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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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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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Mao YS, Lee SJ, Wu CH, Hou CL, Ouyang CS, Liu CF. A hybrid deep learning network for forecasting air pollutant concentrations. APPL INTELL 2022. [DOI: 10.1007/s10489-022-04191-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
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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: 27] [Impact Index Per Article: 13.5] [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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Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China. Int J Hyg Environ Health 2021; 240:113898. [PMID: 34875582 DOI: 10.1016/j.ijheh.2021.113898] [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: 09/07/2021] [Revised: 11/29/2021] [Accepted: 11/30/2021] [Indexed: 11/21/2022]
Abstract
OBJECTIVE To examine the association between air pollution and neonatal congenital heart disease (CHD), and evaluate the cumulative burden of CHD attributed to above certain level for ambient air pollution exposure. METHODS We identified newborns who were diagnosed as CHD by echocardiography in Network Platform for Congenital Heart Disease (NPCHD) from January 2019 to December 2020 in 11 cities eastern China. The exposure lag response relationship between air pollutants (PM2.5, PM10, SO2, NO2, CO, and O3) concentration and CHDs was calculated by the distributed lag nonlinear model (DLNM). We further calculated the cumulative risk ratios (CRRs) of each air pollutant above reference concentrations on CHDs. RESULTS A total of 5904 CHDs from 983, 523 newborns were enrolled in this study. A 10 μg/m3 increase in PM2.5, PM10, SO2, NO2, CO and O3 exposure was associated with an increased risk of higher CHD incident RR = 1.025, 95% CI: 1.016-1.038 for PM2.5 in the third trimester, RR = 1.001, 95% CI: 1.000-1.002 for PM10 in the third trimester, 1.020, 95%CI: 1.004-1.036 for NO2 in the third trimester, RR = 1.001, 95%CI: 1.000-1.002 for O3 in the first trimester, all P value < 0.05). Cumulative effect curves of PM2.5, PM10, SO2, NO2, CO, and O3 were observed as sub-linear with a maximum of 1.876 (95%CI:1.220-2.886), 1.973 (95%CI:1.477,2.637), 2.169 (95%CI:1.347-3.493), 2.902 (95%CI:1.859-4.530), 1.398 (95%CI:1.080-1.809), 2.691 (95%CI:1.705-4.248), respectively. Significant associations were observed for air pollutants and CHDs in cities with higher average education years and babies concepted in cold season. CONCLUSIONS Our findings could provide growing evidence regarding the adverse health effects of air pollution on CHD, thereby strengthening the hypothesis that air pollutants have harmful impacts on cardiac development. Further studies are needed to verify the associations.
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Miao H, Wu H, Zhu Y, Kong L, Yu X, Zeng Q, Chen Y, Zhang Q, Guo P, Wang D. Congenital anomalies associated with ambient temperature variability during fetal organogenesis period of pregnancy: Evidence from 4.78 million births. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 798:149305. [PMID: 34340080 DOI: 10.1016/j.scitotenv.2021.149305] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 07/13/2021] [Accepted: 07/23/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUNDS Evidence for the effects of temperature variability on risk of congenital anomalies is lacking. We aimed to examine the association of temperature variability during fetal organogenesis period (weeks 3-8 post-conception) with major congenital anomalies. METHODS A retrospective cohort study comprising 4,787,356 singleton live-births and stillbirths in China was performed. We defined two temperature variability indices within gestational week i: the standard deviation (SD) of daily temperature (TVSDi) and the maximum day-to-day temperature difference (TVDi). At 6-week long timescales, we computed the SD of daily temperature (TVSD3-8) and the average value of TVDi (TVD3-8). We matched two temperature variability indices, pollutant exposure levels over entire exposure window and data of each mother-infant pairs. An extended generalized estimating equation log-binomial regression model was constructed to explore their associations after adjusting for individual characters, temperature extremes and air pollutants. Stratified and sensitivity analyses were also performed. RESULTS 59,571 neonates were registered as major congenital anomalies besides genetic and chromosomal anomalies. At weekly levels, the highest risk estimates of two temperature variability indices occurred at the 5th week for most anomaly groups. All TVSD5, TVD5, and maximum weekly TVSD and TVD were significantly associated with all anomaly groups; with the increment of 1 °C, the estimated risk ratio (RR) and corresponding 95% confidence interval (CI) ranges from 1.03 (1.01-1.05) to 1.19 (1.08-1.31). At 6-week scales, TVSD3-8 and TVD3-8 were associated with most anomaly subgroups. Overall, the strongest associations were estimated for isolated defects among morphology subgroups and cardiac defects among type subgroups. CONCLUSIONS Exposure to temperature variability during fetal organogenesis period of pregnancy is associated with increased risk of major congenital defects. Our findings provide a research foundation for public health policies, and further mechanism investigation.
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Affiliation(s)
- Huazhang Miao
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China; Guangdong Women and Children Hospital, No.521 Xingnan Road, Guangzhou 511442, China
| | - Haisheng Wu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yingxian Zhu
- Guangdong Women and Children Hospital, No.521 Xingnan Road, Guangzhou 511442, China
| | - Lei Kong
- LAPC & ICCES, Institute of Atmospheric Physics, Chinese Academy of Sciences, Beijing 100029, China; College of Earth and Planetary Sciences, University of Chinese Academy of Sciences, Beijing 100049, China
| | - Xiaolin Yu
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Qinghui Zeng
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Yuliang Chen
- Department of Preventive Medicine, Shantou University Medical College, Shantou 515041, China
| | - Qingying Zhang
- 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.
| | - Dong Wang
- School of Health Management, Southern Medical University, Guangzhou 510515, Guangdong Province, China.
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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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Yang BY, Qu Y, Guo Y, Markevych I, Heinrich J, Bloom MS, Bai Z, Knibbs LC, Li S, Chen G, Jalaludin B, Morawska L, Gao M, Han B, Yu Y, Liu XX, Ou Y, Mai J, Gao X, Wu Y, Nie Z, Zeng XW, Hu LW, Shen X, Zhou Y, Lin S, Liu X, Dong GH. Maternal exposure to ambient air pollution and congenital heart defects in China. ENVIRONMENT INTERNATIONAL 2021; 153:106548. [PMID: 33838617 DOI: 10.1016/j.envint.2021.106548] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 03/19/2021] [Accepted: 03/26/2021] [Indexed: 05/21/2023]
Abstract
BACKGROUND Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. METHOD This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. RESULTS A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01-1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. CONCLUSIONS Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.
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Affiliation(s)
- Bo-Yi Yang
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yanji Qu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Iana Markevych
- Institute of Psychology, Jagiellonian University, Poland
| | - Joachim Heinrich
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Ziemssenstraße 1, 80336 Munich, Germany
| | - Michael S Bloom
- Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
| | - Zhipeng Bai
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Luke C Knibbs
- School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
| | - Gongbo Chen
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Bin Jalaludin
- Centre for Air Quality and Health Research and Evaluation, Glebe, NSW 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
| | - Lidia Morawska
- International Laboratory for Air Quality and Health, Queensland University of Technology (QUT), GPO Box 2434, Brisbane, Queensland 4001, Australia
| | - Meng Gao
- Department of Geography, Hong Kong Baptist University, Hong Kong Special Administrative Region
| | - Bin Han
- State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
| | - Yunjiang Yu
- State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
| | - Xiao-Xuan Liu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Yanqiu Ou
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Jinzhuang Mai
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Xiangmin Gao
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Yong Wu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Zhiqiang Nie
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
| | - Xiao-Wen Zeng
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Li-Wen Hu
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
| | - Xubo Shen
- School of Public Health, Zunyi Medical University, Zunyi 563060, China
| | - Yuanzhong Zhou
- School of Public Health, Zunyi Medical University, Zunyi 563060, China
| | - Shao Lin
- Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA.
| | - Xiaoqing Liu
- Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China.
| | - Guang-Hui Dong
- Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China.
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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: 1] [Impact Index Per Article: 0.3] [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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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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Huang X, Chen J, Zeng D, Lin Z, Herbert C, Cottrell L, Liu L, Ash A, Wang B. The association between ambient air pollution and birth defects in five major ethnic groups in Liuzhou, China. BMC Pediatr 2021; 21:232. [PMID: 33990187 PMCID: PMC8120832 DOI: 10.1186/s12887-021-02687-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2020] [Accepted: 04/16/2021] [Indexed: 11/22/2022] Open
Abstract
Background Studies suggest that exposure to ambient air pollution during pregnancy may be associated with increased risks of birth defects (BDs), but conclusions have been inconsistent. This study describes the ethnic distribution of major BDs and examines the relationship between air pollution and BDs among different ethnic groups in Liuzhou city, China. Methods Surveillance data of infants born in 114 registered hospitals in Liuzhou in 2019 were analyzed to determine the epidemiology of BDs across five major ethnic groups. Concentrations of six air pollutants (PM2.5, PM10, SO2, CO, NO2, O3) were obtained from the Liuzhou Environmental Protection Bureau. Logistic regression was used to examine the associations between ambient air pollution exposure and risk of BDs. Results Among 32,549 infants, 635 infants had BDs, yielding a prevalence of 19.5 per 1000 perinatal infants. Dong ethnic group had the highest prevalence of BDs (2.59%), followed by Yao (2.57%), Miao (2.35%), Zhuang (2.07%), and Han (1.75%). Relative to the Han ethnic group, infants from Zhuang, Miao, Yao and Dong groups had lower risks of congenital heart disease, polydactyly, and hypospadias. The Zhuang ethnic group had higher risks of severe thalassemia, cleft lip and/or palate, and syndactyls. Overall BDs were positively correlated with air pollutants PM10 (aOR =1.14, 95% CI:1.12 ~ 2.43; aOR =1.51, 95% CI:1.13 ~ 2.03 for per 10μg/mg3 increment) and CO (aOR =1.36, 95% CI:1.14 ~ 2.48; aOR =1.75, 95% CI:1.02 ~ 3.61 for every 1 mg /m3 increment) in second and third month of pregnancy. SO2 was also significantly associated with BDs in the second month before the pregnancy (aOR = 1.31; 95% CI: 1.20 ~ 3.22) and third month of pregnancy (aOR =1.75; 95% CI:1.02 ~ 3.61). Congenital heart disease, polydactyl, cleft lip and/or palate were also significantly associated with PM10, SO2 and CO exposures. However, no significant association was found between birth defects and O3, PM2.5 and NO2 exposures (P > 0.05). Conclusion This study provides a comprehensive description of ethnic differences in BDs in Southwest China and broadens the evidence of the association between air pollution exposure during gestation and BDs. Supplementary Information The online version contains supplementary material available at 10.1186/s12887-021-02687-z.
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Affiliation(s)
- Xiaoli Huang
- Liuzhou Maternity and Child Healthcare Hospital, 50 Yingshan Street, Liuzhou, 545003, Guangxi Zhuang Autonomous Region, China
| | - Jichang Chen
- Liuzhou Maternity and Child Healthcare Hospital, 50 Yingshan Street, Liuzhou, 545003, Guangxi Zhuang Autonomous Region, China.
| | - Dingyuan Zeng
- Liuzhou Maternity and Child Healthcare Hospital, 50 Yingshan Street, Liuzhou, 545003, Guangxi Zhuang Autonomous Region, China
| | - Zhong Lin
- Liuzhou Maternity and Child Healthcare Hospital, 50 Yingshan Street, Liuzhou, 545003, Guangxi Zhuang Autonomous Region, China
| | - Carly Herbert
- Department of Population and Quantitative Health Sciences, Albert Sherman Center, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Lesley Cottrell
- Department of Pediatrics, West Virginia University School of Medicine, Morgantown, WV. One Medical Drive, Morgantown, WV, 26506, USA
| | - Liu Liu
- Liuzhou Maternity and Child Healthcare Hospital, 50 Yingshan Street, Liuzhou, 545003, Guangxi Zhuang Autonomous Region, China
| | - Arlene Ash
- Department of Population and Quantitative Health Sciences, Albert Sherman Center, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA
| | - Bo Wang
- Department of Population and Quantitative Health Sciences, Albert Sherman Center, University of Massachusetts Medical School, 368 Plantation Street, Worcester, MA, 01605, USA.
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12
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Shi J, Chen N, Yu W, Liu R, Jin H, Yu Z, Luo L, Gu L, Yang R, Liu Q, Feng W, Wang Z. Status of Comorbid Congenital Anomalies and Their Influence on Resource Use in Pediatric Inpatients: A Serial Cross-Sectional Study in Shanghai, China. Front Public Health 2020; 8:580664. [PMID: 33194984 PMCID: PMC7661780 DOI: 10.3389/fpubh.2020.580664] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 10/05/2020] [Indexed: 11/13/2022] Open
Abstract
Objectives: The status of children with comorbid congenital anomalies (CAs) and their effects on related hospital resource utilization have been minimally investigated. We aimed to describe the congenital anomalies comorbidity status and their effects on hospital resource utilization (length of stay, cost) by pediatric patients. Setting: This study was conducted in five tertiary care children's hospitals in Shanghai, China. Participants: Data were obtained from the inpatients' electronic health records; diagnoses were recorded using International Classification of Disease, Ninth Revision codes. In total, 7,890 children were diagnosed with congenital anomalies (13.13%), which were either primary or secondary. Primary and secondary outcome measures: The dependent variables were length of stay and cost. The independent variables were demographic and clinical characteristics and CA status. Results: In total, 50.98% of the hospitalized patients had comorbid CA conditions. Medical+CA patients were associated with a longer LOS (β = 2.656, P < 0.001), and CA+medical patients were associated with higher costs (β = 7.222, P < 0.001). Cardiovascular, musculoskeletal, and genitourinary diseases were the top three comorbid diseases. The average LOS for the top three comorbid diseases was longest in the medical+CA group, followed by CA+medical group. Cardiovascular disease was the most frequent comorbidity (ranking 1 in the medical+CA group and 2 in the CA+medical group), and the cost of cardiovascular disease was highest in all groups. Conclusions: A high prevalence of comorbid CA conditions was observed among pediatric inpatients in the sampled tertiary hospitals in China. Strategic planning should be improved to guide resource utilization for complex comorbid CA care.
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Affiliation(s)
- Jianwei Shi
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | - Ning Chen
- School of Medicine, Tongji University, Shanghai, China
| | - Wenya Yu
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rui Liu
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Hua Jin
- Shanghai General Practice and Community Health Development Research Center, Shanghai, China
| | | | - Li Luo
- School of Public Health, Fudan University, Shanghai, China
| | - Li Gu
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Rong Yang
- Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, China
| | - Qian Liu
- School of Medicine, Tongji University, Shanghai, China
| | - Wei Feng
- Department of Psychological Medicine, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhaoxin Wang
- School of Public Health, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Shanghai General Practice and Community Health Development Research Center, Shanghai, China
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13
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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: 22] [Impact Index Per Article: 5.5] [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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14
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Cen J, Jia ZL, Zhu CY, Wang XF, Zhang F, Chen WY, Liu KC, Li SY, Zhang Y. Particulate matter (PM10) induces cardiovascular developmental toxicity in zebrafish embryos and larvae via the ERS, Nrf2 and Wnt pathways. CHEMOSPHERE 2020; 250:126288. [PMID: 32114347 DOI: 10.1016/j.chemosphere.2020.126288] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/12/2019] [Revised: 02/13/2020] [Accepted: 02/19/2020] [Indexed: 05/02/2023]
Abstract
Particulate matter (PM10) is one of the most important indicators of the pollution that characterizes air quality. Epidemiological studies have shown that PM10 can cause cardiovascular-related diseases in the population. And, we studied the developmental toxicity of PM10 and the underlying mechanism of its effects on the cardiovascular system of zebrafish embryo/larva. Changes in cardiac morphology, sinus venosus and bulbus arteriosus (SV-BA) distance, heart rate, vascular subintestinalis, blood flow, returned blood volume, and reactive oxygen species (ROS) level were measured, and changes in the expression levels of certain genes were assessed via RT-PCR. The results showed that PM10 caused a significant increase in pericardial sac area and SV-BA distance, a decrease in heart rate, inhibition of vascular subintestinalis growth, blood flow obstruction, reduced venous return, and other cardiovascular toxicities. PM10 induced an increase in the ROS level and significant increases in the expression levels of ERS signalling pathway factors and Nrf2 signalling pathway factors. The expression levels of the Wnt pathway-related genes also showed significant changes. Furthermore, ROS inhibitor N-Acetyl-l-cysteine (NAC) could ameliorate the cardiovascular toxicity of PM10 in zebrafish larvae. It is speculated that PM10 may result in cardiovascular toxicity by inducing higher ROS levels in the body, which could then induce ERS and lead to defects in the expression of genes related to the Wnt signalling pathway. The Nrf2 signalling pathway was activated as a stress compensatory mechanism during the early stage of PM10-induced cardiovascular injury. However, it was insufficient to counteract the PM10-induced cardiovascular toxicity.
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Affiliation(s)
- Juan Cen
- Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, Henan Province, PR China
| | - Zhi-Li Jia
- Key Laboratory of Natural Medicine and Immuno-Engineering, Henan University, Kaifeng, Henan Province, PR China; Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China
| | - Cheng-Yue Zhu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China
| | | | - Feng Zhang
- College of Pharmacy, Henan University, Kaifeng, Henan Province, PR China
| | - Wei-Yun Chen
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China
| | - Ke-Chun Liu
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China
| | - Sai-Yu Li
- Shandong Analysis and Test Center, Jinan, Shandong Province, PR China.
| | - Yun Zhang
- Biology Institute, Qilu University of Technology (Shandong Academy of Sciences), Jinan, Shandong Province, PR China.
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15
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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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Spatial Clusters of Children with Cleft Lip and Palate and Their Association with Polluted Zones in the Monterrey Metropolitan Area. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16142488. [PMID: 31336885 PMCID: PMC6678111 DOI: 10.3390/ijerph16142488] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/02/2019] [Revised: 06/27/2019] [Accepted: 07/09/2019] [Indexed: 11/17/2022]
Abstract
This study examines the spatial structure of children with cleft lip and palate (CLP) and its association with polluted areas in the Monterrey Metropolitan Area (MMA). The Nearest Neighbor Index (NNI) and the Spatial Statistical Scan (SaTScan) determined that the CLP cases are agglomerated in spatial clusters distributed in different areas of the city, some of them grouping up to 12 cases of CLP in a radius of 1.2 km. The application of the interpolation by empirical Bayesian kriging (EBK) and the inverse distance weighted (IDW) method showed that 95% of the cases have a spatial interaction with values of particulate matter (PM10) of more than 50 points. The study also shows that 83% of the cases interacted with around 2000 annual tons of greenhouse gases. This study may contribute to other investigations applying techniques for the identification of environmental and genetic factors possibly associated with congenital malformations and for determining the influence of contaminating substances in the incidence of these diseases, particularly CLP.
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17
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Zhao B, Wang M, Lü C, Meng H, Fan Q, Guo J, Wang W, Wang H, Zhou H, He J. Increasing risk of congenital anomalies associated with seasonal pattern of air pollution: Differences by maternal comorbidities. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2019; 167:317-323. [PMID: 30343146 DOI: 10.1016/j.ecoenv.2018.10.037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 08/12/2018] [Accepted: 10/10/2018] [Indexed: 06/08/2023]
Abstract
To interpret the relationship of the seasonal pattern of air pollution exposure associated with increased risk of congenital anomalies (CA) and the trimester-specific effects. In this work, 55,428 hospital records with 847 doctor-diagnosed CA from July 2013 to December 2016 were collected in Hohhot, China. Maternal exposure to critical air pollutants (SO2, CO, PM10, O3, NO2 and PM2.5) were estimated using an inverse distance weighted (IDW) method on the basis of the ambient air quality monitoring stations. Logistic regression analysis was employed to determine the association of CA (in terms of odds ratio (OR) and 95% confidence interval (CI)) in three trimesters with heating/none heating season exposure. The results showed that CO exposure was found a significant association with ORs (95% CI) 1.58 (1.09, 2.27) changing from IQR2-3 and 1.40 (1.01, 1.93) changing from IQR3-IQR4 in 1st trimester and 1.51 (1.12, 2.04) changing from IQR2-3 in 2nd trimester, respectively. PM10 also presented significant association with ORs (95% CI) 1.42(1.08, 1.86) changing from IQR3-4 in 2nd trimester. Exposure effects were found more obvious in heating season, i.e. CO exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 5.21(2.02, 7.44), 2.24 (1.21, 4.15) and 1.84 (1.10, 3.11) in 1st trimester, respectively; PM2.5 exposure levels were associated with the risks of CA with IQR changing ORs (95% CI) of 3.76 (1.48, 6.55), 2.45 (1.10, 5.44) and 3.30 (1.63, 6.67) in 2nd trimester, respectively. Our findings suggested some positive associations of pregnancy and CA with maternal exposure to ambient CO and PM2.5 during the 1st and 2nd trimester after controlling for maternal comorbidities general covariates and other pollutants. PM10 was also found significantly associated with increased risk of CA in 2nd trimester besides seasons. There was no association found in 3rd trimester.
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Affiliation(s)
- Boyi Zhao
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Min Wang
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Changwei Lü
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
| | - Haixia Meng
- The Affiliated Hospital of Inner Mongolia Medical University, 010050 Hohhot, China
| | - Qingyun Fan
- Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jing Guo
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Wenqing Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haoji Wang
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China
| | - Haijun Zhou
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Environmental Monitoring Center of Inner Mongolia, 010011 Hohhot, China
| | - Jiang He
- Ministry of Education Key Laboratory of Ecology and Resource Use of the Mongolian Plateau & Inner Mongolia Key Laboratory of Grassland Ecology, School of Ecology and Environment, Inner Mongolia University, Hohhot 010021, China; Institute of Environmental Geology, Inner Mongolia University, Hohhot 010021, China.
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18
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Melody SM, Ford J, Wills K, Venn A, Johnston FH. Maternal exposure to short-to medium-term outdoor air pollution and obstetric and neonatal outcomes: A systematic review. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2019; 244:915-925. [PMID: 30469286 DOI: 10.1016/j.envpol.2018.10.086] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 10/16/2018] [Accepted: 10/18/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Little is known about the impacts of maternal exposure to acute episodes of outdoor air pollution, such as that resulting from wildfires, on obstetric and neonatal outcomes. This systematic review aims to synthesise the existing literature exploring the relationship between maternal exposure to short-to medium-term changes in outdoor air quality and obstetric and neonatal outcomes. METHODS A systematic search of peer-reviewed articles using PubMed, Cochrane Library, EMBASE, ScienceDirect, Web of Science, ProQuest, GreenFILE and Scopus was conducted in January 2018 using selected search terms. Quality of included studies were assessed using the Newcastle Ottawa Scale. RESULTS Eleven studies were included; eight assessed the impact of maternal exposure to air pollution exacerbation events, such as wildfires, oil well fires and volcanic eruptions, and three assessed the impact of improvement events, such as the 2018 Beijing Olympics and closure of industrial activities, on obstetric and neonatal outcomes. Studies were highly heterogenous in methodology. Six studies found a significant association between acute changes in air quality and markers of fetal growth restriction, while two did not. Three studies found an adverse association between acute changes in air quality and markers of gestational maturity, and one did not. CONCLUSION Overall, there is some evidence that maternal exposure to acute changes in air quality of short-to medium-term duration increases the risk of fetal growth restriction and preterm birth. The relationship for other adverse obstetric or neonatal outcomes is less clear.
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Affiliation(s)
- Shannon M Melody
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.
| | - Jane Ford
- Clinical and Population Perinatal Health Research, Kolling Institute, Northern Sydney Local Health District, St Leonards, New South Wales, Australia; Northern Clinical School, Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Karen Wills
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Alison Venn
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia
| | - Fay H Johnston
- Menzies Institute for Medical Research, University of Tasmania, 17 Liverpool Street, Hobart, Tasmania, Australia.
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19
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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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20
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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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21
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Nicoll R. Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15102096. [PMID: 30257432 PMCID: PMC6210579 DOI: 10.3390/ijerph15102096] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/12/2018] [Revised: 09/19/2018] [Accepted: 09/21/2018] [Indexed: 12/12/2022]
Abstract
Congenital heart defects (CHDs) are a common birth defect of largely unknown etiology, with high fetal and neonatal mortality. A review of CHDs and environmental contaminant exposure found that meta-analyses showed only modest associations for smoking, vehicle exhaust components, disinfectant by-products and proximity to incinerators, with stronger results from the newer, larger and better quality studies masked by the typical absence of effect in older studies. Recent studies of exposure to agricultural pesticides, solvents, metals and landfill sites also showed associations. Certain contaminants have been associated with certain CHDs, with septal defects being the most common. Frequent methodological problems include failure to account for potential confounders or maternal/paternal preconception exposure, differences in diagnosing, defining and classifying CHDs, grouping of defects to increase power, grouping of contaminants with dissimilar mechanisms, exclusion of pregnancies that result in death or later life diagnosis, and the assumption that maternal residence at birth is the same as at conception. Furthermore, most studies use measurement estimates of one exposure, ignoring the many additional contaminant exposures in daily life. All these problems can distort and underestimate the true associations. Impaired methylation is a common mechanism, suggesting that supplementary folate may be protective for any birth defect.
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Affiliation(s)
- Rachel Nicoll
- Department of Public Health and Clinical Medicine, Umeå University, SE 901-87 Umeå, Sweden.
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