73 and 0.66, respectively), but not postnatally detected cases (NNR = 1.08). Notably, there was significant dispersion of postnatally detected TGA cases (NNR = 1.22) There was no pattern for prenatally detected TGA or HLHS when analyzed individually. CONCLUSIONS The spatial distribution of HLHS and TGA is not random; these conditions occur in geographic clusters. Clustering of all patients in the study population and dispersion of postnatal diagnosis of TGA represent opportunities for improved delivery of fetal cardiac care.
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Affiliation(s)
- Jennifer Klein
- Division of Cardiology, Children's National Hospital, Washington, DC.
| | - Gina Dwyer
- Child Health Advocacy Institute, Children's National Hospital, Washington, DC
| | - Mary T Donofrio
- Division of Cardiology, Children's National Hospital, Washington, DC
| | - Anita Krishnan
- Division of Cardiology, Children's National Hospital, Washington, DC
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15
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Zhang H, Zhang X, Zhao X, Cheng G, Chang H, Ye X, Wang J, Yu Z, Wang Q, Huang C. Maternal exposure to air pollution and congenital heart diseases in Henan, China: A register-based case-control study. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2022; 229:113070. [PMID: 34920182 DOI: 10.1016/j.ecoenv.2021.113070] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 11/27/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Association between ambient air pollution and congenital heart diseases (CHDs) remains inconclusive, and the critical exposure windows has not been well studied. OBJECTIVES This case-control study aimed to assess the effect of ambient air pollution exposure on the risk of CHDs and the subtypes in Henan, China, and further to explore potential susceptible windows. METHODS Daily average particulate matter with an aerodynamic diameter of ≤2.5 µm (PM2.5) and ≤10 µm (PM10), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO) and ozone (O3) were collected by Chinese Air Quality Reanalysis datasets. Binary logistic regression was used to examine trimester-specific associations between per 10 μg/m3 increase in air pollutants and CHDs as well as the major subtypes. Distributed lag models incorporating logistic regression were applied to explore weekly-specific associations. RESULTS A total of 196,069 singleton live births were included during 2013-2018, 643 CHDs were identified (3.3‰). We found that first and second trimester CO exposure increased overall CHDs risk, the adjusted odds ratio (aOR) and 95% confidence interval (CI) were 1.066 (1.010-1.125) and 1.065 (1.012-1.122). For CHDs subtypes, we observed that NO2 and CO in first trimester, PM2.5 and PM10 in the second trimester exposure were associated with the risk of atrial septal defect (ASD), the susceptible windows of air pollutants and ASD mainly occurred in the 1st- 6th gestational weeks. No positive association was observed for air pollution and tetralogy of Fallot. CONCLUSION Our findings suggest that ambient air pollution exposure is associated with the risk of CHDs especially for ASD, and the susceptible windows generally occurred in first trimester. Further well-designed longitudinal studies are warranted to confirm our findings.
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Affiliation(s)
- Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China; School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Xiaoan Zhang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xin Zhao
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Guomei Cheng
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Hui Chang
- The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaofang Ye
- Shanghai Key Laboratory of Meteorology and Health, Shanghai Meteorological Service, Shanghai, China
| | - Jingzhe Wang
- MNR Key Laboratory for Geo-Environmental Monitoring of Great Bay Area & Guangdong Key Laboratory of Urban Informatics & Shenzhen Key Laboratory of Spatial Smart Sensing and Services, Shenzhen University, Shenzhen, China
| | - Zengli Yu
- School of Public Health, Zhengzhou University, Zhengzhou, China.
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China
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16
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Yu G, Chen Y, Tang J, Lin Z, Zheng F, Zheng C, Zhou J, Su Q, Wu S, Li H. Meta-analyses of maternal exposure to atmospheric particulate matter and risk of congenital anomalies in offspring. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:55869-55887. [PMID: 34491504 DOI: 10.1007/s11356-021-16200-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Accepted: 08/24/2021] [Indexed: 06/13/2023]
Abstract
Congenital anomalies are the main causes of infant death and disability. Previous studies have suggested that maternal exposure to particulate matter is related to congenital malformation. However, the conclusions of this study remain controversial. Hence, meta-analyses were performed to assess the relationship between maternal exposure to particulate matter and the risk of congenital anomalies. The Medline, Embase, and Web of Science databases were systemically searched from inception until August 2020 to find articles related to birth defects and particulate matter. The pooled risk estimated for the combination of pollution outcomes was calculated for each study by performing fixed effects or random effects models. The existence of heterogeneity and publication bias in relevant studies was also examined. Thirty studies were included in the analysis. A statistically increased summary risk valuation was found. PM10 exposure was associated with an increased risk of congenital heart disease, neural tube defects, and cleft lip with or without cleft palate (OR per 10 μg/m3 = 1.05, 95% CI, 1.03-1.07; OR per 10 μg/m3 = 1.04, 95% CI, 1.01-1.06; OR per 10 μg/m3 = 1.03, 95% CI, 1.01-1.06). Maternal exposure to particulate matter might be associated with an increased risk of congenital anomalies. Our results indicate the dangers of particulate matter exposure on fetal development and the importance of protection against exposure to such particles during pregnancy. The schematic representation of the association between maternal exposure to PM2.5/PM10 and congenital anomalies in offspring, and geographic distribution of the included reports in the meta-analyses.
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Affiliation(s)
- Guangxia Yu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Yao Chen
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Jianping Tang
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Zhifeng Lin
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Fuli Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Chunyan Zheng
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Jinfu Zhou
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Qianqian Su
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China
| | - Siying Wu
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China.
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
| | - Huangyuan Li
- Fujian Key Lab of Environmental Factors and Cancer, School of Public Health, Fujian Medical University, Fuzhou, China.
- Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, 350122, China.
- Key Lab of Environment and Health, School of Public Health, Fujian Medical University, Fuzhou, China.
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17
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Yan F, Liu H, Zhang H, Yi L, Wu Y, Deng C, Qiu Y, Ma X, Li Q, Yang F, Xu W, Tao J, Buonocore JJ, Zhan Y, Dai L. Association between maternal exposure to gaseous pollutants and atrial septal defect in China: A nationwide population-based study. ENVIRONMENTAL RESEARCH 2021; 200:111472. [PMID: 34097890 DOI: 10.1016/j.envres.2021.111472] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 05/27/2021] [Accepted: 06/01/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The association between maternal exposure to gaseous air pollutants and congenital heart defects (CHD) remains unclear. The concentration-response relationship and the time windows of susceptibility to gaseous pollutants may vary by pollutant species and CHD subtypes. OBJECTIVE We aimed to examine the relationship between maternal exposures to four species of gaseous pollutants (NO2, O3, SO2, and CO) and atrial septal defect (ASD), which is a common subtype of CHD, and to determine the critical time windows of susceptibility for each gaseous pollutant. METHODS Among 1,253,633 infants born between October 1, 2013 and December 31, 2016 in China, 1937 newborns were diagnosed with isolated ASD, a prevalence of 1.55‰. Maternal exposures to the gaseous pollutants were estimated by matching the geocoded maternal addresses with the gridded ambient concentrations. The adjusted odds ratios (aOR) between exposures and ASD were quantified by using mixed-effects logistic regression models. RESULTS We found significantly positive associations between ASD and maternal exposures to NO2, O3, SO2, and CO during entire pregnancy, first-, second-, and third-trimester. However, no statistically significant association was found between maternal exposure to PM2.5, PM2.5-10 and ASD risk (P > 0.05). In the fully adjusted model with respect to average exposure over entire pregnancy, the adjusted odds ratios (aOR) for each 10 μg/m3 increment of NO2, O3, SO2 were 1.33 (95% CI: 1.22-1.45), 1.13 (95% CI: 1.10-1.16), 1.28 (95% CI: 1.20-1.35), respectively; the aOR for each 100 μg/m3 increment of CO was 1.10 (95% CI: 1.06-1.15). The observed concentration-response relationships varied by exposure periods and pollutants, with the strongest association for NO2 during the 1st-8th embryology weeks, for O3 during the third trimester, for SO2 during the second trimester, and for CO without obvious variation. CONCLUSIONS The findings suggest an increased risk of ASD in association with maternal exposures to four common gaseous pollutants. From the perspective of birth defects prevention and ASD risk mitigation, it is critical to reduce maternal exposure to gaseous pollutants especially during the most susceptible time windows.
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Affiliation(s)
- Fangyuan Yan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Hanmin Liu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Hanyue Zhang
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Ling Yi
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yangyang Wu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Changfei Deng
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Yang Qiu
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China
| | - Xia Ma
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Qi Li
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Fumo Yang
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; National Engineering Research Center for Flue Gas Desulfurization, Chengdu, Sichuan, 610065, China
| | - Wenli Xu
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jing Tao
- National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China
| | - Jonathan J Buonocore
- Center for Climate, Health, and the Global Environment at Harvard T.H. Chan School of Public Health, Boston, MA, 02115, United States
| | - Yu Zhan
- Department of Environmental Science and Engineering, Sichuan University, Chengdu, Sichuan, 610065, China; National Engineering Research Center for Flue Gas Desulfurization, Chengdu, Sichuan, 610065, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, 610041, China.
| | - Li Dai
- The Joint Laboratory for Pulmonary Development and Related Diseases, West China Institute of Women and Children's Health, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, 610041, China; National Center for Birth Defects Monitoring, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, 610041, China; Med-X Center for Informatics, Sichuan University, Chengdu, Sichuan, 610041, China.
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18
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Jiang W, Liu Z, Ni B, Xie W, Zhou H, Li X. Independent and interactive effects of air pollutants and ambient heat exposure on congenital heart defects. Reprod Toxicol 2021; 104:106-113. [PMID: 34311057 DOI: 10.1016/j.reprotox.2021.07.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 07/10/2021] [Accepted: 07/19/2021] [Indexed: 12/16/2022]
Abstract
Accumulating studies have been focused on the independent effects of air pollutants and ambient heat exposure on congenital heart defects (CHDs) but with inconsistent results, and their interactive effect remains unclear. A case-control study including 921 cases and 9210 controls was conducted in Changsha, China in warm season in 2015-2018. The gravidas were assigned monthly averages of daily air pollutants and daily maximum temperature using the nearest monitoring station method and city-wide average method, respectively, during the first trimester of pregnancy. Multivariate logistic regression models were used to estimate the independent effects of each air pollutant and different ambient heat exposure indicators. Their additive joint effects were quantified using attribute proportions of interaction (API). Increasing SO2 consistently increased the risk of CHDs in the first trimester of pregnancy, with aORs ranging from 1.78 to 2.04. CO, NO2 and PM2.5 exposure in the first month of pregnancy, and O3 exposure in the second and third month of pregnancy were also associated with elevated risks of CHDs, with aORs ranging from 1.04 to 1.15. Depending on the ambient heat exposure indicator used, air pollutants showed more apparent synergistic effects (API > 0) with less and moderately intense heat exposure. Maternal exposure to CO, NO2, SO2, PM2.5 and O3 during early pregnancy increased risk of CHDs, and ambient heat exposure may enhance these effects. Our findings help to understand the interactive effect of air pollution with ambient heat exposure on CHDs, which is of vital public health significance.
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Affiliation(s)
- Wen Jiang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Zhiyu Liu
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Bin Ni
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Wanqin Xie
- Maternal and Child Health Care Hospital of Hunan Province, Changsha, China.
| | - Haiyan Zhou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
| | - Xingli Li
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China.
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19
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Al Noaimi G, Yunis K, El Asmar K, Abu Salem FK, Afif C, Ghandour LA, Hamandi A, Dhaini HR. Prenatal exposure to criteria air pollutants and associations with congenital anomalies: A Lebanese national study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 281:117022. [PMID: 33813197 DOI: 10.1016/j.envpol.2021.117022] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2020] [Revised: 02/19/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
Maternal exposure to air pollution has been associated with a higher birth defect (BD) risk. Previous studies suffer from inaccurate exposure assessment methods, confounding individual-level variations, and classical analytical modelling. This study aimed to examine the association between maternal exposure to criteria air pollutants and BD risk. A total of 553 cases and 10,214 controls were identified from private and public databases. Two subgroups were then formed: one for a matched case-control design, and another for Feature Selection (FS) analysis. Exposure assessment was based on the mean air pollutant-specific levels in the mother's residential area during the specific BD gestational time window of risk (GTWR) and other time intervals. Multivariate regression models outcomes consistently showed a significant protective effect for folic acid intake and highlighted parental consanguinity as a strong BD risk factor. After adjusting for these putative risk factors and other covariates, results show that maternal exposure to PM2.5 during the first trimester is significantly associated with a higher overall BD risk (OR:1.05, 95%CI:1.01-1.09), and with a higher risk of genitourinary defects (GUD) (OR:1.06, 95%CI:1.01-1.11) and neural tube defects (NTD) (OR:1.10, 95%CI:1.03-1.17) during specific GTWRs. Maternal exposure to NO2 during GTWR exhibited a significant protective effect for NTD (OR:0.94, 95%CI:0.90-0.99), while all other examined associations were not statistically significant. Additionally, maternal exposure to SO2 during GTWR showed a significant association with a higher GUD risk (OR:1.17, 95%CI:1.08-1.26). When limiting selection to designated monitor coverage radiuses, PM2.5 maintained significance with BD risk and showed a significant gene-environment interaction for GUD (p = 0.018), while NO2 protective effect expanded to other subtypes. On the other hand, FS analysis confirmed maternal exposure to PM2.5 and NO2 as important features for GUD, CHD, and NTD. Our findings, set the basis for building a novel BD risk prediction model.
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Affiliation(s)
- Ghaliya Al Noaimi
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Lebanon.
| | - Khalid Yunis
- Department of Pediatrics and Adolescent Medicine, Faculty of Medicine, American University of Beirut, Lebanon.
| | - Khalil El Asmar
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Lebanon.
| | - Fatima K Abu Salem
- Department of Computer Science, Faculty of Arts and Sciences, American University of Beirut, Lebanon.
| | - Charbel Afif
- EMMA Laboratory, Center for Analysis and Research, Faculty of Science, Saint-Joseph University, Beirut, Lebanon; Climate and Atmosphere Research Center, The Cyprus Institute, Nicosia, Cyprus.
| | - Lilian A Ghandour
- Department of Epidemiology and Population Health, Faculty of Health Sciences, American University of Beirut, Lebanon.
| | - Ahmad Hamandi
- Department of Computer Science, Faculty of Arts and Sciences, American University of Beirut, Lebanon.
| | - Hassan R Dhaini
- Department of Environmental Health, Faculty of Health Sciences, American University of Beirut, Lebanon.
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20
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Ma Z, Cao X, Chang Y, Li W, Chen X, Tang NJ. Association between gestational exposure and risk of congenital heart disease: A systematic review and meta-analysis. ENVIRONMENTAL RESEARCH 2021; 197:111014. [PMID: 33716027 DOI: 10.1016/j.envres.2021.111014] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 05/21/2023]
Abstract
Congenital heart disease (CHD) is the most common congenital anomaly and one of the leading causes of newborn death. Few studies analyze multiple ambient air pollutants and different congenital heart disease subtypes at the same time. We conducted a meta-analysis to explore the association between gestational air pollution exposure and CHD subtypes. We searched PubMed, Embase, Web of Science from inception till July 31, 2020. Newcastle Ottawa Scale (NOS) was used to evaluate the quality of the literature. Funnel plots and Egger's regression were used to estimate publication bias. Heterogeneity was evaluated by the chi-square test and the coefficient of inconsistency I2 in this study. Finally, we performed a subgroup analysis to find reasons for heterogeneity. In the preliminary analysis, the result shows that the association between air pollutants and congenital heart disease was not statistically significant, except for CO and SO2. There is a positive association between air pollutants and ventricular septal defect (VSD) in our subtype analysis, the OR (95%CI) for PM10, PM2.5, and O3 was 1.057(1.005-1.109), 1.208(1.080-1.337), and 1.205(1.101-1.310), respectively. In addition, we also observed a negative association between SO2 and atrial septal defect (ASD) (OR: 0.817, 95%CI: 0.743-0.890) in subgroup analysis. The source of heterogeneity in our study mainly included study area and exposure time. These findings have implications for researchers to further study the relationship between air pollution and congenital heart disease.
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Affiliation(s)
- Zhao Ma
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Xue Cao
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China
| | - Ying Chang
- Tianjin Central Hospital of Gynecology Obstetrics/Maternity Hospital of Nankai University, No.156 Sanma Road, Nankai District, Tianjin, 300100, China; Prenatal Diagnosis Center / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, 300100, China
| | - Wen Li
- Tianjin Central Hospital of Gynecology Obstetrics/Maternity Hospital of Nankai University, No.156 Sanma Road, Nankai District, Tianjin, 300100, China; Prenatal Diagnosis Center / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, 300100, China
| | - Xu Chen
- Tianjin Central Hospital of Gynecology Obstetrics/Maternity Hospital of Nankai University, No.156 Sanma Road, Nankai District, Tianjin, 300100, China; Prenatal Diagnosis Center / Tianjin Key Laboratory of Human Development and Reproductive Regulation, Tianjin, 300100, China.
| | - Nai Jun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, No. 22 Meteorological Station Road, Heping District, Tianjin, 300070, China; Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, 300070, China; Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, 300070, China.
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21
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Khalili Doroodzani A, Dobaradaran S, Akhbarizadeh R, Raeisi A, Rahmani E, Mahmoodi M, Nabipour I, Keshmiri S, Darabi AH, Khamisipour G, Mahmudpour M, Keshtkar M. Diet, exposure to polycyclic aromatic hydrocarbons during pregnancy, and fetal growth: A comparative study of mothers and their fetuses in industrial and urban areas in Southwest Iran. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 276:116668. [PMID: 33611204 DOI: 10.1016/j.envpol.2021.116668] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2020] [Revised: 01/30/2021] [Accepted: 02/01/2021] [Indexed: 06/12/2023]
Abstract
The presence of polycyclic aromatic hydrocarbons (PAHs) in the fetal environment is a high-priority concern due to the fetus being more sensitive than adults to these ubiquitous xenobiotics. The aim of the present study was to compare the maternal and fetal serum levels of ΣPAHs and their effects on fetal growth in an industrial and an urban area in Southwest Iran. The industrial area was the petrochemical and gas area (PGA) of the Central District of Asaluyeh County and the urban area (UA) was the Central District of Bushehr County, Ninety-nine maternal serum (MS) and 99 cord serum (CS) samples from the PGA and 100 MS and 100 CS samples from the UA were collected during May 2018 to February 2019. The mean concentrations of ΣPAHs were significantly (p < 0.05) higher in the PGA than the UA in both MS (157.71 vs. 93.56 μg/L) and CS (155.28 vs. 93.19 μg/L) samples. Naphthalene (NAP) was the predominant PAH detected in all the studied samples. Significant negative associations were found between birth weight and anthracene (ANT) level in MS (β = -22.917, p = 0.032; weight decrement = 22.917 g for a 1 μg/L increase in ANT); head circumference and chrysene (CHR) level in MS (β = -0.206, p = 0.023; head circumference decrement = 0.206 cm for a 1 μg/L increase in CHR); and birth height and NAP level in CS (β = -0.20, p = 0.005; height decrement = 0.20 cm for a 1 μg/L increase in NAP). Maternal diet had a significant effect on the serum levels of PAHs. The results of this study showed that transmission of PAHs from mother to fetus through the cord blood is an important issue and mothers who live in industrial areas and consume PAH-containing foodstuffs, and their fetuses, are more at risk than those living in a non-industrial urban area.
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Affiliation(s)
- Atefeh Khalili Doroodzani
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Sina Dobaradaran
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran; Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran.
| | - Razegheh Akhbarizadeh
- Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran; The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Alireza Raeisi
- Department of Internal Medicine, School of Medicine Shiraz University of Medical Sciences, Bushehr, Iran
| | - Elham Rahmani
- OB and GYN Ward, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Marzieh Mahmoodi
- Department of Biostatistics and Epidemiology, School of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine Biotechnology Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Saeed Keshmiri
- Faculty of Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Amir Hossein Darabi
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Gholamreza Khamisipour
- Department of Hematology, Faculty of Allied Medicine, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mehdi Mahmudpour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Mozhgan Keshtkar
- Department of Environmental Health Engineering, Faculty of Health and Nutrition, Bushehr University of Medical Sciences, Bushehr, Iran; Systems Environmental Health and Energy Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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22
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Lee KS, Lim YH, Choi YJ, Kim S, Bae HJ, Han C, Lee YA, Hong YC. Prenatal exposure to traffic-related air pollution and risk of congenital diseases in South Korea. ENVIRONMENTAL RESEARCH 2020; 191:110060. [PMID: 32805245 DOI: 10.1016/j.envres.2020.110060] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/02/2020] [Accepted: 08/07/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Previous studies have suggested links between exposure to ambient air pollutants and increased risk of congenital heart defects. However, few studies have investigated the association between other congenital diseases and traffic-related air pollution. In this study, we assessed the relationship between prenatal exposure to fine particulate matter (PM2.5) and nitrogen dioxide (NO2) with congenital diseases in South Korea. METHODS Patients with one or more congenital diseases and a control group of patients with non-infective gastroenteritis and colitis with a case:control ratio of 1:3 were obtained from the National Health Insurance Service data for 2008-2013 in South Korea. We estimated the associations of PM2.5 and NO2 exposures with congenital diseases using generalized estimation equations after controlling for covariates. RESULTS Maternal PM2.5 exposure during the first and second trimester showed positive associations with overall congenital diseases, with changes of 14.7% (95% confidence intervals (CI), 9.3%, 20.3%) and 16.2% (95% CI, 11.0%, 21.7%), respectively, per 11.1 μg/m3 and 10.2 μg/m3 increase of PM2.5 interquartile range (IQR). Similarly, NO2 exposure during the first and second trimester was associated with increased numbers of overall congenital anomalies, with 8.2% (95% CI, 4.2%, 12.3%) and 15.6% (95% CI, 9.3%, 22.2%) more cases, respectively, per 10.6 ppb increase of NO2. We found that maternal PM2.5 exposure during the first and second trimesters of pregnancy was significantly associated with increased risk of specific congenital diseases, including subtypes affecting the circulatory, genitourinary, and musculoskeletal system. However, no significant associations were observed during the third trimester. Maternal NO2 exposure across the entire pregnancy was associated with malformations of the musculoskeletal system. CONCLUSIONS Our study identified significant links between in utero exposure to PM2.5 and NO2 and certain congenital diseases, and suggests that stricter controls on PM2.5 and NO2 concentrations are required.
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Affiliation(s)
- Kyung-Shin Lee
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, South Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, 03080, South Korea.
| | - Youn-Hee Lim
- Section of Environmental Health, Department of Public Health, University of Copenhagen, Copenhagen, 1014, Denmark; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, 03080, South Korea.
| | - Yoon-Jung Choi
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, South Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, 03080, South Korea.
| | - Soontae Kim
- Department of Environmental and Safety Engineering, Ajou University, Suwon, 16499, South Korea.
| | - Hyun Joo Bae
- Korea Environment Institute, Sejong, 30147, South Korea.
| | - Changwoo Han
- Department of Preventive Medicine and Public Health Chungnam National University College of Medicine, Daejeon, 35015, South Korea.
| | - Young Ah Lee
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, 03080, South Korea.
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 03080, South Korea; Environmental Health Center, Seoul National University College of Medicine, Seoul, 03080, South Korea; Institute of Environmental Medicine, Seoul National University Medical Research Center, Seoul, 03080, South Korea.
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23
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Hall KC, Robinson JC. Association between maternal exposure to pollutant particulate matter 2.5 and congenital heart defects: a systematic review. ACTA ACUST UNITED AC 2020; 17:1695-1716. [PMID: 31021973 DOI: 10.11124/jbisrir-2017-003881] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
OBJECTIVE The objective of this review was to determine if there was an association between maternal exposure to pollutant particulate matter 2.5 during the first trimester of pregnancy and congenital heart defects within the first year of life. INTRODUCTION The environment is recognized as an important determinant of health for both the individual and population. Air pollution specifically is a major environmental risk factor impacting health with links to asthma, heart disease, obesity, and fetal developmental complications. Of the commonly monitored air pollutants, particulate matter 2.5 has associations with health, especially among vulnerable populations such as children and pregnant women. A congenital heart defect is a fetal complication that impacts 34.3 million infants globally, with more than 80% of the diagnoses having an unknown etiology. Although environmental risk factors such as air pollution are thought to be a risk factor in the diagnosis of a congenital heart defect, epidemiologic research evidence is limited. INCLUSION CRITERIA This review considered studies that evaluated maternal exposure to the air pollutant particulate matter 2.5 during the first trimester (weeks 1-12) of fetal development. The primary outcome was a diagnosis of a congenital heart defect in an infant within the first year of life. METHODS A three-step search strategy was utilized in this review and included 11 databases and two websites. Studies published from January 2002 to September 2018 were eligible for inclusion. Only papers published in English were included. Eligible studies underwent critical appraisal by two independent reviewers using standardized critical appraisal instruments from JBI. Quantitative data were extracted from the included studies independently by two reviewers. Odds ratios (ORs) and 95% confidence intervals (CIs) were extracted for the individual outcome measures, specifically atrial septal defect, ventricular septal defect, and tetralogy of fallot, respectively. The defects were identified and pooled, where possible, in statistical meta-analysis. Where statistical pooling was not possible, findings were reported narratively. RESULTS Five studies were identified that met the inclusion criteria, including three cohort and two case-control designs. Each individual study identified at least one statistically significant increase or inverse association between particulate matter 2.5 and a congenital heart defect. An increased risk was identified with more than seven isolated and two groupings of congenital heart defects. An inverse risk was identified with two isolated and one grouping of congenital heart defects. Meta-analysis results were: atrial septal defect, OR = 0.65 (95% CI, 0.37 to 1.15); ventricular septal defect, OR = 1.02 (95% CI, 075 to 1.37); and tetralogy of fallot, OR = 1.16 (95% CI, 0.78 to 1.73), indicating no statistically significant findings. CONCLUSION There was no significant evidence to support an association between air pollutant particulate matter 2.5 and a congenital heart defect in the first year of life. However, few studies met the rigorous inclusion criteria, and the studies that did had high heterogeneity, making it difficult to complete a meta-analysis with such a limited number of articles. Further research is needed to standardize the outcomes and pollutant monitoring methods, and provide comparable analysis results so that future synthesis of the literature can be conducted.
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Affiliation(s)
- Katie C Hall
- School of Nursing, University of Mississippi Medical Center, Jackson, USA.,Mississippi Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence
| | - Jennifer C Robinson
- School of Nursing, University of Mississippi Medical Center, Jackson, USA.,Mississippi Centre for Evidence Based Practice: a Joanna Briggs Institute Centre of Excellence
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24
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Hu CY, Huang K, Fang Y, Yang XJ, Ding K, Jiang W, Hua XG, Huang DY, Jiang ZX, Zhang XJ. Maternal air pollution exposure and congenital heart defects in offspring: A systematic review and meta-analysis. CHEMOSPHERE 2020; 253:126668. [PMID: 32278917 DOI: 10.1016/j.chemosphere.2020.126668] [Citation(s) in RCA: 58] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Revised: 03/27/2020] [Accepted: 03/30/2020] [Indexed: 05/21/2023]
Abstract
BACKGROUND Congenital heart defects (CHDs) has a multifactorial causation with a strong genetic component and many environmental triggers. Emerging body of empirical studies suggest that air pollution is an important contributor to the development of CHDs, however, there still remains some controversy over the current evidence, and to the authors' knowledge, no studies have reviewed the most recent evidence. OBJECTIVES We performed a systematic review and meta-analysis of epidemiological literature to investigate the relationship between maternal air pollution exposure and CHDs risk in offspring. The presence of heterogeneity and publication bias across available studies were also examined. METHODS An extensive literature search of epidemiological studies pertaining to air pollution and CHDs, published in English language, until August 1, 2019 was conducted. Summary risk estimates of pollution-outcome combinations were calculated for i) risk per specific increment of concentration and ii) risk at high versus low exposure level in each study using fixed-effect model or random-effects model. RESULTS A total of 26 studies were finally included. In the meta-analyses, high versus low carbon monoxide (CO) exposure was associated with an increased risk of tetralogy of Fallot [odds ratio (OR) = 1.21, 95% confidence interval (CI): 1.04-1.41], yet particulate matter ≤ 5 μm (PM2.5) exposure was marginally associated with it. Increased risk of atrial septal defects (ASDs) was found for each 10 μg/m3 and 10 ppb increment in particulate matter ≤ 10 μm (PM10) and ozone (O3) exposure, respectively (OR = 1.04, 95% CI: 1.00-1.09; OR = 1.09, 95% CI: 1.02-1.17). Categorical nitrogen dioxide (NO2) exposure was associated with an increased risk of coarctation of the aorta (OR for high versus low = 1.14, 95% CI: 1.02-1.26). Analyses for other combinations yielded none statistically significant associations. Sensitive analyses showed similar findings. CONCLUSIONS The summary effect estimates from this study suggest statistically significant associations between increased risk of specific CHDs subtypes and PM2.5, PM10, NO2, CO, and O3 exposures. Further studies, especially conducted in developing countries, with improvements in exposure assessing, outcome harmonizing, and mechanistic understanding are needed to elaborate the suggestive associations.
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Affiliation(s)
- Cheng-Yang Hu
- Department of Humanistic Medicine, School of Humanistic Medicine, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China; Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Kai Huang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Yuan Fang
- Department of Public health, Erasmus MC University Medical Center, P.O. Box 2040, 3000 CA, Rotterdam, the Netherlands
| | - Xiao-Jing Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Kun Ding
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Wen Jiang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Xiao-Guo Hua
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China
| | - Da-Yan Huang
- Department of Obstetrics and Gynecology, Maternal and Child Health Hospital Affiliated to Anhui Medical University, 15# Yimin Road, Hefei, 230001, China
| | - Zheng-Xuan Jiang
- Department of Ophthalmology, The Second Affiliated Hospital of Anhui Medical University, 678# Furong Road, Hefei, 230601, China.
| | - Xiu-Jun Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81# Meishan Road, Hefei, 230032, China.
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25
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Wang L, Xiang X, Mi B, Song H, Dong M, Zhang S, Bi Y, Zhao Y, Li Q, Zhang Q, Zhang L, Yan H, Wang D, Dang S. Association between early prenatal exposure to ambient air pollution and birth defects: evidence from newborns in Xi'an, China. J Public Health (Oxf) 2020; 41:494-501. [PMID: 30137461 DOI: 10.1093/pubmed/fdy137] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 06/26/2018] [Accepted: 07/25/2018] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate an association between birth defects and exposure to sulfur dioxide (SO2), nitrogen dioxide (NO2) and particles ≤10 μm in an aerodynamic diameter (PM10) during early pregnancy in Xi'an, China. METHODS Birth defect data were from the Birth Defects Monitoring System of Xi'an, and data on ambient air pollutants during 2010-15 were from the Xi'an Environmental Protection Bureau. A generalized additive model (GAM) was used to investigate the relationship between birth defects and ambient air pollutants. RESULTS Among the 8865 cases with birth defects analyzed, the overall incidence of birth defects was 117.33 per 10 000 infants. Ambient air pollutant exposure during the first trimester increased the risk of birth defects by 10.3% per 10 μg/m3 increment of NO2 and 3.4% per 10 μg/m3 increment of PM10. No significant association was found between birth defects and SO2. Moreover, NO2 increased risk of neural tube defects, congenital heart disease, congenital polydactyly, cleft palate, digestive system abnormalities and gastroschisis, and PM10 was associated with congenital heart disease and cleft lip with or without cleft palate. CONCLUSIONS Chinese women should avoid exposure to high levels of NO2 and PM10 during the first 3 months of pregnancy.
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Affiliation(s)
- Lingling Wang
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Xiaomei Xiang
- Xi'an Maternal and Child Health Hospital, No. 73, Xidajie Road, Xi'an, Shaanxi Province, PR China
| | - Baibing Mi
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Hui Song
- Xi'an Maternal and Child Health Hospital, No. 73, Xidajie Road, Xi'an, Shaanxi Province, PR China
| | - Min Dong
- Xi'an Maternal and Child Health Hospital, No. 73, Xidajie Road, Xi'an, Shaanxi Province, PR China
| | - Shuiping Zhang
- Xi'an Maternal and Child Health Hospital, No. 73, Xidajie Road, Xi'an, Shaanxi Province, PR China
| | - Yuxue Bi
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Yaling Zhao
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Qiang Li
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Qi Zhang
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Li Zhang
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Hong Yan
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China.,Nutrition and Food Safety Engineering Research Center of Shaanxi Province, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
| | - Duolao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Pembroke Place, Liverpool, UK
| | - Shaonong Dang
- Xi'an Jiaotong University, Health Science Center, No. 76, Yanta West Road, Xi'an, Shaanxi Province, PR China
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Sarizadeh R, Dastoorpoor M, Goudarzi G, Simbar M. The Association Between Air Pollution and Low Birth Weight and Preterm Labor in Ahvaz, Iran. Int J Womens Health 2020; 12:313-325. [PMID: 32440227 PMCID: PMC7211085 DOI: 10.2147/ijwh.s227049] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Accepted: 02/20/2020] [Indexed: 01/03/2023] Open
Abstract
PURPOSE Pregnant women and fetuses are sensitive to air pollution due to physiological changes in pregnancy. The aim of this study was to determine the relationship between exposure to air pollution, low birth weight and preterm labor in Ahvaz. METHODS This research was a time-series study. The research sample consisted of all data about low birth weight and preterm labor pregnant women from Imam Khomeini Hospital and Razi Hospital in Ahvaz city. Air pollutant data including O3, NO, NO2, SO2, CO, PM10 and PM2.5 and climate data were collected from the Environmental Protection Agency and the Khuzestan Province during a 10-year period from 2008 to 2018. The generalized additive models (GAMs) with different air pollutant lags up to 6 days were used. RESULTS The results of multiple GAM model have shown that there is a direct and significant relationship between exposure to PM10 at 0-6-day lag, SO2 at 2- and 3-day lag and low birth weight. In addition, there was a direct and significant correlation between exposure to NO2, NO, CO and PM2.5 at 0-6-day lag and preterm labor. CONCLUSION The results indicate the effect of air pollutants on low birth weight and preterm labor. Therefore, pregnant women should be informed about the negative consequences of air pollution and avoid exposure to polluted air during pregnancy.
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Affiliation(s)
- Reihaneh Sarizadeh
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
| | - Maryam Dastoorpoor
- Department of Biostatistics and Epidemiology, Menopause Andropause Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Department of Environmental Health Engineering, Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Masoumeh Simbar
- Midwifery and Reproductive Health Research Center, School of Nursing and Midwifery, Shahid Beheshti University of Medical Science, Tehran, Iran
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27
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Yang Y, Lin Q, Liang Y, Ruan Z, Acharya BK, Zhang S, Qian Z, McMillin SE, Hinyard L, Sun J, Wang C, Ge H, Wu X, Guo X, Lin H. Maternal air pollution exposure associated with risk of congenital heart defect in pre-pregnancy overweighted women. THE SCIENCE OF THE TOTAL ENVIRONMENT 2020; 712:136470. [PMID: 31931190 DOI: 10.1016/j.scitotenv.2019.136470] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 12/25/2019] [Accepted: 12/31/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVES Prenatal exposure to air pollutant has been associated with congenital heart defect (CHD). However, no study has investigated this effect in pre-pregnancy overweighted women. This study aimed to evaluate gestational exposure to particulate pollutant (PM2.5) and gaseous air pollutants (O3 and NO2) on the risk of CHD, and explore the potential effect modifiers including maternal age, pre-pregnancy BMI and pregestational diseases. METHODS In this birth cohort study, a total of 63,213 pregnant women in Foshan, China were initially recruited and followed from their first hospital visit for pregnancy to delivery during 2015-2019. CHD cases were confirmed by the records in hospital- and population- based birth defect surveillance systems. Air pollutant exposures were estimated by the daily concentrations measured in air monitoring stations in each participant's residential county. Mixed-effects regression models, adjusted for potential confounding factors were applied to estimate the associations between air pollutant and CHD during the first three months of the pregnancy. RESULTS A total of 985 (1.6%) newborns were identified as CHD cases. For each 10 μg/m3 increase in ambient O3 during the 1st month, the OR values for CHD were 1.03 (95% CI: 0.94, 1.13) in pre-pregnancy normal weighted women and 1.24 (95% CI: 1.01, 1.53) in pre-pregnancy overweighted women. For each 10 μg/m3 increase in NO2 during the 3rd month, the OR values for CHD were 1.09 (95% CI: 1.01, 1.18) in pre-pregnancy normal weighted women and 1.27 (95% CI: 1.07, 1.51) in pre-pregnancy overweighted women. No significant associations were found between PM2.5 exposure and CHD in our analysis. CONCLUSIONS This study demonstrates that gaseous air pollutants (O3 and NO2) exposure during the cardiac embryogenesis period is associated with an increased risk of CHD, particularly for pre-pregnancy overweighted women.
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Affiliation(s)
- Yin Yang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Qingmei Lin
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Yin Liang
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Zengliang Ruan
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Bipin Kumar Acharya
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Shiyu Zhang
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Zhengmin Qian
- Department of Epidemiology and Biostatistics, College form Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Stephen Edward McMillin
- School of Social Work, College for Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Leslie Hinyard
- Center for Health Outcomes Research, Saint Louis University, St. Louis, MO, USA
| | - Jia Sun
- Department of Epidemiology and Biostatistics, College form Public Health & Social Justice, Saint Louis University, St. Louis, MO, USA
| | - Changke Wang
- National Climate Center, China Meteorological Administration, Beijing, China
| | - Haibo Ge
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Xueli Wu
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China
| | - Xiaoling Guo
- Foshan Women and Children Hospital Affiliated to Southern Medical University, Foshan, China.
| | - Hualiang Lin
- Department of Epidemiology, School of Public Health, Sun Yat-sen University, Guangzhou, China.
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Choi G, Stingone JA, Desrosiers TA, Olshan AF, Nembhard WN, Shaw GM, Pruitt S, Romitti PA, Yazdy MM, Browne ML, Langlois PH, Botto L, Luben TJ. Maternal exposure to outdoor air pollution and congenital limb deficiencies in the National Birth Defects Prevention Study. ENVIRONMENTAL RESEARCH 2019; 179:108716. [PMID: 31546130 PMCID: PMC6842662 DOI: 10.1016/j.envres.2019.108716] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 07/28/2019] [Accepted: 09/01/2019] [Indexed: 05/04/2023]
Abstract
BACKGROUND Congenital limb deficiencies (CLDs) are a relatively common group of birth defects whose etiology is mostly unknown. Recent studies suggest maternal air pollution exposure as a potential risk factor. AIM To investigate the relationship between ambient air pollution exposure during early pregnancy and offspring CLDs. METHODS The study population was identified from the National Birth Defects Prevention Study, a population-based multi-center case-control study, and consisted of 615 CLD cases and 5,701 controls with due dates during 1997 through 2006. Daily averages and/or maxima of six criteria air pollutants (particulate matter <2.5 μm [PM2.5], particulate matter <10 μm [PM10], nitrogen dioxide [NO2], sulfur dioxide [SO2], carbon monoxide [CO], and ozone [O3]) were averaged over gestational weeks 2-8, as well as for individual weeks during this period, using data from EPA air monitors nearest to the maternal address. Logistic regression was used to estimate odds ratios (aORs) and 95% confidence intervals (CIs) adjusted for maternal age, race/ethnicity, education, and study center. We estimated aORs for any CLD and CLD subtypes (i.e., transverse, longitudinal, and preaxial). Potential confounding by co-pollutant was assessed by adjusting for one additional air pollutant. Using the single pollutant model, we further investigated effect measure modification by body mass index, cigarette smoking, and folic acid use. Sensitivity analyses were conducted restricting to those with a residence closer to an air monitor. RESULTS We observed near-null aORs for CLDs per interquartile range (IQR) increase in PM10, PM2.5, and O3. However, weekly averages of the daily average NO2 and SO2, and daily max NO2, SO2, and CO concentrations were associated with increased odds of CLDs. The crude ORs ranged from 1.03 to 1.12 per IQR increase in these air pollution concentrations, and consistently elevated aORs were observed for CO. Stronger associations were observed for SO2 and O3 in subtype analysis (preaxial). In co-pollutant adjusted models, associations with CO remained elevated (aORs: 1.02-1.30); but aORs for SO2 and NO2 became near-null. The aORs for CO remained elevated among mothers who lived within 20 km of an air monitor. The aORs varied by maternal BMI, smoking status, and folic acid use. CONCLUSION We observed modest associations between CLDs and air pollution exposures during pregnancy, including CO, SO2, and NO2, though replication through further epidemiologic research is warranted.
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Affiliation(s)
- Giehae Choi
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States.
| | - Jeanette A Stingone
- Department of Epidemiology, Columbia University, New York, NY, United States
| | - Tania A Desrosiers
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Andrew F Olshan
- Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United States
| | - Wendy N Nembhard
- Department of Epidemiology, Fay Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Gary M Shaw
- Stanford School of Medicine, Stanford, CA, United States
| | - Shannon Pruitt
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States; Oak Ridge Institute for Science and Education, Oak Ridge, TN, United States
| | - Paul A Romitti
- Department of Epidemiology, The University of Iowa, Iowa City, IA, United States
| | - Mahsa M Yazdy
- Massachusetts Department of Health, Boston, MA, United States
| | | | - Peter H Langlois
- Texas Department of State Health Services, Austin, TX, United States
| | - Lorenzo Botto
- Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UT, USA
| | - Thomas J Luben
- Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, United States
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McKenzie LM, Allshouse W, Daniels S. Congenital heart defects and intensity of oil and gas well site activities in early pregnancy. ENVIRONMENT INTERNATIONAL 2019; 132:104949. [PMID: 31327466 DOI: 10.1016/j.envint.2019.104949] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Revised: 06/17/2019] [Accepted: 06/19/2019] [Indexed: 05/28/2023]
Abstract
BACKGROUND Preliminary studies suggest that offspring to mothers living near oil and natural gas (O&G) well sites are at higher risk of congenital heart defects (CHDs). OBJECTIVES Our objective was to address the limitations of previous studies in a new and more robust evaluation of the relationship between maternal proximity to O&G well site activities and births with CHDs. METHODS We employed a nested case-control study of 3324 infants born in Colorado between 2005 and 2011. 187, 179, 132, and 38 singleton births with an aortic artery and valve (AAVD), pulmonary artery and valve (PAVD), conotruncal (CTD), or tricuspid valve (TVD) defect, respectively, were frequency matched 1:5 to controls on sex, maternal smoking, and race and ethnicity yielding 2860 controls. We estimated monthly intensities of O&G activity at maternal residences from three months prior to conception through the second gestational month with our intensity adjusted inverse distance weighted model. We used logistic regression models adjusted for O&G facilities other than wells, intensity of air pollution sources not associated with O&G activities, maternal age and socioeconomic status index, and infant sex and parity, to evaluate associations between CHDs and O&G activity intensity groups (low, medium, and high). RESULTS Overall, CHDs were 1.4 (1.0, 2.0) and 1.7 (1.1, 2.6) times more likely than controls in the medium and high intensity groups, respectively, compared to the low intensity group. PAVDs were 1.7 (0.93, 3.0) and 2.5 (1.1, 5.3) times more likely in the medium and high intensity groups for mothers with an address found in the second gestational month. In rural areas, AAVDs, CTDs, and TVDs were 1.8 (0.97, 3.3) and 2.6 (1.1, 6.1); 2.1 (0.96, 4.5) and 4.0 (1.4, 12); and 3.4 (0.95, 12) and 4.6 (0.81, 26) times more likely than controls in the medium and high intensity groups. CONCLUSIONS This study provides further evidence of a positive association between maternal proximity to O&G well site activities and several types of CHDs, particularly in rural areas.
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Affiliation(s)
- Lisa M McKenzie
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA.
| | - William Allshouse
- Department of Environmental and Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Campus, Aurora, CO, USA
| | - Stephen Daniels
- Department of Pediatrics, University of Colorado School of Medicine, University of Colorado Anschutz Campus, Aurora, CO, USA
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Lavigne E, Lima I, Hatzopoulou M, Van Ryswyk K, Decou ML, Luo W, van Donkelaar A, Martin RV, Chen H, Stieb DM, Crighton E, Gasparrini A, Elten M, Yasseen AS, Burnett RT, Walker M, Weichenthal S. Spatial variations in ambient ultrafine particle concentrations and risk of congenital heart defects. ENVIRONMENT INTERNATIONAL 2019; 130:104953. [PMID: 31272016 DOI: 10.1016/j.envint.2019.104953] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 06/19/2019] [Accepted: 06/21/2019] [Indexed: 05/21/2023]
Abstract
BACKGROUND Cardiovascular malformations account for nearly one-third of all congenital anomalies, making these the most common type of birth defects. Little is known regarding the influence of ambient ultrafine particles (<0.1 μm) (UFPs) on their occurrence. OBJECTIVE This population-based study examined the association between prenatal exposure to UFPs and congenital heart defects (CHDs). METHODS A total of 158,743 singleton live births occurring in the City of Toronto, Canada between April 1st 2006 and March 31st 2012 were identified from a birth registry. Associations between exposure to ambient UFPs between the 2nd and 8th week post conception when the foetal heart begins to form and CHDs identified at birth were estimated using random-effects logistic regression models, adjusting for personal- and neighbourhood-level covariates. We also investigated multi-pollutant models accounting for co-exposures to PM2.5, NO2 and O3. RESULTS A total of 1468 CHDs were identified. In fully adjusted models, UFP exposures during weeks 2 to 8 of pregnancy were not associated with overall CHDs (Odds Ratio (OR) per interquartile (IQR) increase = 1.02, 95% CI: 0.96-1.08). When investigating subtypes of CHDs, UFP exposures were associated with ventricular septal defects (Odds Ratio (OR) per interquartile (IQR) increase = 1.13, 95% CI: 1.03-1.33), but not with atrial septal defect (Odds Ratio (OR) per interquartile (IQR) increase = 0.89, 95% CI: 0.74-1.06). CONCLUSION This is the first study to evaluate the association between prenatal exposure to UFPs and the risk of CHDs. UFP exposures during a critical period of embryogenesis were associated with an increased risk of ventricular septal defect.
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Affiliation(s)
- Eric Lavigne
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada.
| | - Isac Lima
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Marianne Hatzopoulou
- Department of Civil Engineering, University of Toronto, Toronto, Ontario, Canada
| | - Keith Van Ryswyk
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada
| | - Mary Lou Decou
- Maternal & Infant Health Section, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Wei Luo
- Maternal & Infant Health Section, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Aaron van Donkelaar
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Randall V Martin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, Nova Scotia, Canada; Harvard-Smithsonian Centre for Astrophysics, Cambridge, MA, USA
| | - Hong Chen
- Population Studies Division, Health Canada, Ottawa, Ontario, Canada; Public Health Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada
| | - David M Stieb
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada; Population Studies Division, Health Canada, Vancouver, British Columbia, Canada
| | - Eric Crighton
- Institute for Clinical Evaluative Sciences, Ottawa, Ontario, Canada; Department of Geography, Environment and Geomatics, University of Ottawa, Ottawa, Ontario, Canada
| | - Antonio Gasparrini
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, UK
| | - Michael Elten
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Abdool S Yasseen
- Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada
| | | | - Mark Walker
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada; Better Outcomes Registry and Network Ontario, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, Ontario, Canada
| | - Scott Weichenthal
- Air Health Science Division, Health Canada, Ottawa, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Huang CC, Chen BY, Pan SC, Ho YL, Guo YL. Prenatal exposure to PM 2.5 and Congenital Heart Diseases in Taiwan. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 655:880-886. [PMID: 30481714 DOI: 10.1016/j.scitotenv.2018.11.284] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2018] [Revised: 11/12/2018] [Accepted: 11/19/2018] [Indexed: 05/21/2023]
Abstract
Gestational exposure to ambient air pollution has been associated with Congenital Heart Diseases (CHDs). However, only a few studies, with inconsistent results, have investigated the effects of PM2.5 exposure during early pregnancy. This study aims to evaluate the association between prenatal exposure to PM2.5 and CHDs occurrence. We selected 782 births reported to have CHDs between 2007 and 2014 from the Taiwanese Birth Registry and randomly selected 4692 controls without any birth defects using a population-based case-control design. Data of exposure to ambient air pollutants, mainly PM2.5, PM10, CO, SO2, NO2, and O3 during weeks 3-8 of pregnancy were retrieved from air quality monitoring stations and interpolated to every township using ordinary kriging. We applied unconditional logistic regression models adjusted for potential confounders to evaluate the associations. The results revealed a positive correlation between increased PM2.5 exposure (adjusted odds ratio [aOR] = 1.21, 95% confidence interval [CI] = 1.03-1.42, per interquartile range change = 13.4 μg/m3) during early pregnancy and overall CHDs occurrence. Furthermore, we found that atrial septal defect (aOR = 1.43, 95% CI = 1.01-2.02), endocardial cushion defect (aOR = 2.37, 95% CI = 1.01-5.58), and pulmonary artery and valve stenosis (aOR = 1.71, 95% CI = 1.06-2.78) were significantly associated with PM2.5 exposures. No similar effects were observed for the other air pollutants. This study has demonstrated some positive associations between increased PM2.5 exposure during the critical period of cardiac embryogenesis and certain CHDs occurrence.
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Affiliation(s)
- Ching-Chun Huang
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Bing-Yu Chen
- Department of Medical Research and Development, Chang Gung Memorial Hospital, Keelung, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Shih-Chun Pan
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Yi-Lwun Ho
- Division of Cardiology, Department of Internal Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan; Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.
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Xiong L, Xu Z, Wang H, Liu Z, Xie D, Wang A, Kong F. The association between ambient air pollution and birth defects in four cities in Hunan province, China, from 2014 to 2016. Medicine (Baltimore) 2019; 98:e14253. [PMID: 30681619 PMCID: PMC6358400 DOI: 10.1097/md.0000000000014253] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2018] [Revised: 12/28/2018] [Accepted: 01/02/2019] [Indexed: 12/04/2022] Open
Abstract
This study was performed to assess whether air pollution was positively associated with birth defects and if a specific pregnancy stage played a role. This was a population-based case-control study comprising 153,822 perinatal births in four cities located in Hunan province, China, during the period 2014 to 2016. Exposure to SO2, NO2, and PM10 in each pregnant woman in the first 3 months before pregnancy, and in the first and third trimester was assessed. The risk of birth defects related to SO2 in the first 3 months before pregnancy was between 1.191 and 1.566. In the first trimester stage the risk was between 1.104 and 1.348. The risk of birth defects related to NO2 before pregnancy was 1.285 (95%CI: 1.180-1.399), in the first trimester stage the risk was between 1.280 (95%CI: 1.197-1.368) and 1.380 (95%CI: 1.293-1.473). In the third month before delivery the risk was 1.484 (95%CI: 1.366-1.613). The risk of birth defects related to PM10 in the first month of pregnancy was 1.098 (95%CI: 1.057-1.140), and in the third month before delivery the risk was 1.296 (95%CI: 1.222-1.375). SO2 had a greater effect on the prophase of pregnancy, while NO2 and PM10 had an effect in the late third trimester.
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Affiliation(s)
- Lili Xiong
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Zenghui Xu
- Changsha Environment Protection College, Changsha, China
| | - Hua Wang
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Zhiyu Liu
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Donghua Xie
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Aihua Wang
- Hunan Province Maternal and Children Care Hospital, Changsha, China
| | - Fanjuan Kong
- Hunan Province Maternal and Children Care Hospital, Changsha, China
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Stapleton P. Should Perturbation of the Preconceptive Environment be Considered a Risk Factor for the Development of Cardiovascular Disease Later in Life? J Am Heart Assoc 2018; 7:e011249. [PMID: 30561259 PMCID: PMC6405617 DOI: 10.1161/jaha.118.011249] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
See Article by Tanwar et al
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Affiliation(s)
- Phoebe Stapleton
- 1 Department of Pharmacology and Toxicology Ernest Mario School of Pharmacy Rutgers University Piscataway NJ.,2 Environmental and Occupational Health Sciences Institute Piscataway NJ
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Baek KI, Ding Y, Chang CC, Chang M, Sevag Packard RR, Hsu JJ, Fei P, Hsiai TK. Advanced microscopy to elucidate cardiovascular injury and regeneration: 4D light-sheet imaging. PROGRESS IN BIOPHYSICS AND MOLECULAR BIOLOGY 2018; 138:105-115. [PMID: 29752956 PMCID: PMC6226366 DOI: 10.1016/j.pbiomolbio.2018.05.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Revised: 04/30/2018] [Accepted: 05/04/2018] [Indexed: 12/20/2022]
Abstract
The advent of 4-dimensional (4D) light-sheet fluorescence microscopy (LSFM) has provided an entry point for rapid image acquisition to uncover real-time cardiovascular structure and function with high axial resolution and minimal photo-bleaching/-toxicity. We hereby review the fundamental principles of our LSFM system to investigate cardiovascular morphogenesis and regeneration after injury. LSFM enables us to reveal the micro-circulation of blood cells in the zebrafish embryo and assess cardiac ventricular remodeling in response to chemotherapy-induced injury using an automated segmentation approach. Next, we review two distinct mechanisms underlying zebrafish vascular regeneration following tail amputation. We elucidate the role of endothelial Notch signaling to restore vascular regeneration after exposure to the redox active ultrafine particles (UFP) in air pollutants. By manipulating the blood viscosity and subsequently, endothelial wall shear stress, we demonstrate the mechanism whereby hemodynamic shear forces impart both mechanical and metabolic effects to modulate vascular regeneration. Overall, the implementation of 4D LSFM allows for the elucidation of mechanisms governing cardiovascular injury and regeneration with high spatiotemporal resolution.
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Affiliation(s)
- Kyung In Baek
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Yichen Ding
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Chih-Chiang Chang
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Megan Chang
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - René R Sevag Packard
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Jeffrey J Hsu
- Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA.
| | - Peng Fei
- School of Optical and Electronic Information, Huazhong University of Science and Technology, Wuhan 430074, China.
| | - Tzung K Hsiai
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA 90095, USA; Department of Medicine, David Geffen School of Medicine at University of California, Los Angeles, Los Angeles, CA 90095, USA; Medical Engineering, California Institute of Technology, Pasadena, CA 91106, USA.
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35
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The association of air pollution with congenital anomalies: An exploratory study in the northern Netherlands. Int J Hyg Environ Health 2018; 221:1061-1067. [DOI: 10.1016/j.ijheh.2018.07.008] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 07/09/2018] [Accepted: 07/17/2018] [Indexed: 12/17/2022]
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Hall KC, Robinson JC. The association between maternal exposure to pollutant particulate matter 2.5 and neonatal congenital heart defects: a systematic review protocol. ACTA ACUST UNITED AC 2018; 15:2257-2264. [PMID: 28902692 DOI: 10.11124/jbisrir-2016-003284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
REVIEW QUESTION The objective of this review is to identify if there is an association between maternal exposure to pollutant particulate matter 2.5 during the first trimester of pregnancy and neonatal congenital heart defects within the first year of life.
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Affiliation(s)
- Katie C Hall
- 1School of Nursing, University of Mississippi Medical Center, Jackson, USA 2UMMC School of Nursing Evidence Based Practice and Research Team: a Joanna Briggs Institute Affiliated Group, Jackson, USA
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Ma LG, Chen QH, Wang YY, Wang J, Ren ZP, Cao ZF, Cao YR, Ma X, Wang BB. Spatial pattern and variations in the prevalence of congenital heart disease in children aged 4-18 years in the Qinghai-Tibetan Plateau. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 627:158-165. [PMID: 29426137 DOI: 10.1016/j.scitotenv.2018.01.194] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Revised: 01/19/2018] [Accepted: 01/19/2018] [Indexed: 05/28/2023]
Abstract
PURPOSE This study aimed to investigate the spatial distribution pattern of the prevalence of congenital heart disease (CHD) in children in Qinghai-Tibetan Plateau (QTP), a high-altitude region in China. METHODS Epidemiological data from a survey on the prevalence of CHD in Qinghai Province including 288,066 children (4-18 years) were used in this study. The prevalence and distribution pattern of CHD was determined by sex, CHD subtype, and nationality and altitude. Spatial pattern analysis using Getis-Ord Gi⁎ was used to identify the spatial distribution of CHD. Bayesian spatial binomial regression was performed to examine the relationship between the prevalence of CHD and environmental risk factors in the QTP. RESULTS The prevalence of CHD showed a significant spatial clustering pattern. The Tibetan autonomous prefecture of Yushu (average altitude > 4000 m) and the Mongolian autonomous county of Henan (average altitude > 3600 m) in Huangnan had the highest prevalence of CHD. Univariate analysis showed that with ascending altitude, the total prevalence of CHD, that in girls and boys with CHD, and that of the subtypes PDA and ASD increasing accordingly. Thus, environmental factors greatly contributed to the prevalence of CHD. CONCLUSIONS The prevalence of CHD shows significant spatial clustering pattern in the QTP. The CHD subtype prevalence clustering pattern has statistical regularity which would provide convenient clues of environmental risk factors. Our results may provide support to make strategies of CHD prevention, to reduce the incidence of CHD in high altitude regions of China.
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Affiliation(s)
- Li-Guang Ma
- National Research Institute for Family Planning, Beijing 100081, PR China; Beijing GIStone Information Technology Co Ltd., Beijing 100101,PR China
| | - Qiu-Hong Chen
- Central Laboratory, Qinghai Cardiovascular Diseases Vocational Hospital, Xining, Qinghai 810012, PR China.
| | - Yuan-Yuan Wang
- National Research Institute for Family Planning, Beijing 100081, PR China
| | - Jing Wang
- Department of Medical Genetics and Developmental Biology, School of Medical Basic, Capital Medical University, Beijing 100069, PR China
| | - Zhou-Peng Ren
- State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, PR China
| | - Zong-Fu Cao
- National Research Institute for Family Planning, Beijing 100081, PR China
| | - Yan-Rong Cao
- Beijing GIStone Information Technology Co Ltd., Beijing 100101,PR China
| | - Xu Ma
- National Research Institute for Family Planning, Beijing 100081, PR China; Peking Union Medical College, Beijing 100730, PR China.
| | - Bin-Bin Wang
- National Research Institute for Family Planning, Beijing 100081, PR China; Peking Union Medical College, Beijing 100730, PR China.
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Baek KI, Packard RRS, Hsu JJ, Saffari A, Ma Z, Luu AP, Pietersen A, Yen H, Ren B, Ding Y, Sioutas C, Li R, Hsiai TK. Ultrafine Particle Exposure Reveals the Importance of FOXO1/Notch Activation Complex for Vascular Regeneration. Antioxid Redox Signal 2018; 28:1209-1223. [PMID: 29037123 PMCID: PMC5912723 DOI: 10.1089/ars.2017.7166] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
AIMS Redox active ultrafine particles (UFP, d < 0.2 μm) promote vascular oxidative stress and atherosclerosis. Notch signaling is intimately involved in vascular homeostasis, in which forkhead box O1 (FOXO1) acts as a co-activator of the Notch activation complex. We elucidated the importance of FOXO1/Notch transcriptional activation complex to restore vascular regeneration after UFP exposure. RESULTS In a zebrafish model of tail injury and repair, transgenic Tg(fli1:GFP) embryos developed vascular regeneration at 3 days post amputation (dpa), whereas UFP exposure impaired regeneration (p < 0.05, n = 20 for control, n = 28 for UFP). UFP dose dependently reduced Notch reporter activity and Notch signaling-related genes (Dll4, JAG1, JAG2, Notch1b, Hey2, Hes1; p < 0.05, n = 3). In the transgenic Tg(tp1:GFP; flk1:mCherry) embryos, UFP attenuated endothelial Notch activity at the amputation site (p < 0.05 vs. wild type [WT], n = 20). A disintegrin and metalloproteinase domain-containing protein 10 (ADAM10) inhibitor or dominant negative (DN)-Notch1b messenger RNA (mRNA) disrupted the vascular network, whereas notch intracellular cytoplasmic domain (NICD) mRNA restored the vascular network (p < 0.05 vs. WT, n = 20). UFP reduced FOXO1 expression, but not Master-mind like 1 (MAML1) or NICD (p < 0.05, n = 3). Immunoprecipitation and immunofluorescence demonstrated that UFP attenuated FOXO1-mediated NICD pull-down and FOXO1/NICD co-localization, respectively (p < 0.05, n = 3). Although FOXO1 morpholino oligonucleotides (MOs) attenuated Notch activity, FOXO1 mRNA reversed UFP-mediated reduction in Notch activity to restore vascular regeneration and blood flow (p < 0.05 vs. WT, n = 5). Innovation and Conclusion: Our findings indicate the importance of the FOXO1/Notch activation complex to restore vascular regeneration after exposure to the redox active UFP. Antioxid. Redox Signal. 28, 1209-1223.
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Affiliation(s)
- Kyung In Baek
- 1 Department of Bioengineering, University of California , Los Angeles, Los Angeles, California
| | - René R Sevag Packard
- 2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Jeffrey J Hsu
- 2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Arian Saffari
- 3 Department of Civil and Environmental Engineering, University of Southern California , Los Angeles, California
| | - Zhao Ma
- 1 Department of Bioengineering, University of California , Los Angeles, Los Angeles, California
| | - Anh Phuong Luu
- 2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Andrew Pietersen
- 1 Department of Bioengineering, University of California , Los Angeles, Los Angeles, California
| | - Hilary Yen
- 1 Department of Bioengineering, University of California , Los Angeles, Los Angeles, California
| | - Bin Ren
- 4 Division of Hematology and Oncology, Medical College of Wisconsin , Milwaukee, Wisconsin.,5 Blood Research Institute , Blood Center of Wisconsin, Milwaukee, Wisconsin
| | - Yichen Ding
- 2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Constantinos Sioutas
- 3 Department of Civil and Environmental Engineering, University of Southern California , Los Angeles, California
| | - Rongsong Li
- 2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California
| | - Tzung K Hsiai
- 1 Department of Bioengineering, University of California , Los Angeles, Los Angeles, California.,2 Division of Cardiology, Department of Medicine, University of California , Los Angeles, Los Angeles, California.,6 Research Services, Veteran Affairs Greater Los Angeles Healthcare System, Los Angeles , California
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Zhang TN, Li D, Wu QJ, Xia J, Wen R, Chen XC, Yang N, Chen YL, Huang YH, Liu CF. Exposure to Nitrogen Oxide in the First Trimester and Risk of Cardiovascular-Related Malformations: A Dose-Response Meta-Analysis of Observational Studies. BIOMED RESEARCH INTERNATIONAL 2018; 2018:1948407. [PMID: 29850486 PMCID: PMC5914127 DOI: 10.1155/2018/1948407] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/14/2017] [Revised: 02/23/2018] [Accepted: 03/05/2018] [Indexed: 11/24/2022]
Abstract
Nitrogen oxide (NO x ) is produced during combustion at high temperature, which is a major constituent of air pollutants. Recent studies suggested inconsistent results on the association between NO x exposure and cardiovascular-related malformations. We aimed to assess aforementioned association in pregnant women in the first trimester and cardiovascular-related malformations of infants. A systematic literature review identified studies for observational studies about NO x exposure and cardiovascular-related malformation in PubMed. Random-effect models were used to estimate summary odds ratio (SOR) and 95% confidence intervals (CIs) for aforementioned association. Finally, nine studies met the inclusion criteria. Overall, the SOR of cardiovascular-related malformation per 10 ppb increment in NO x and NO2 concentration was 1.01 (95% CI: 0.98-1.04; I2 = 38.6%, P = 0.09) and 0.99 (95% CI: 0.95-1.04; I2 = 37.8%, P = 0.13), respectively. Stratifying by study design, geographic locations, and confounded adjustments, the majority of strata showed negative results, which were consistent with the main findings. However, we found that exposure to NO x and NO2 in the first trimester increased the risk of coarctation of the aorta (COA) malformation by 13% and 19%, respectively. Our study provided limited evidence regarding the association between NO x exposure in the first trimester and cardiovascular-related malformations in infants.
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Affiliation(s)
- Tie-Ning Zhang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Da Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jing Xia
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ri Wen
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xing-Chen Chen
- Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ni Yang
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Ling Chen
- Liaoning Women and Children's Health Hospital, Shenyang, China
| | - Yan-Hong Huang
- Department of Science and Education, Shenyang Women and Children Health Care Centre, Shenyang, China
| | - Chun-Feng Liu
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
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40
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Wong P, Denburg A, Dave M, Levin L, Morinis JO, Suleman S, Wong J, Ford-Jones E, Moore AM. Early life environment and social determinants of cardiac health in children with congenital heart disease. Paediatr Child Health 2018; 23:92-95. [PMID: 29686491 PMCID: PMC5905484 DOI: 10.1093/pch/pxx146] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023] Open
Abstract
Congenital heart disease is a significant cause of infant mortality. Epidemiology and social context play a crucial role in conditioning disease burden and modulating outcomes, while diagnosis and treatment remain resource intensive. This review will address the role of social demographics, environmental exposure, epigenetics and nutrition in the aetiology of congenital heart disease. We then discuss the determinant effect of social factors on the provision and outcomes of care for congenital heart disease and implications for practice. It is our hope that enhanced knowledge of the intersection of social determinants of health and congenital heart disease will facilitate effective preventative strategies at the individual and population levels to optimize heart health outcomes across the life course.
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Affiliation(s)
- Peter Wong
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | | | - Malini Dave
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Leo Levin
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Julia Orkin Morinis
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Shazeen Suleman
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Jonathan Wong
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Elizabeth Ford-Jones
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
| | - Aideen M Moore
- Department of Paediatrics, The Hospital for Sick Children and University of Toronto, Toronto, Ontario
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41
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Zhang Y, Yan W, Ji X, Yue H, Li G, Sang N. Maternal NO2 exposure induces cardiac hypertrophy in male offspring via ROS-HIF-1α transcriptional regulation and aberrant DNA methylation modification of Csx/Nkx2.5. Arch Toxicol 2018; 92:1563-1579. [DOI: 10.1007/s00204-018-2166-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2017] [Accepted: 01/17/2018] [Indexed: 12/12/2022]
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Dastoorpoor M, Idani E, Goudarzi G, Khanjani N. Acute effects of air pollution on spontaneous abortion, premature delivery, and stillbirth in Ahvaz, Iran: a time-series study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:5447-5458. [PMID: 29214476 DOI: 10.1007/s11356-017-0692-9] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2017] [Accepted: 11/06/2017] [Indexed: 05/22/2023]
Abstract
Living in areas with high air pollution may have adverse effects on human health. There are few studies about the association between breathing polluted air and adverse pregnancy outcomes in the Middle East. The aim of this study was to determine the relationship between air pollution and spontaneous abortion, premature birth, and stillbirth in Ahvaz. A time-series study was conducted. Data about spontaneous abortion, premature deliveries, and stillbirth was collected from Ahvaz Imam Khomeini Hospital. Air pollution data including NO, CO, NO2, PM10, SO2, O3, and climate data were, respectively, collected from the Environmental Protection Agency and the Khuzestan Province Meteorology Office from March 2008 until March 2015. The relationship between air pollutants with the number of abortions, premature births, and stillbirths was found using a quasi-Poisson distributed lag model, adjusted by trend, seasonality, temperature, relative humidity, weekdays, and holidays. The average daily dust in Ahvaz on 7.2% days of the year was higher than 500 μg/m3 (very dangerous). Findings from this study indicate a significant association between each 10-unit increase in SO2 and spontaneous abortion in lag 0 and 9 days. There was a significant relation between each 10-unit increase in NO2 and CO, and premature birth in lag 0. Also, we found a significant association between each 10-unit increase in CO and premature delivery in lag 1; PM10 and premature delivery in lags 10, 11, and 12; and NO and premature delivery in lags 3, 4, 10, 11, 12, and 13 (p value < 0.05). Contact with polluted air during pregnancy may increase adverse pregnancy outcomes and stillbirth. Pregnant women should avoid polluted air.
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Affiliation(s)
- Maryam Dastoorpoor
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Esmaeil Idani
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Gholamreza Goudarzi
- Air Pollution and Respiratory Diseases Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Environmental Technologies Research Center (ETRC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Narges Khanjani
- Environmental Health Engineering Research Center, Kerman University of Medical Sciences, Kerman, Iran.
- Monash Centre for Occupational and Environmental Health, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
- Department of Epidemiology and Biostatistics, Faculty of Public Health, Kerman Medical University, Kerman, Iran.
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43
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Ren S, Haynes E, Hall E, Hossain M, Chen A, Muglia L, Lu L, DeFranco E. Periconception Exposure to Air Pollution and Risk of Congenital Malformations. J Pediatr 2018; 193:76-84.e6. [PMID: 29237538 PMCID: PMC5794608 DOI: 10.1016/j.jpeds.2017.09.076] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2017] [Revised: 08/21/2017] [Accepted: 09/27/2017] [Indexed: 11/18/2022]
Abstract
OBJECTIVE To evaluate the association between increased exposure to airborne fine particulate matter (PM2.5) during the periconception period with risk of congenital anomalies. STUDY DESIGN Using birth certificate data from the Ohio Department of Health (2006-2010) and PM2.5 data from the US Environmental Protection Agency's 57 monitoring stations located throughout Ohio, the geographic coordinates of the mother's residence for each birth were linked to the nearest PM2.5 monitoring station and monthly exposure averages were calculated. The association between congenital anomalies and increased PM2.5 levels was estimated, with adjustment for coexistent risk factors. RESULTS After adjustment for coexisting risk factors, exposure to increased levels of PM2.5 in the air during the periconception period was modestly associated with risk of congenital anomalies. Compared with other periconception exposure windows, increased exposure during the 1 month before conception was associated with the highest risk increase at lesser distances from monitoring stations. The strongest influences of PM2.5 on individual malformations were found with abdominal wall defects and hypospadias, especially during the 1-month preconception. CONCLUSIONS Increased exposure to PM2.5 in the periconception period is associated with some modest risk increases for congenital malformations. The most susceptible time of exposure appears to be the 1 month before and after conception. Although the increased risk with PM2.5 exposure is modest, the potential impact on a population basis is noteworthy because all pregnant women have some degree of exposure.
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Affiliation(s)
- Sheng Ren
- Department of Mathematics, University of Cincinnati, Cincinnati, OH; Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Erin Haynes
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Eric Hall
- Perinatal Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Monir Hossain
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Louis Muglia
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Long Lu
- Division of Biomedical Informatics, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Emily DeFranco
- Division of Biostatistics and Epidemiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, University of Cincinnati College of Medicine, Cincinnati, OH
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44
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Congenital heart defects of fetus after maternal exposure to organic and inorganic environmental factors: a cohort study. Oncotarget 2017; 8:100717-100723. [PMID: 29246015 PMCID: PMC5725057 DOI: 10.18632/oncotarget.20110] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Accepted: 07/25/2017] [Indexed: 11/25/2022] Open
Abstract
Objective Maternal exposure to various contaminants has been reported to be correlated with congetinal heart defects (CHDs). In this study, the effect of maternal exposure to organic and inorganic environmental factors upon the incidence of CHDs was investigated. We conducted a retrospective birth cohort study of infants born in the Maternal and Child Health Hospital of Panyu District in Guangzhou. Materials and Methods A total of 5381 cases with complete medical records, including mothers, fathers, and infants, were enrolled. The relationship between maternal occupational exposure to hazardous substances and strong noise during pregnancy and CHDs was analyzed. Occupational exposure to hazardous substances increased the incidence of CHDs. Results Forty-eight of 145 mothers (33.1%) in the CHDs group worked in hazardous and strong noise factories, while the corresponding percentage mothers in the control group was 22.8% (1193/5236). The percentage of mothers with a history of contact with organic solvents and exposure to strong noise in the CHDs group was significantly higher than the control group. There was no significant difference in the histories of contact with heavy metals, high temperatures, and other extreme environments between two groups. Conclusions Hazardous substances in factories, especially organic solvents, were identified as potential risk factors for CHDs. Besides, exposure to high noise also increased the incidence of CHDs.
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Giraldo-Grueso M, Echeverri D, Conde R. The doctor of the plague. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2017.11.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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46
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Giraldo-Grueso M, Echeverri D, Conde R. “Il dottore della peste”. REVISTA COLOMBIANA DE CARDIOLOGÍA 2017. [DOI: 10.1016/j.rccar.2017.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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47
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Stingone JA, Luben TJ, Carmichael SL, Aylsworth AS, Botto LD, Correa A, Gilboa SM, Langlois PH, Nembhard WN, Richmond-Bryant J, Shaw GM, Olshan AF. Maternal Exposure to Nitrogen Dioxide, Intake of Methyl Nutrients, and Congenital Heart Defects in Offspring. Am J Epidemiol 2017; 186:719-729. [PMID: 28520847 PMCID: PMC5610640 DOI: 10.1093/aje/kwx139] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2016] [Revised: 10/12/2016] [Accepted: 10/25/2016] [Indexed: 01/06/2023] Open
Abstract
Nutrients that regulate methylation processes may modify susceptibility to the effects of air pollutants. Data from the National Birth Defects Prevention Study (United States, 1997-2006) were used to estimate associations between maternal exposure to nitrogen dioxide (NO2), dietary intake of methyl nutrients, and the odds of congenital heart defects in offspring. NO2 concentrations, a marker of traffic-related air pollution, averaged across postconception weeks 2-8, were assigned to 6,160 nondiabetic mothers of cases and controls using inverse distance-squared weighting of air monitors within 50 km of maternal residences. Intakes of choline, folate, methionine, and vitamins B6 and B12 were assessed using a food frequency questionnaire. Hierarchical regression models, which accounted for similarities across defects, were constructed, and relative excess risks due to interaction were calculated. Relative to women with the lowest NO2 exposure and high methionine intake, women with the highest NO2 exposure and lowest methionine intake had the greatest odds of offspring with a perimembranous ventricular septal defect (odds ratio = 3.23, 95% confidence interval: 1.74, 6.01; relative excess risk due to interaction = 2.15, 95% confidence interval: 0.39, 3.92). Considerable departure from additivity was not observed for other defects. These results provide modest evidence of interaction between nutrition and NO2 exposure during pregnancy.
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Affiliation(s)
- Jeanette A. Stingone
- Correspondence to Dr. Jeanette A. Stingone, Icahn School of Medicine, Department of Environmental Medicine and Public Health, One Gustave Levy Place, Box 1057 New York, NY 10029 (e-mail: )
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48
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Liu CB, Hong XR, Shi M, Chen XQ, Huang HJ, Chen JH, Yang K, Chen SQ, Chen HQ, Kan HD, Sun QH. Effects of Prenatal PM 10 Exposure on Fetal Cardiovascular Malformations in Fuzhou, China: A Retrospective Case-Control Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2017; 125:057001. [PMID: 28557713 PMCID: PMC5726369 DOI: 10.1289/ehp289] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Revised: 05/30/2016] [Accepted: 06/17/2016] [Indexed: 05/17/2023]
Abstract
BACKGROUND Maternal exposure to ambient air pollution has been associated with an increased risk of congenital heart defects in offspring; however, the results are inconsistent. OBJECTIVES We investigated whether there is an association between prenatal exposure to particulate matter with diameter ≤10μm (PM10) during early pregnancy and fetal cardiovascular malformations. METHODS The gravidae from a hospital-based case–control study in Fuzhou, China, during 2007–2013 were assigned 10-d or 1-mo averages of daily PM10 using an air monitor–based inverse distance weighting method during early pregnancy. A total of 662 live-birth or selectively terminated cases and 3,972 live-birth controls were enrolled. The exposure was considered as a categorical variable. A multivariable logistic regression model was constructed to quantify the adjusted odds ratios (aORs) of the exposure to PM10 and the risks of fetal cardiovascular malformations. RESULTS PM10 levels were positively associated with the risks of atrial septal defect (aORs ranging from 1.29 to 2.17), patent ductus arteriosus [aORs = 1.54, 1.63; 95% confidence intervals (CIs): 1.17, 2.23; 1.06, 3.24], overall fetal cardiovascular malformations (aOR = 1.28; 95% CI: 1.03, 1.61), ventricular septal defect (aOR = 1.19; 95% CI: 1.00, 1.43), and tetralogy of Fallot (aOR = 1.44; 95% CI: 1.01, 2.19) in the various observed periods scaled by 10 d or 1 mo in the first and second gestation months. The strongest associations were observed for exposure to PM10 in the second quartile, whereas the associations were attenuated when higher concentrations of PM10 in the third and fourth quartiles of the exposure were evaluated. No correlations of PM10 levels with these cardiovascular malformations in the other time periods of gestation were observed. CONCLUSIONS Our findings suggest some positive associations between maternal exposure to ambient PM10 during the first two months of pregnancy and fetal cardiovascular malformations. https://doi.org/10.1289/EHP289.
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Affiliation(s)
- Chao-Bin Liu
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Xin-Ru Hong
- Department of Obstetrics and Gynecology, Fuzhou General Hospital, Fuzhou, Fujian, China
- Fuzhou Clinic Medical College, Fujian Medical University, Fuzhou, Fujian, China
- Dongfang Affiliated Hospital of Xiamen University, Fuzhou, Fujian, China
- China International Science & Technology Cooperation Base for Environmental Factors on Early Development, Fuzhou, Fujian, China
| | - Miao Shi
- Department of Obstetrics and Gynecology, Fuzhou General Hospital, Fuzhou, Fujian, China
- Fuzhou Clinic Medical College, Fujian Medical University, Fuzhou, Fujian, China
| | - Xiao-Qiu Chen
- Central Station of Environmental Monitoring of Fujian Province, Fuzhou, Fujian, China
| | - Hui-Juan Huang
- Department of Obstetrics and Gynecology, Fuzhou General Hospital, Fuzhou, Fujian, China
- Fuzhou Clinic Medical College, Fujian Medical University, Fuzhou, Fujian, China
- Dongfang Affiliated Hospital of Xiamen University, Fuzhou, Fujian, China
| | - Jin-Hua Chen
- Department of Statistics, Fuzhou General Hospital, Fuzhou, Fujian, China
| | - Kai Yang
- Dongfang Affiliated Hospital of Xiamen University, Fuzhou, Fujian, China
| | - Su-Qing Chen
- Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Han-Qiang Chen
- Department of Neonatology, Fujian Maternity and Child Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, China
| | - Hai-Dong Kan
- Department of Environmental Health, School of Public Health, Fudan University, Shanghai, China
| | - Qing-Hua Sun
- Division of Environmental Health Sciences, College of Public Health, Ohio State University, Columbus, Ohio, USA
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Abstract
OBJECTIVE This study aimed to explore evidence for the influence of air pollution on the risk of birth defects in China and contribute to establish prevention strategies. METHODS We conducted a retrospective cohort study in Anqing city, Eastern China, from 2010 to 2012. Binary logistic regression models were used to estimate odds ratios (ORs) per 10 μg/m3 change for SO2, NO2, and PM10. RESULTS For continuous exposure to SO2 (10 μg/m increase), the adjusted OR for birth defects is 1.20 [95% confidence interval (95% CI) 1.09 to 1.29] in the preconception. A 10 μg/m increase in SO2 (adjusted OR 1.26, 95% CI 1.15 to 1.36) during the second trimester is strongly associated with birth defects. No associations have been observed for NO2 and PM10. CONCLUSION The results suggested that exposure to ambient SO2 during pregnancy may increase the risk of birth defects.
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50
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Vecoli C, Pulignani S, Andreassi MG. Genetic and Epigenetic Mechanisms Linking Air Pollution and Congenital Heart Disease. J Cardiovasc Dev Dis 2016; 3:jcdd3040032. [PMID: 29367575 PMCID: PMC5715723 DOI: 10.3390/jcdd3040032] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2016] [Revised: 11/08/2016] [Accepted: 11/26/2016] [Indexed: 12/11/2022] Open
Abstract
Epidemiological studies strongly suggest that parental air pollutants exposure during the periconceptional period may play a major role in causing fetal/newborn malformations, including a frequent heterogeneity in the methods applied and a difficulty in estimating the clear effect of environmental toxicants. Moreover, only some couples exposed to toxicants during the pre-conception period give birth to a child with congenital anomalies. The reasons for such phenomena remain elusive but they can be explained by the individual, innate ability to metabolize these contaminants that eventually defines the ultimate dose of a biological active toxicant. In this paper, we reviewed the major evidence regarding the role of parental air pollutant exposure on congenital heart disease (CHD) risk as well as the modulating effect on detoxification systems. Finally, major epigenetic alterations induced by adverse environment contaminants have been revised as possible mechanisms altering a correct heart morphogenesis.
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Affiliation(s)
- Cecilia Vecoli
- Institute of Clinical Physiology-National Research Council (CNR), Via Moruzzi, 1 56124 Pisa, Italy.
| | - Silvia Pulignani
- Institute of Clinical Physiology-National Research Council (CNR), Via Moruzzi, 1 56124 Pisa, Italy.
| | - Maria Grazia Andreassi
- Institute of Clinical Physiology-National Research Council (CNR), Via Moruzzi, 1 56124 Pisa, Italy.
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