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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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Dong J, Hao T. Association of maternal and paternal risk factors with risk of congenital heart disease in infants: a case-control study. Ir J Med Sci 2024; 193:95-99. [PMID: 37249792 DOI: 10.1007/s11845-023-03409-3] [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: 04/01/2023] [Accepted: 05/15/2023] [Indexed: 05/31/2023]
Abstract
OBJECTIVE We aimed to explore maternal and paternal risk factors with risk of congenital heart disease in infants. METHODS A total of 125 congenital heart disease (CHD) infants and 125 controls were included in Heping Hospital Affiliated to Changzhi Medical College, Shanxi, China. Subjects were diagnosed between Jan 1, 2016 and Dec 31, 2021 in the present study. All the characteristics were collected with questionnaire by face-to-face interview, including maternal and paternal risk factors. Conditional logistic regression was conducted to explore the risk factors with risk of congenital heart disease in infants. RESULTS For maternal risk factors, we found that age, number of pregnancies, systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) were risk factors for CHD infants, and the ORs (95%CIs) were 1.15 (1.06-1.23) for age, 1.13 (1.02-1.29) for SBP, 1.06 (1.02-1.18) for DBP, 1.22 (1.16-1.31) for BMI. Compared with one pregnancy, the ORs (95%CIs) were 1.17 (1.05-1.29) for two pregnancies and 1.25 (1.16-1.47) for more pregnancies. For paternal risk factors, we found that age (OR = 1.07, 95%CI = 1.01-1.19), smoking (OR = 1.11, 95%CI = 1.03-1.27), drinking (OR = 1.04, 95%CI = 1.02-1.19), and BMI (OR = 1.15, 95%CI = 1.03-1.28) were risk factors for CHD infants. CONCLUSION We found that age, number of pregnancies, SBP, DBP, and BMI are maternal risk factors for CHD infants. And age, smoking, drinking, and BMI are paternal risk factors for CHD infants.
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Affiliation(s)
- Jianxia Dong
- Department of Preventive Health Care, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China
| | - Tianyou Hao
- Department of Preventive Health Care, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi, China.
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Krakauer KN, Cevallos PC, Amakiri UO, Saldana GM, Lipman KJ, Howell LK, Wan DC, Khosla RK, Nazerali R, Sheckter CC. US air pollution is associated with increased incidence of non-syndromic cleft lip/palate. J Plast Reconstr Aesthet Surg 2024; 88:344-351. [PMID: 38064913 DOI: 10.1016/j.bjps.2023.11.012] [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: 03/01/2023] [Revised: 11/08/2023] [Accepted: 11/15/2023] [Indexed: 01/02/2024]
Abstract
Maternal cigarette use is associated with the fetal development of orofacial clefts. Air pollution should be investigated for similar causation. We hypothesize that the incidence of non-syndromic cleft lip with or without palate (NSCLP) and non-syndromic cleft palate (NSCP) would be positively correlated with air pollution concentration. METHODS The incidence of NSCLP and NSCP per 1000 live births from 2016 to 2020 was extracted from the Centers for Disease Control and Prevention Vital Statistics Database and merged with national reports on air pollution using the Environmental Protection Agency Air Quality Systems annual data. The most commonly reported pollutants were analyzed including benzene, sulfur dioxide (SO2), particulate matter (PM) 2.5, PM 10, ozone (O3), and carbon monoxide (CO). Multivariable negative binomial and Poisson log-linear regression models evaluated the incidence of NSCLP and NSCP as a function of the pollutants, adjusting for race. All p-values are reported with Bonferroni correction. RESULTS The median NSCLP incidence was 0.22/1000 births, and isolated NSCP incidence was 0.18/1000 births. For NSCLP, SO2 had a coefficient estimate (CE) of 0.60 (95% CI [0.23, 0.98], p < 0.007) and PM 2.5 had a CE of 0.20 (95% CI [0.10, 0.31], p < 0.005). Among isolated NSCP, no pollutants were found to be significantly associated. CONCLUSION SO2 and PM 2.5 were significantly correlated with increased incidence of NSCLP. The American people and perinatal practitioners should be aware of the connection to allow for risk reduction and in utero screening.
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Affiliation(s)
- Kelsi N Krakauer
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA
| | - Priscila C Cevallos
- Geisel School of Medicine at Dartmouth, 1 Rope Ferry Road, Hanover, NH 03755, USA
| | - Uche O Amakiri
- Icahn School of Medicine at Mt. Sinai, 1 Gustave L. Levy Pl, New York, NY 10029, USA
| | - Golddy M Saldana
- University of California Davis School of Medicine, 4610 X Street, Sacramento, CA 95817, USA
| | - Kelsey J Lipman
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA
| | - Lori K Howell
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Oregon Health and Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR 97239, USA
| | - Derrick C Wan
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA
| | - Rohit K Khosla
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA
| | - Rahim Nazerali
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA
| | - Clifford C Sheckter
- Division of Plastic and Reconstructive Surgery, Department of Surgery, Stanford University, 300 Pasteur Drive, Palo Alto, CA 94305, USA.
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Kc A, Halme S, Gurung R, Basnet O, Olsson E, Malmqvist E. Association between usage of household cooking fuel and congenital birth defects-18 months multi-centric cohort study in Nepal. Arch Public Health 2023; 81:144. [PMID: 37568204 PMCID: PMC10416396 DOI: 10.1186/s13690-023-01169-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Accepted: 08/06/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND - An estimated 240,000 newborns die worldwide within 28 days of birth every year due to congenital birth defect. Exposure to poor indoor environment contributes to poor health outcomes. In this research, we aim to evaluate the association between the usage of different type household cooking fuel and congenital birth defects in Nepal, as well as investigate whether air ventilation usage had a modifying effect on the possible association. METHODS - This is a secondary analysis of multi-centric prospective cohort study evaluating Quality Improvement Project in 12 public referral hospitals of Nepal from 2017 to 2018. The study sample was 66,713 women with a newborn, whose information was available in hospital records and exit interviews. The association between cooking fuel type usage and congenital birth defects was investigated with adjusted multivariable logistic regression. To investigate the air ventilation usage, a stratified multivariable logistic regression analysis was performed. RESULTS -In the study population (N = 66,713), 60.0% used polluting fuels for cooking and 89.6% did not have proper air ventilation. The prevalence rate of congenital birth defect was higher among the families who used polluting fuels for cooking than those who used cleaner fuels (5.5/1000 vs. 3.5/1000, p < 0.001). Families using polluting fuels had higher odds (aOR 1.49; 95% CI; 1.16, 1.91) of having a child with a congenital birth defect compared to mothers using cleaner fuels adjusted with all available co-variates. Families not using ventilation while cooking had even higher but statistically insignificant odds of having a child with congenital birth defects (aOR 1.34; 95% CI; 0.86, 2.07) adjusted with all other variates. CONCLUSION - The usage of polluted fuels for cooking has an increased odds of congenital birth defects with no significant association with ventilation. This study adds to the increasing knowledge on the adverse effect of polluting fuels for cooking and the need for action to reduce this exposure.
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Affiliation(s)
- Ashish Kc
- School of Public Health and Community Medicine, University of Gothenburg, Medicinargatan 18, Gothenburg, Sweden.
| | - Sanni Halme
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Rejina Gurung
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Research Division, Golden Community, Lalitpur, Nepal
| | - Omkar Basnet
- Research Division, Golden Community, Lalitpur, Nepal
| | - Erik Olsson
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
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Nirel R, Shoham T, Rotem R, Ahmad WA, Koren G, Kloog I, Golan R, Levine H. Maternal exposure to particulate matter early in pregnancy and congenital anomalies in offspring: Analysis of concentration-response relationships in a population-based cohort with follow-up throughout childhood. THE SCIENCE OF THE TOTAL ENVIRONMENT 2023; 880:163082. [PMID: 37004765 DOI: 10.1016/j.scitotenv.2023.163082] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 03/22/2023] [Accepted: 03/22/2023] [Indexed: 05/27/2023]
Abstract
Studies have suggested an association between particulate matter (PM) air pollution and certain congenital anomalies (CAs). However, most studies assumed a linear concentration-response relation and were based on anomalies that were ascertained at birth or up to 1 year of age. We investigated associations between exposures to PM during the first trimester of pregnancy and CAs in 9 organ systems using birth and childhood follow-up data from a leading health care provider in Israel. We conducted a retrospective population-based cohort study among 396,334 births, 2004-2015. Daily PM data at a 1 × 1 km spatial grid were obtained from a satellite-derived prediction models and were linked to the mothers' residential addresses at birth. Adjusted odds ratios (ORs) were estimated with logistic regression models using exposure levels as either continuous or categorical variables. We captured 57,638 isolated CAs with estimated prevalence of 96 and 136 anomalies per 1000 births in the first year of life and by age 6 years, respectively. Analysis of continuous PM with diameter < 2.5 μm (PM2.5) indicated a supra-linear relation with anomalies in the circulatory, respiratory, digestive, genital and integument systems (79 % of CAs). The slope of the concentration-response function was positive and steepest for PM2.5 lower than the median concentration (21.5 μg/m3) and had a less steep or negative slope at higher levels. Similar trends were observed for PM2.5 quartiles. For example, for cardiac anomalies, the ORs were 1.09 (95 % confidence interval: 1.02, 1.15), 1.04 (0.98, 1.10) and 1.00 (0.94, 1.07) for births in the second, third and fourth quartiles, respectively, when compared to the first quartile. In sum, this study adds new evidence for adverse effects of air pollution on neonatal health even with low-level air pollution. Information on late diagnosis of children with anomalies is important in evaluating the burden of disease.
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Affiliation(s)
- Ronit Nirel
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel.
| | - Tomer Shoham
- Department of Statistics and Data Science, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Ran Rotem
- Maccabi Institute of Research and Innovation, Maccabi Healthcare Services, Tel-Aviv, Israel; Department of Environmental Health, Harvard TH Chan School of Public Health, Boston, MA, United States
| | - Wiessam Abu Ahmad
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Gideon Koren
- The Dr. Miriam and Sheldon G. Adelson Medical School, Ariel University, Ariel, Israel
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Rachel Golan
- Department of Epidemiology, Biostatistics and Community Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Hagai Levine
- Braun School of Public Health and Community Medicine, Hadassah Medical Center, Faculty of Medicine, Hebrew University of Jerusalem, Jerusalem, Israel
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Chen H, Zhang Y, Zhang L, Liu J, Jin L, Ren A, Li Z. Indoor air pollution from coal combustion and tobacco smoke during the periconceptional period and risk for neural tube defects in offspring in five rural counties of Shanxi Province, China, 2010-2016. ENVIRONMENT INTERNATIONAL 2023; 171:107728. [PMID: 36610357 DOI: 10.1016/j.envint.2023.107728] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 12/12/2022] [Accepted: 01/01/2023] [Indexed: 06/17/2023]
Abstract
Indoor air pollution may increase the risk for neural tube defects (NTDs) in Chinese rural populations. However, this association remains a subject of debate. We conducted a population-based case-control study of 222 NTD and 517 control mothers recruited between 2010 and 2016 in five rural areas in northern China. An indoor air pollution exposure evaluation index (IAPEEI) was used to evaluate mothers' exposure to tobacco-sourced and coal-sourced indoor air pollution. Essential characteristics were collected using structured questionnaires within 10 days of delivery. We found that exposure to indoor air pollution (IAPEEI ≥ 1) can lead to 3.41 times the risk of conceiving NTD fetuses compared with the no-exposure group (IAPEEI = 0) (adjusted odds ratio and 95 % confidence interval: 3.41 [2.34-5.02]). The risk increased with increasing IAPEEI score, indicating a clear dose-response trend (P < 0.001). Using a coal stove for heating (especially in the bedroom) and passive smoking are significantly associated with an increased likelihood of NTD occurrence. Exposure to indoor air pollution is a daily reality for rural women in China, and its impact on reproductive health deserves extensive attention.
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Affiliation(s)
- Huiting Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Yali Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Le Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Jufen Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Lei Jin
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Aiguo Ren
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China
| | - Zhiwen Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing 100191, China; Institute of Reproductive and Child Health/National Health Commission Key Laboratory of Reproductive Health, Peking University School of Public Health, Beijing, China.
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Ma Z, Li W, Yang J, Qiao Y, Cao X, Ge H, Wang Y, Liu H, Tang N, Yang X, Leng J. Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study. Environ Health Prev Med 2023; 28:4. [PMID: 36642530 PMCID: PMC9845069 DOI: 10.1265/ehpm.22-00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease. METHODS The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease. RESULTS A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants. CONCLUSIONS This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.
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Affiliation(s)
- Zhao Ma
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Weiqin Li
- Tianjin Women and Children’s Health Center, Tianjin, China
| | - Jicui Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Yijuan Qiao
- Tianjin Women and Children’s Health Center, Tianjin, China
| | - Xue Cao
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Han Ge
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Wang
- Tianjin Women and Children’s Health Center, Tianjin, China
| | - Hongyan Liu
- Tianjin Women and Children’s Health Center, Tianjin, China
| | - Naijun Tang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Xueli Yang
- Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University, Tianjin, China,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Junhong Leng
- Tianjin Women and Children’s Health Center, Tianjin, China
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Martin L, Zhang Y, First O, Mustieles V, Dodson R, Rosa G, Coburn-Sanderson A, Adams CD, Messerlian C. Lifestyle interventions to reduce endocrine-disrupting phthalate and phenol exposures among reproductive age men and women: A review and future steps. ENVIRONMENT INTERNATIONAL 2022; 170:107576. [PMID: 36283156 PMCID: PMC9890927 DOI: 10.1016/j.envint.2022.107576] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 09/08/2022] [Accepted: 10/08/2022] [Indexed: 05/04/2023]
Abstract
Non-persistent endocrine-disrupting chemicals (EDCs), including phthalates and phenols, are ubiquitous in both the environment and human body. A growing body of epidemiologic studies have identified concerning links between EDCs and adverse reproductive and developmental health effects. Despite consistent evidence, risk assessments and policy interventions often arrive late. This presents an urgent need to identify evidence-based interventions for implementation at both clinical and community levels to reduce EDC exposure, especially in susceptible populations. The reproductive life cycle (menarche to menopause for females and after pubertal onset for males) includes some of the most vulnerable periods to environmental exposures, such as the preconception and perinatal stages, representing a key window of opportunity to intervene and prevent unfavorable health outcomes. This review aims to synthesize and assess behavioral, dietary, and residential EDC-driven interventions to develop recommendations for subsequent, larger-scale studies that address knowledge-gaps in current interventions during the reproductive life cycle. We selected 21 primary interventions for evaluation, in addition to four supplemental interventions. Among these, accessible (web-based) educational resources, targeted replacement of (known) toxic products, and personalization of the intervention through meetings and support groups, were the most promising strategies for reducing EDC concentrations. However, we document a paucity of interventions to prevent phthalate and phenol exposures during the reproductive years, especially among men. Accordingly, we recommend additional, larger clinical and community-based intervention studies to reduce EDC exposure. Specifically, future intervention studies should focus on short-term, mid-, and long-term exposure reduction to phthalates and phenols. The latter, especially, is required for the development of clinical and public health guidelines to promote reproductive and developmental health globally.
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Affiliation(s)
- Leah Martin
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Yu Zhang
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Olivia First
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Vicente Mustieles
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Gabriela Rosa
- Massachusetts General Hospital Fertility Center, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Ayanna Coburn-Sanderson
- Massachusetts General Hospital Fertility Center, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Charleen D Adams
- Massachusetts General Hospital Fertility Center, Department of Obstetrics and Gynecology, Boston, MA, USA
| | - Carmen Messerlian
- Department of Environmental Health, Harvard T.H. Chan School of Public Heath, Boston, MA, USA; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA; Massachusetts General Hospital Fertility Center, Department of Obstetrics and Gynecology, Boston, MA, USA.
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Yu WJ, Li N, Gong TT, Zhang JY, Jiang YT, Zhao YH, Huang YH, Li J, Liu S, Chen YL, Li LL, Jiang CZ, Chen ZJ, Wu QJ. Association Between Maternal Exposure to SO2 and Congenital Ear Malformations in Offspring: A Population-Based Case-Control Study in Liaoning Province, China. Int J Public Health 2022; 67:1604945. [PMID: 35872708 PMCID: PMC9302193 DOI: 10.3389/ijph.2022.1604945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 06/09/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives: To examine associations between maternal sulfur dioxide (SO2) exposure and congenital ear malformations risk in offspring.Methods: We surveyed 1676 cases with congenital ear malformations and 7950 controls from the Maternal and Child Health Certificate Registry of Liaoning Province between 2010 and 2015. SO2 concentrations were obtained from the Municipal Environment Protection Bureau of Liaoning Province. Multivariable logistic regression models and Restricted cubic splines (RCS) model were used to assess the aforementioned association.Results: There were significant associations between maternal SO2 exposure and congenital ear malformations risk during the 3 months before conception (OR Q4 vs. Q1 = 1.93, 95% CI = 1.43–2.59) and the 3 months after conception (OR Q4 vs. Q1 = 1.63, 95% CI = 1.22–2.18). Similar results were obtained in the analysis of single-month exposure windows, except for the third month before conception and the third month after conception. Moreover, these findings were broadly consistent across subgroups and robust in sensitivity analyses. There were non-linear dose-response associations between SO2 exposure and congenital ear malformations based on restricted cubic spline model analysis.Conclusion: Maternal SO2 exposure is associated with increased congenital ear malformations risk in offspring.
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Affiliation(s)
- Wei-Jun Yu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Institute for Prevention and Control of Infection and Infectious Diseases, Liaoning Provincial Center for Disease Control and Prevention, Shenyang, China
| | - Na Li
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Ting-Ting Gong, ; Qi-Jun Wu,
| | - Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Ting Jiang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Hong Huang
- Department of Ophthalmology, Shenyang Women’s and Children’s Hospital, Shenyang, China
| | - Jing Li
- Department of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Shu Liu
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Yan-Ling Chen
- Office of Institution, Liaoning Women and Children’s Health Hospital, Shenyang, China
| | - Li-Li Li
- Department of Children’s Health Prevention, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Cheng-Zhi Jiang
- School of Environmental and Chemical Engineering, Shenyang Ligong University, Shenyang, China
| | - Zong-Jiao Chen
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
- *Correspondence: Ting-Ting Gong, ; Qi-Jun Wu,
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10
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Jiang W, Liu Z, Ni B, Xie W, Zhou H, Li X. Modification of the effects of nitrogen dioxide and sulfur dioxide on congenital limb defects by meteorological conditions. Hum Reprod 2021; 36:2962-2974. [PMID: 34382079 DOI: 10.1093/humrep/deab187] [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: 04/01/2021] [Revised: 07/12/2021] [Indexed: 12/19/2022] Open
Abstract
STUDY QUESTION Can meteorological conditions modify the associations between NO2 and SO2 exposure and congenital limb defects (CLDs) during the first trimester of pregnancy? SUMMARY ANSWER Increases in NO2 and SO2 exposure were consistently associated with higher risks of CLDs during the first trimester of pregnancy; both low- and high-temperature exposure and high air humidity act synergistically with the two air pollutants on CLDs. WHAT IS KNOWN ALREADY Animal studies have indicated air pollutants are associated with CLDs, but corresponding epidemiological studies are limited with equivocal conclusions. Meteorological conditions are closely connected to the generation, diffusion, distribution and even chemical toxicity of air pollutants. STUDY DESIGN, SIZE, DURATION This case-control study included 972 cases of CLDs and 9720 controls in Changsha, China during 2015-2018. PARTICIPANTS/MATERIALS, SETTING, METHODS Cases from the hospital based monitoring system for birth defects (including polydactyly, syndactyly, limb shortening, and clubfoot) and healthy controls from the electronic medical records system were studied. Complete data on daily average NO2 and SO2 concentrations and meteorological variables were obtained from local monitoring stations to estimate monthly individual exposures during the first trimester of pregnancy, using the nearest monitoring station approach for NO2 and SO2 concentrations, and the city-wide average approach for temperature and relative humidity, respectively. The 25th and 75th percentiles of daily mean temperature, as well as the 50th percentile of daily mean relative humidity during the study period were used to classify high- and low-temperature exposure, and high humidity exposure based on existing evidence and local climate characteristics. Multivariate logistic regression models were used to estimate the independent effects per 10 μg/m3 increase in NO2 and SO2 on CLDs, and the attribute proportions of interaction (API) were used to quantify the additive joint effects of air pollutants with meteorological conditions after including a cross product interaction term in the regression models. MAIN RESULTS AND THE ROLE OF CHANCE NO2 and SO2 exposures during the first trimester of pregnancy were consistently and positively associated with overall CLDs and subtypes, with adjusted odd ratios (aORs) ranging from 1.13 to 1.27 for NO2, and from 1.37 to 2.49 for SO2. The effect estimates were generally observed to be the strongest in the first month and then attenuated in the second and third months of pregnancy. Synergistic effects of both low and high temperature in combination with NO2 (with APIs ranging from 0.07 to 0.38) and SO2 (with APIs ranging from 0.18 to 0.51) appeared in the first trimester of pregnancy. Several significant modifying effects by high humidity were also observed, especially for SO2 (with APIs ranging from 0.13 to 0.38). Neither NO2 nor SO2 showed an interactive effect with season of conception. LIMITATIONS, REASONS FOR CAUTION The methods used to estimate individual exposure levels of air pollutants and meteorological factors may lead to the misclassification bias because of the lack of information on maternal activity patterns and residential mobility during pregnancy. Moreover, we were unable to consider several potentially confounding factors, including socioeconomic status, maternal nutrient levels, alcohol use and smoking during early pregnancy due to unavailable data, although previous studies have suggested limited change to the results after when including these factors in the analysis. WIDER IMPLICATIONS OF THE FINDINGS The findings are helpful for understanding the combined effects of air pollution and meteorological conditions on birth defects. Environmental policies and practices should be formulated and implemented to decrease air pollutant emissions and improve meteorological conditions to reduce their harmful effects on pregnancy. Additionally, pregnant women should be suggested to reduce outdoor time when the air quality is poor, especially when ambient temperature is higher or lower than what is comfortable, or when it is excessively humid. STUDY FUNDING/COMPETING INTEREST(S) The study is funded by Major Scientific and Technological Projects for Collaborative Prevention and Control of Birth Defects in Hunan Province (2019SK1012), Major Research and Development Projects in Hunan Province (2018SK2060) and Scientific and Technological Department Projects in Hunan Province (2017SK50802). There are no competing interests. TRIAL REGISTRATION NUMBER N/A.
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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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11
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Liu FH, Xing Z, Gong TT, Zhang JY, Huang YH, Li J, Liu S, Chen YL, Li LL, Jiang CZ, Chen ZJ, Zhao YH, Wu QJ. Maternal exposure to sulfur dioxide and the risk of oral clefts in Liaoning Province, China: a population-based case-control study. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:39101-39109. [PMID: 33745054 DOI: 10.1007/s11356-021-13461-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 03/11/2021] [Indexed: 06/12/2023]
Abstract
There is limited and equivocal epidemiological evidence relating to the association between maternal sulfur dioxide (SO2) exposure and the risk of oral clefts (OCs) in offspring. We performed a population-based case-control study in Liaoning province to evaluate aforementioned relationship during 3 months before conception, the first trimester of pregnancy, and their single months. The study involved 3086 patients with OCs and 7950 controls. Data relating to SO2 concentration was acquired from air monitoring stations throughout the study period. We used a multivariable logistic regression model to evaluate the association between exposure to SO2 and the risk of OCs during the exposure windows. Maternal SO2 exposure was positively related to OCs during the 3 months before conception (odds ratio = 1.38, 95% confidence interval: 1.15-1.65; P for trend < 0.01). Positive relationships were obtained from the first and second months before conception and the first month of pregnancy. Thus, our research reflects a relationship between SO2 exposure and the risk of OCs. Future studies are now required to verify the association between SO2 exposure and OCs during pregnancy and indicate the most relevant vulnerable exposure time windows.
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Affiliation(s)
- Fang-Hua Liu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ze Xing
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Ting-Ting Gong
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Hong Huang
- Department of Ophthalmology, Shenyang Women's and Children's Hospital, No.87, Da Nan Street, Shenyang, Liaoning, 110011, People's Republic of China.
| | - Jing Li
- Department of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Shu Liu
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Yan-Ling Chen
- Office of Institution, Liaoning Women and Children's Health Hospital, Shenyang, China
| | - Li-Li Li
- Department of Children's Health Prevention, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Cheng-Zhi Jiang
- School of Environmental and Chemical Engineering, Shenyang Ligong University, Shenyang, China
| | - Zong-Jiao Chen
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China.
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, No.36, San Hao Street, Shenyang, Liaoning, 110004, People's Republic of China.
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12
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Zhang S, Yue DM, Zhang JY, Huang YH, Li J, Liu S, Chen YL, Li LL, Jiang CZ, Chen ZJ, Zhao YH, Wu QJ. Maternal exposure to sulfur dioxide before and after conception and the risk of hypospadias in offspring. Ann N Y Acad Sci 2021; 1502:99-109. [PMID: 34247395 DOI: 10.1111/nyas.14624] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 12/01/2022]
Abstract
As far as we know, there have been no studies exploring the association between maternal sulfur dioxide (SO2 ) exposure and the risk of hypospadias in offspring. We aimed to evaluate this association during the 3 months before conception and the first trimester. A population-based case-control study was conducted in male infants, consisting of 348 cases of hypospadias and 4023 controls. Maternal exposure to SO2 , particulate matter with aerodynamic diameters ≤10 μm (PM10 ), and nitrogen dioxide (NO2 ) was assessed by averaging the concentrations recorded at all stations in the mother's city of residence. Air pollutants were tested for multicollinearity using variance inflation factor analysis. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated by multivariable logistic regression models. SO2 exposure during the 3 months before conception was significantly associated with the risk of hypospadias (highest tertile: OR = 7.40, 95% CI: 3.54-15.62). When focusing on shorter exposure windows, similar associations were observed for SO2 exposure in the first and second month before and the first month after conception. In conclusion, maternal exposure to SO2 during the 3 months before and the first and second months after conception may increase the risk of hypospadias in offspring.
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Affiliation(s)
- Shuang Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Dong-Mei Yue
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jia-Yu Zhang
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Hong Huang
- Department of Ophthalmology, Shenyang Women's and Children's Hospital, Shenyang, China
| | - Jing Li
- Department of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Shu Liu
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Yan-Ling Chen
- Liaoning Women and Children's Health Hospital, Shenyang, China
| | - Li-Li Li
- Department of Children's Health Prevention, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Cheng-Zhi Jiang
- School of Environmental and Chemical Engineering, Shenyang Ligong University, Shenyang, China
| | - Zong-Jiao Chen
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, Shenyang, China
| | - Yu-Hong Zhao
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Qi-Jun Wu
- Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
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13
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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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14
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Ravindra K, Chanana N, Mor S. Exposure to air pollutants and risk of congenital anomalies: A systematic review and metaanalysis. THE SCIENCE OF THE TOTAL ENVIRONMENT 2021; 765:142772. [PMID: 33183823 DOI: 10.1016/j.scitotenv.2020.142772] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 09/28/2020] [Accepted: 09/30/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Congenital malformations are considered as one of the significant causes of preterm as well as neonatal morbidity and mortality. Literature suggests the association of diverse congenital deformities with maternal exposure to air pollutants. However, the evidence is still inconclusive on the manifestation of these during pregnancy. Thus, systematic review was done on the available epidemiological studies studying the effect of air pollutants on congenital malformations. Furthermore, the meta-analysis was conducted for several combinations of air pollutants and congenital defects. METHODS Twenty six epidemiological studies were extracted from the databases and examined for association of risk of congenital defects with air pollutant concentrations. Metaanalysis was done if the risk estimates of the same anomaly and pollutant group were reported in at least three studies. RESULTS Each study reported a statistically significant increased risk of congenital malformation with some air pollutant, amid the several tested combinations. Our meta-analysis reported that nitrogen dioxide and PM2.5 were associated with the risk of pulmonary valve stenosis with OR = 1.74 and OR = 1.42 respectively. The risk of developing tetralogy of Fallot (TOF) was observed to be associated with PM2.5 with OR = 1.52. SO2 exposure was related to a high risk of the ventricular septal defect (VSD) with OR = 1.15 and orofacial defects (OR = 1.27). CONCLUSION It is evidenced that ambient air pollutants have some effect on congenital malformations. Standard case definitions, improved methods of exposure, and better control of confounders will improve future research in this area.
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Affiliation(s)
- Khaiwal Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Neha Chanana
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Suman Mor
- Department of Environment Sciences, Panjab University, Chandigarh 160014, India
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15
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Zhang Y, Qiu J, Zhou M, He X, Cui H, Xu X, Lv L, Lin X, Zhang C, Zhang H, Xu R, Yi B, Mao B, Huang H, Jin L, Zhuo H, Sun P, Liu Q, Zhang Y. Cooking stoves and risk of birth defects in urban China. ENVIRONMENTAL RESEARCH 2021; 194:110731. [PMID: 33453184 DOI: 10.1016/j.envres.2021.110731] [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: 10/10/2020] [Revised: 12/20/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Birth defects are a leading cause of infant death. Pregnant women spend a large amount of time indoors, and little research from population-based studies has investigated the association between indoor air pollution and birth defects. We aimed to examine whether using coal, biomass, or electromagnetic stoves for cooking is associated with risk of birth defects compared to using gas stoves. METHODS A birth cohort study was conducted from 2010 to 2012 in Lanzhou, China. Cases (n = 264) were singleton births with birth defects, which were defined as abnormalities of structure or function, including metabolism, presented at birth based on the International Classification of Diseases (ICD)-10 codes. Controls (n = 9926) were defined as singleton live births without birth defects. Unconditional logistic regression models were employed to estimate the association adjusting for confounding variables. RESULTS Compared to gas stoves for cooking, biomass (OR = 2.66, 95%CI: 1.38-5.13), and electromagnetic stove (OR = 1.90, 95%CI: 1.26-2.88) for cooking were associated with an increased risk of birth defects. The significant associations remained among non-congenital heart disease (CHD) defects but not CHDs. CONCLUSIONS Using biomass or electromagnetic stoves for cooking during pregnancy was associated with an increased risk of birth defects. Additional studies are warranted to confirm these novel findings. Studies with larger sample size or greater statistical power are also warranted to better estimate the associations for individual birth defects.
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Affiliation(s)
- Yaqun Zhang
- Department of Ecology and Environment of Gansu Province, Lanzhou, Gansu, China.
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Min Zhou
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Hongmei Cui
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Ling Lv
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Xiaojuan Lin
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Chong Zhang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Honghong Zhang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Ruifeng Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Bin Yi
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Baohong Mao
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China
| | - Huang Huang
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Lan Jin
- Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Haoran Zhuo
- Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Peiyuan Sun
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, China.
| | - Yawei Zhang
- National Cancer Center, National Clinical Research Center for Cancer, Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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16
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Mullen M, Zhang A, Lui GK, Romfh AW, Rhee JW, Wu JC. Race and Genetics in Congenital Heart Disease: Application of iPSCs, Omics, and Machine Learning Technologies. Front Cardiovasc Med 2021; 8:635280. [PMID: 33681306 PMCID: PMC7925393 DOI: 10.3389/fcvm.2021.635280] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 01/13/2021] [Indexed: 11/13/2022] Open
Abstract
Congenital heart disease (CHD) is a multifaceted cardiovascular anomaly that occurs when there are structural abnormalities in the heart before birth. Although various risk factors are known to influence the development of this disease, a full comprehension of the etiology and treatment for different patient populations remains elusive. For instance, racial minorities are disproportionally affected by this disease and typically have worse prognosis, possibly due to environmental and genetic disparities. Although research into CHD has highlighted a wide range of causal factors, the reasons for these differences seen in different patient populations are not fully known. Cardiovascular disease modeling using induced pluripotent stem cells (iPSCs) is a novel approach for investigating possible genetic variants in CHD that may be race specific, making it a valuable tool to help solve the mystery of higher incidence and mortality rates among minorities. Herein, we first review the prevalence, risk factors, and genetics of CHD and then discuss the use of iPSCs, omics, and machine learning technologies to investigate the etiology of CHD and its connection to racial disparities. We also explore the translational potential of iPSC-based disease modeling combined with genome editing and high throughput drug screening platforms.
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Affiliation(s)
- McKay Mullen
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Physiology, Morehouse School of Medicine, Atlanta, GA, United States
| | - Angela Zhang
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Genetics, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - George K Lui
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Medicine, Division of Cardiovascular Medicine, Stanford University, Stanford, CA, United States.,Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Stanford, CA, United States
| | - Anitra W Romfh
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Genetics, Stanford School of Medicine, Stanford University, Stanford, CA, United States.,Department of Pediatrics, Division of Pediatric Cardiology, Stanford University, Stanford, CA, United States
| | - June-Wha Rhee
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Genetics, Stanford School of Medicine, Stanford University, Stanford, CA, United States
| | - Joseph C Wu
- Stanford Cardiovascular Institute, Stanford University, Stanford, CA, United States.,Department of Genetics, Stanford School of Medicine, Stanford University, Stanford, CA, United States.,Department of Radiology, Stanford University, Stanford, CA, United States
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17
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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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18
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Prenatal exposure to ambient air pollution and adverse pregnancy outcomes in Ahvaz, Iran: a generalized additive model. Int Arch Occup Environ Health 2020; 94:309-324. [PMID: 32936369 DOI: 10.1007/s00420-020-01577-8] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2020] [Accepted: 09/01/2020] [Indexed: 01/15/2023]
Abstract
OBJECTIVE There is some evidence about the short-term effects of air pollutants on adverse pregnancy outcomes. The aim of this study was to determine the association between air pollutants and spontaneous abortion, stillbirth, gestational hypertension, preeclampsia, gestational diabetes and macrosomia in Ahvaz, which is one of the most polluted cities in the Middle East. METHODS Data on adverse pregnancy outcomes and air pollutants including ozone (O3), nitric oxide (NO), nitrogen dioxide (NO2), sulfur dioxide (SO2), carbon monoxide (CO), particles with a diameter of less than 10 µm (PM10) and particles with a diameter less than 2.5 µm (PM2.5) were inquired from the Health Department of Ahvaz Jundishapur University of Medical Sciences and the Environmental Protection Agency of Khuzestan Province for the years 2008-2018. A time series analysis using the generalized additive model (GAM) with up to 6-day lags was used. RESULTS The results showed that the SO2 pollutant on 0, 1, 3, 4, and 6-day lags and PM10 on lag 0 had direct and significant associations with spontaneous abortion. NO, NO2 and CO on 0-6-day lags, and O3 on 6-day lags showed direct and significant associations with preeclampsia. NO and NO2 pollutants showed significant and direct associations with gestational diabetes, during 0- and 6-day lags. NO on 0-, 3- and 4-day lags, CO in all 0-6-day lags and PM2.5 on 1-, 3-, 5-, and 6-day lags showed direct and significant associations with macrosomia. None of the pollutants showed significant associations with stillbirth or gestational hypertension. CONCLUSIONS The results of this study suggest that some air pollutants are associated with spontaneous abortion, preeclampsia, gestational diabetes and macrosomia. This study further emphasizes the need to control ambient air pollution.
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Xia J, Huang YH, Li J, Liu S, Chen YL, Li LL, Jiang CZ, Chen ZJ, Wang Y, Liu XM, Wang XM, Wang J. Maternal exposure to ambient particulate matter 10 μm or less in diameter before and after pregnancy, and anencephaly risk: A population-based case-control study in China. ENVIRONMENTAL RESEARCH 2020; 188:109757. [PMID: 32535358 DOI: 10.1016/j.envres.2020.109757] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND There is no epidemiological evidence on the effects of maternal exposure to ambient particulate matter 10 μm or less in diameter (PM10) and anencephaly risk in offspring. METHODS We conducted a population-based case-control study in Liaoning Province, China. The case group consisted of 663 cases with anencephaly and the control group consisted of 7950 healthy infants from the Maternal and Child Health Certificate Registry of Liaoning Province that were born between 2010 and 2015. Daily PM10 concentrations were obtained from 77 monitoring stations located within the study area. A multivariable logistic regression model was established to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS Maternal PM10 exposure was significantly associated with an increased risk of anencephaly at three months before conception (highest versus lowest tertile: OR = 1.74, 95% CI: 1.29-2.34; per 10 μg/m3 increment: OR = 1.13, 95% CI: 1.06-1.20) and three months after conception (highest versus lowest tertile: OR = 1.93, 95% CI: 1.44-2.60; per 10 μg/m3 increment: OR = 1.01, 95% CI: 0.95-1.08). The evaluation of shorter exposure windows revealed similar associations for PM10 exposure from the third month before pregnancy to the third month after pregnancy. CONCLUSIONS Maternal PM10 exposure is positively associated with anencephaly risk during the critical period of neural system development.
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Affiliation(s)
- Jing Xia
- Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
| | - Yan-Hong Huang
- Department of Ophthalmology, Shenyang Women's and Children's Hospital, Shenyang, China.
| | - Jing Li
- Department of Science and Education, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Shu Liu
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, China
| | - Yan-Ling Chen
- Liaoning Women and Children's Health Hospital, Shenyang, China
| | - Li-Li Li
- Department of Children's Health Prevention, Shenyang Maternity and Child Health Hospital, Shenyang, China
| | - Cheng-Zhi Jiang
- School of Environmental and Chemical Engineering, Shenyang Ligong University, Shenyang, China
| | - Zong-Jiao Chen
- Department of Atmospheric Environment Monitoring, Liaoning Eco-environmental Monitoring Center, China
| | - Ying Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xue-Min Liu
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Xiao-Ming Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
| | - Jun Wang
- Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China.
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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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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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Huang CC, Pan SC, Chen BY, Guo YL. Periconceptional exposure to air pollution and congenital hypospadias among full-term infants. ENVIRONMENTAL RESEARCH 2020; 183:109151. [PMID: 32000002 DOI: 10.1016/j.envres.2020.109151] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 01/09/2020] [Accepted: 01/16/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND Evidence regarding whether prenatal exposure to air pollution increases the risk of hypospadias remains limited. The aim of the study is to evaluate the association between exposure to ambient air pollution during early pregnancy and the incidence of hypospadias. METHODS We conducted a 1:10 case-control study using the Taiwanese Birth Registry database. Male full-term infants reported to have hypospadias were defined as cases, and controls were randomly selected from male full-term infants without any congenital anomaly. The monthly average of ambient air pollutants, including PM10, PM2.5, PM2.5-10, NO2, NOx, O3, and O3 8-h maximum, from 3 months before conception to 6 months post conception was retrieved from air quality monitoring stations and interpolated to the level of township using the kriging method. Multivariable logistic regression models were utilized to evaluate the associations. RESULTS A total of 200 hypospadias cases, with 2000 healthy controls sampled, were reported during 2007-2014. The results revealed that PM2.5 exposure during the first 3 months after conception (odds ratio [OR] = 1.29, 95% confidence interval [CI]: 1.01-1.65, per interquartile range [IQR] = 15.6 μg/m3) and O3 exposure during the first month after conception (OR = 1.40, 95% CI: 1.08-1.82, per IQR = 8.0 ppb) were associated with a higher incidence of hypospadias. CONCLUSIONS The results of the study suggest that early gestational exposure to ambient air pollution increases the risk of hypospadias among full-term infants.
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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
| | - Shih-Chun Pan
- Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Bing-Yu Chen
- Department of Medical Research and Development, Chang Gung Memorial Hospital, Keelung, Taiwan
| | - Yue Leon Guo
- Department of Environmental and Occupational Medicine, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan; Institute of Environmental and Occupational Health Sciences, College of Public Health, National Taiwan University, Taipei, Taiwan; National Institute of Environmental Health Sciences, National Health Research Institutes, Miaoli, Taiwan.
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Association between maternal exposure to ambient PM 10 and neural tube defects: A case-control study in Liaoning Province, China. Int J Hyg Environ Health 2020; 225:113453. [PMID: 31986338 DOI: 10.1016/j.ijheh.2020.113453] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 01/01/2020] [Accepted: 01/14/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND The potential association between maternal exposure to ambient PM10 and offspring neural tube defects (NTDs) is a contentious issue. This study aims to evaluate the aforementioned association at a provincial level in China. METHODS A total of 2736 cases and 7950 randomly selected healthy infants included in the Maternal and Child Health Certificate Registry of Liaoning Province and delivered between 2010 and 2015 were recruited. Daily PM10 concentrations were obtained from all available monitoring stations located within the study area. A multivariable logistic regression model was established to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). RESULTS PM10 exposure was significantly associated with the risk of NTDs during the three months preconception (per 10 μg/m3 increment: OR = 1.10, 95% CI 1.07-1.14; per standard deviation [27 μg/m3] increment: OR = 1.29, 95% CI 1.18-1.41; highest tertile: OR = 1.61, 95% CI 1.37-1.91) and the first trimester (highest tertile: OR = 1.57, 95% CI: 1.31-1.87). When focusing on shorter exposure windows, similar associations were observed for PM10 exposure from the third month before pregnancy to the third month after pregnancy. Sensitivity analyses using propensity score matching yielded consistent findings. CONCLUSIONS Maternal exposure to PM10 is positively associated with NTDs during the critical period of fetal neural tube development. However, due to the limitation of the exposure assessment as well as potential residual confounding, further research is warranted to confirm our findings.
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Parkes B, Hansell AL, Ghosh RE, Douglas P, Fecht D, Wellesley D, Kurinczuk JJ, Rankin J, de Hoogh K, Fuller GW, Elliott P, Toledano MB. Risk of congenital anomalies near municipal waste incinerators in England and Scotland: Retrospective population-based cohort study. ENVIRONMENT INTERNATIONAL 2020; 134:104845. [PMID: 31230843 DOI: 10.1016/j.envint.2019.05.039] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/13/2019] [Accepted: 05/14/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Few studies have investigated congenital anomalies in relation to municipal waste incinerators (MWIs) and results are inconclusive. OBJECTIVES To conduct a national investigation into the risk of congenital anomalies in babies born to mothers living within 10 km of an MWI associated with: i) modelled concentrations of PM10 as a proxy for MWI emissions more generally and; ii) proximity of residential postcode to nearest MWI, in areas in England and Scotland that are covered by a congenital anomaly register. METHODS Retrospective population-based cohort study within 10 km of 10 MWIs in England and Scotland operating between 2003 and 2010. Exposure was proximity to MWI and log of daily mean modelled ground-level particulate matter ≤10 μm diameter (PM10) concentrations. RESULTS Analysis included 219,486 births, stillbirths and terminations of pregnancy for fetal anomaly of which 5154 were cases of congenital anomalies. Fully adjusted odds ratio (OR) per doubling in PM10 was: 1·00 (95% CI 0·98-1·02) for all congenital anomalies; 0·99 (0·97-1·01) for all congenital anomalies excluding chromosomal anomalies. For every 1 km closer to an MWI adjusted OR was: 1·02 (1·00-1·04) for all congenital anomalies combined; 1·02 (1·00-1·04) for all congenital anomalies excluding chromosomal anomalies; and, for specific anomaly groups, 1·04 (1·01-1·08) for congenital heart defect sand 1·07 (1·02-1·12) for genital anomalies. DISCUSSION We found no increased risk of congenital anomalies in relation to modelled PM10 emissions, but there were small excess risks associated with congenital heart defects and genital anomalies in proximity to MWIs. These latter findings may well reflect incomplete control for confounding, but a possible causal effect cannot be excluded.
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Affiliation(s)
- Brandon Parkes
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Anna L Hansell
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London W2 1NY, UK; Centre for Environmental Health and Sustainability, University of Leicester, Leicester LE1 7RH, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
| | - Rebecca E Ghosh
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK
| | - Philippa Douglas
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK; Population Health and Occupational Disease, National Heart and Lung Institute, Imperial College London, SW3 6LR, UK
| | - Daniela Fecht
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK
| | - Diana Wellesley
- University Hospital Southampton, Faculty of Medicine and Wessex Clinical Genetics Service, Southampton, UK
| | - Jennifer J Kurinczuk
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Headington, Oxford, UK
| | - Judith Rankin
- Institute of Health & Society, Newcastle University, Newcastle upon Tyne, UK
| | - Kees de Hoogh
- Swiss Tropical and Public Health Institute, Basel, Switzerland; University of Basel, Basel, Switzerland
| | - Gary W Fuller
- MRC-PHE Centre for Environment and Health, Environmental Research Group, School of Population Health and Environment Sciences, King's College London, London, SE1 9NH, UK
| | - Paul Elliott
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; Directorate of Public Health and Primary Care, Imperial College Healthcare NHS Trust, London W2 1NY, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
| | - Mireille B Toledano
- UK Small Area Health Statistics Unit, MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, W2 1PG, UK; National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Health Impact of Environmental Hazards, Department of Epidemiology and Biostatistics, Imperial College London, London W2 1PG, UK; MRC-PHE Centre for Environment and Health, Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, St Mary's Campus, Norfolk Place, London W2 1PG, UK.
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Chen T, Jin H, Wang H, Yao Y, Aniagu S, Tong J, Jiang Y. Aryl hydrocarbon receptor mediates the cardiac developmental toxicity of EOM from PM 2.5 in P19 embryonic carcinoma cells. CHEMOSPHERE 2019; 216:372-378. [PMID: 30384306 DOI: 10.1016/j.chemosphere.2018.10.160] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 10/17/2018] [Accepted: 10/22/2018] [Indexed: 06/08/2023]
Abstract
Ambient fine particulate matter (PM2.5) has been found to be associated with congenital heart defects, but the molecular mechanisms remain to be elucidated. Our previous study revealed that extractable organic matter (EOM) from PM2.5 exerted cardiac developmental toxicity in zebrafish embryos. The aim of the current study is to explore the effects of EOM on cardiac differentiation of P19 mouse embryonic carcinoma stem cells. We found that EOM at 10 μg/ml (a non-cytotoxic dose level) significantly reduced the proportion of cardiac muscle troponin (cTnT) positive cells and the percentage of spontaneously beating embryoid bodies, indicating a severe inhibition of cardiac differentiation. Immunofluorescence and qPCR data demonstrated that EOM increased the expression levels of the aryl hydrocarbon receptor (AhR) and its target gene Cyp1A1 and diminished the expression level of β-catenin. Furthermore, EOM treatment significantly upregulated cell proliferation rate and elevated the percentage of γH2A.X positive cells without affecting apoptosis. It is worth noting that the EOM-induced changes in gene expression, cellular proliferation and DNA double strain breaks were attenuated by the AhR antagonist CH223191. In conclusion, our data indicate that AhR mediates the inhibitory effects of EOM (from PM2.5) on the cardiac differentiation of P19 cells.
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Affiliation(s)
- Tao Chen
- Medical College of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Hongmei Jin
- Medical College of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Huimin Wang
- Medical College of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Yugang Yao
- Suzhou Environmental Monitor Center, Key Laboratory of Atmospheric Combined Pollution Monitoring, Environmental Protection Department of Jiangsu Province, Suzhou, China
| | - Stanley Aniagu
- Toxicology Division, Texas Commission on Environmental Quality, Austin, TX, USA
| | - Jian Tong
- Medical College of Soochow University, Suzhou, China; Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Soochow University, Suzhou, China
| | - Yan Jiang
- Medical College of Soochow University, Suzhou, China.
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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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Liu C, Li Q, Yan L, Wang H, Yu J, Tang J, Yao H, Li S, Zhang Y, Guo Y. The association between maternal exposure to ambient particulate matter of 2.5 μm or less during pregnancy and fetal congenital anomalies in Yinchuan, China: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2019; 122:316-321. [PMID: 30455103 DOI: 10.1016/j.envint.2018.11.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/15/2018] [Revised: 10/26/2018] [Accepted: 11/12/2018] [Indexed: 05/28/2023]
Abstract
BACKGROUND Few studies from western countries have linked prenatal exposure to ambient particulate matter <2.5 μm (PM2.5) with increased risk of congenital anomalies. However, the results are mixed. Particularly, evidence is limited for Chinese pregnant women. METHODS In this retrospective cohort study, we matched the data of all pregnant women laboured in public hospitals during 2015-2016 in Yinchuan, a capital city of northwest China and the data of daily average PM2.5, nitrogen dioxide (NO2), sulphur dioxide (SO2) and ozone (O3) concentrations of the nearest monitor station. We calculated a time-dependent exposure over the entire pregnancy for each woman. We used a time varying Cox proportional hazards model to explore the association between PM2.5 exposure and the risk of congenital anomalies, after adjusting for individual confounders and other pollutants. RESULTS A total of 39,386 singleton live births were included in the study, and 530 (1.35%) were with congenital anomalies. An increase of 10 μg/m3 in PM2.5 exposure over the entire pregnancy was significantly associated with increased risk of congenital anomalies, with hazard ratio (HR) of 1.35 [95% confidence interval (95%CI): 1.16, 1.58]. For subtype analyses, PM2.5 exposure exhibited a significant association with cardiac anomalies and other unclassifiable anomalies, with HRs of 1.60 (95%CI: 1.24, 2.08) and 1.42 (95%CI: 1.07, 1.89), respectively. The impacts of PM2.5 exposure on orofacial anomalies and musculoskeletal anomalies were not significant. CONCLUSION Our results indicate high concentration of PM2.5 could increase the risk of congenital anomalies among Chinese, especially for cardiac anomalies. Self-protective measures involving reducing PM2.5 pollution exposure during pregnancy as well as environmental policies aiming to restrict PM2.5 emission could be helpful to reduce the burden of cognitional anomalies.
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Affiliation(s)
- Can Liu
- Department of Scientific Research, Peking University Third Hospital, Beijing, China
| | - Qin Li
- Department of Maternal and Child Health, School of Public Health, Peking University, Beijing, China; Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lailai Yan
- Department of Laboratorial Science and Technology, School of Public Health, Peking University, Beijing, China
| | - Huijun Wang
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, Ningxia, China
| | - Jing Yu
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, Ningxia, China
| | - Juxiang Tang
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, Ningxia, China
| | - Haiyan Yao
- Yinchuan Maternal and Child Health Care Hospital, Yinchuan, Ningxia, China
| | - Shanshan Li
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
| | - Yajuan Zhang
- Key Laboratory of Fertility Preservation and Maintenance of Ministry of Education, Key Laboratory of Reproduction and Genetics in Ningxia, School of Public Health and Management, Ningxia Medical University, Yinchuan, Ningxia, China.
| | - Yuming Guo
- Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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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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Ren Z, Zhu J, Gao Y, Yin Q, Hu M, Dai L, Deng C, Yi L, Deng K, Wang Y, Li X, Wang J. Maternal exposure to ambient PM 10 during pregnancy increases the risk of congenital heart defects: Evidence from machine learning models. THE SCIENCE OF THE TOTAL ENVIRONMENT 2018; 630:1-10. [PMID: 29471186 DOI: 10.1016/j.scitotenv.2018.02.181] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Revised: 02/08/2018] [Accepted: 02/15/2018] [Indexed: 05/21/2023]
Abstract
Previous research suggested an association between maternal exposure to ambient air pollutants and risk of congenital heart defects (CHDs), though the effects of particulate matter ≤10μm in aerodynamic diameter (PM10) on CHDs are inconsistent. We used two machine learning models (i.e., random forest (RF) and gradient boosting (GB)) to investigate the non-linear effects of PM10 exposure during the critical time window, weeks 3-8 in pregnancy, on risk of CHDs. From 2009 through 2012, we carried out a population-based birth cohort study on 39,053 live-born infants in Beijing. RF and GB models were used to calculate odds ratios for CHDs associated with increase in PM10 exposure, adjusting for maternal and perinatal characteristics. Maternal exposure to PM10 was identified as the primary risk factor for CHDs in all machine learning models. We observed a clear non-linear effect of maternal exposure to PM10 on CHDs risk. Compared to 40μgm-3, the following odds ratios resulted: 1) 92μgm-3 [RF: 1.16 (95% CI: 1.06, 1.28); GB: 1.26 (95% CI: 1.17, 1.35)]; 2) 111μgm-3 [RF: 1.04 (95% CI: 0.96, 1.14); GB: 1.04 (95% CI: 0.99, 1.08)]; 3) 124μgm-3 [RF: 1.01 (95% CI: 0.94, 1.10); GB: 0.98 (95% CI: 0.93, 1.02)]; 4) 190μgm-3 [RF: 1.29 (95% CI: 1.14, 1.44); GB: 1.71 (95% CI: 1.04, 2.17)]. Overall, both machine models showed an association between maternal exposure to ambient PM10 and CHDs in Beijing, highlighting the need for non-linear methods to investigate dose-response relationships.
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Affiliation(s)
- Zhoupeng Ren
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
| | - Jun Zhu
- National Office of Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China; National Center for Birth Defect Monitoring of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yanfang Gao
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
| | - Qian Yin
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
| | - Maogui Hu
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China
| | - Li Dai
- National Office of Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Changfei Deng
- National Office of Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Lin Yi
- National Center for Birth Defect Monitoring of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Kui Deng
- National Center for Birth Defect Monitoring of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Yanping Wang
- National Office of Maternal and Child Health Surveillance of China, Department of Obstetrics, West China Second University Hospital, Sichuan University, Chengdu, China
| | - Xiaohong Li
- National Center for Birth Defect Monitoring of China, Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, China; Key Laboratory of Birth Defects and Related Diseases of Women and Children, Sichuan University, Ministry of Education, China.
| | - Jinfeng Wang
- State Key Laboratory of Resources and Environmental Information System (LREIS), Institute of Geographic Science and Natural Resource Research, Chinese Academy of Sciences, Beijing, China; University of Chinese Academy of Sciences, Beijing, China.
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30
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Zhao J, Zhang B, Yang S, Mei H, Qian Z, Liang S, Zhang Y, Hu K, Tan Y, Xian H, Belue R, Jordan SS, Xu S, Zheng T, Du Y. Maternal exposure to ambient air pollutant and risk of oral clefts in Wuhan, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2018; 238:624-630. [PMID: 29614471 DOI: 10.1016/j.envpol.2018.03.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2017] [Revised: 02/26/2018] [Accepted: 03/15/2018] [Indexed: 06/08/2023]
Abstract
Maternal exposure to ambient air pollution has been related to oral clefts in offspring; however, the epidemiologic evidence is equivocal. Especially, the association between high levels of exposure to ambient air pollution during pregnancy and oral clefts remains unclear. The objective of this study was to evaluate whether high levels of maternal exposure to PM2.5, PM10, O3, CO and SO2 are related to increased risk of oral clefts in Wuhan, China. A population-based study was conducted using cohort of 105,927 live-born infants, fetal deaths, and stillbirths during a two-year period from 2011 to 2013. For each participant, weekly and monthly averages of daily mean concentrations for each pollutant were estimated. Multiple logistic regression analyses were constructed to quantify the adjusted odds ratios (aORs) for the relationship between each air pollutant and oral clefts while controlling for key covariates. Using monthly averages, a cleft lip with or without cleft palate (CLP) was associated with PM2.5 (aORs 2nd month = 1.34, CI:1.19-1.49; aORs 3rd month=1.14, CI:1.02-1.28), PM10 (aORs 2nd month = 1.11, CI:1.00-1.23) and CO (aORs 2nd month = 1.31, CI:1.14-1.51; aORs 3rd month = 1.17, CI:1.03-1.33). A cleft palate only (CPO) was associated with PM2.5 (aORs 2nd month = 1.24, CI: 1.03-1.48), and O3 (aORs 2nd month = 1.21, CI: 1.03-1.42; aORs 3rd month = 1.18, CI: 1.02-1.37). Our findings reveal an association between air pollutants exposure and the risk of oral clefts. Future studies are needed to confirm these associations, and clarify the causality related to specific pollutants during the most relevant vulnerable exposure time windows for oral clefts during pregnancy.
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Affiliation(s)
- Jinzhu Zhao
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China; Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Bin Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Shaoping Yang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Hui Mei
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Zhengmin Qian
- Department of Epidemiology & Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Shengwen Liang
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Yiming Zhang
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province, 430000, China
| | - Yafei Tan
- Wuhan Children's Hospital (Wuhan Maternal and Child Healthcare Hospital), Tongji Medical College, Huazhong University of Science & Technology, Wuhan, Hubei Province, 430030, China
| | - Hong Xian
- Department of Epidemiology & Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Rhonda Belue
- Department of Health Management and Policy, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Savannah S Jordan
- Department of Epidemiology & Biostatistics, College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education & Ministry of Environmental Protection, State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.
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31
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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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32
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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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33
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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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34
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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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35
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Pedersen M, Garne E, Hansen-Nord N, Hjortebjerg D, Ketzel M, Raaschou-Nielsen O, Nybo Andersen AM, Sørensen M. Exposure to air pollution and noise from road traffic and risk of congenital anomalies in the Danish National Birth Cohort. ENVIRONMENTAL RESEARCH 2017; 159:39-45. [PMID: 28763732 DOI: 10.1016/j.envres.2017.07.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Revised: 07/11/2017] [Accepted: 07/15/2017] [Indexed: 06/07/2023]
Abstract
BACKGROUND Ambient air pollution has been associated with certain congenital anomalies, but few studies rely on assessment of fine-scale variation in air quality and associations with noise from road traffic are unexplored. METHODS Among 84,218 liveborn singletons (1997-2002) from the Danish National Birth Cohort with complete covariate data and residential address history from conception until birth, we identified major congenital anomalies in 4018 children. Nitrogen dioxide (NO2) and noise from road traffic (Lden) burden during fetal life was modeled. Outcome and covariate data were derived from registries, hospital records and questionnaires. Odds ratios (ORs) for eleven major anomaly groups associated with road traffic pollution during first trimester were estimated using logistic regression with generalized estimating equation (GEE) approach. RESULTS Most of the associations tested did not suggest increased risks. A 10-µg/m3 increase in NO2 exposure during first trimester was associated with an adjusted ORs of 1.22 (95% confidence interval: 0.98-1.52) for ear, face and neck anomalies; 1.14 0.98-1.33) for urinary anomalies. A 10-dB increase in road traffic noise was also associated with these subgroups of anomalies as well as with an increased OR for orofacial cleft anomalies (1.17, 0.94-1.47). Inverse associations for several both air pollution and noise were observed for atrial septal defects (0.85, 0.68-1.04 and 0.81, 0.65-0.99, respectively). CONCLUSIONS Residential road traffic exposure to noise or air pollution during pregnancy did not seem to pose a risk for development of congenital anomalies.
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Affiliation(s)
- Marie Pedersen
- Centre for Epidemiology and Screening, Department of Public Health, University of Copenhagen, Øster Farimagsgade 5A, 1014 Copenhagen K, Denmark; Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Ester Garne
- Pediatric Department, Hospital Lillebaelt, Skovvangen 2-8, 6000 Kolding, Denmark.
| | - Nete Hansen-Nord
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Dorrit Hjortebjerg
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
| | - Matthias Ketzel
- Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
| | - Ole Raaschou-Nielsen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark; Department of Environmental Science, Aarhus University, Frederiksborgvej 399, 4000 Roskilde, Denmark.
| | - Anne-Marie Nybo Andersen
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Gothersgade 160, 1123 Copenhagen K, Denmark.
| | - Mette Sørensen
- Danish Cancer Society Research Center, Strandboulevarden 49, 2100 Copenhagen Ø, Denmark.
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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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Jacobs M, Zhang G, Chen S, Mullins B, Bell M, Jin L, Guo Y, Huxley R, Pereira G. The association between ambient air pollution and selected adverse pregnancy outcomes in China: A systematic review. THE SCIENCE OF THE TOTAL ENVIRONMENT 2017; 579:1179-1192. [PMID: 27913015 PMCID: PMC5252829 DOI: 10.1016/j.scitotenv.2016.11.100] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 10/31/2016] [Accepted: 11/16/2016] [Indexed: 05/05/2023]
Abstract
The association between exposure to ambient air pollution and respiratory or cardiovascular endpoints is well-established. An increasing number of studies have shown that this exposure is also associated with adverse pregnancy outcomes. However, the majority of research has been undertaken in high-income western countries, with relatively lower levels of exposure. There is now a sufficient number of studies to warrant an assessment of effects in China, a relatively higher exposure setting. We conducted a systematic review of 25 studies examining the association between ambient air pollution exposure and adverse pregnancy outcomes (lower birth weight, preterm birth, mortality, and congenital anomaly) in China, published between 1980 and 2015. The results indicated that sulphur dioxide (SO2) was more consistently associated with lower birth weight and preterm birth, and that coarse particulate matter (PM10) was associated with congenital anomaly, notably cardiovascular defects.
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Affiliation(s)
- Milena Jacobs
- School of Public Health, Curtin University, WA, Australia.
| | - Guicheng Zhang
- School of Public Health, Curtin University, WA, Australia
| | - Shu Chen
- School of Public Health, Curtin University, WA, Australia
| | - Ben Mullins
- School of Public Health, Curtin University, WA, Australia
| | - Michelle Bell
- School of Forestry and Environmental Studies, Yale University, CT, USA
| | - Lan Jin
- School of Forestry and Environmental Studies, Yale University, CT, USA
| | - Yuming Guo
- School of Population Health, University of Queensland, QLD, Australia
| | - Rachel Huxley
- School of Public Health, Curtin University, WA, Australia
| | - Gavin Pereira
- School of Public Health, Curtin University, WA, Australia
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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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Zhang B, Zhao J, Yang R, Qian Z, Liang S, Bassig BA, Zhang Y, Hu K, Xu S, Dong G, Zheng T, Yang S. Ozone and Other Air Pollutants and the Risk of Congenital Heart Defects. Sci Rep 2016; 6:34852. [PMID: 27752048 PMCID: PMC5067649 DOI: 10.1038/srep34852] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 09/21/2016] [Indexed: 11/09/2022] Open
Abstract
The objective of this study was to evaluate whether high levels of maternal exposure to O3, SO2, NO2, CO are related to increased risk of congenital heart defects (CHDs) in Wuhan, China. The study included mothers living in the central districts of Wuhan during pregnancy over the two-year period from June 10, 2011 to June 9, 2013. For each study participant, we assigned 1-month averages of O3, SO2, NO2 and CO exposure based on measurements obtained from the nearest exposure monitor to the living residence of mothers during their early pregnancy period. In one-pollutant model, we observed an increased risk of CHDs, ventricular septal defect (VSD), and tetralogy of fallot (TF) with increasing O3 exposure. In two-pollutant model, associations with all CHDs, VSD, and TF for O3 were generally consistent compared to the models that included only O3, with the strongest aORs observed for exposures during the third month of pregnancy. We also observed a positive association between CO exposures during the third month of pregnancy and VSD in two pollution model.Our results contribute to the small body of evidence regarding air pollution exposure and CHDs, but confirmation of these associations will be needed in future studies.
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Affiliation(s)
- Bin Zhang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Jinzhu Zhao
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Rong Yang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Zhengmin Qian
- College for Public Health and Social Justice, Saint Louis University, Saint Louis, MO, USA
| | - Shengwen Liang
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province 430000, China
| | - Bryan A Bassig
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT 06510, USA
| | - Yiming Zhang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
| | - Ke Hu
- Wuhan Environmental Monitoring Center, Wuhan, Hubei Province 430000, China
| | - Shunqing Xu
- Key Laboratory of Environment and Health, Ministry of Education &Ministry of Environmental Protection, and State Key Laboratory of Environmental Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Guanghui Dong
- Department of Environmental Health, School of Public Health, Sun Yat-Sen University, Guangzhou 510080, China
| | - Tongzhang Zheng
- Department of Epidemiology, School of Public Health, Brown University, Providence, RI, USA
| | - Shaoping Yang
- Wuhan Medical &Healthcare Center for Women and Children, Wuhan, Hubei Province 430030, China
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Teng C, Wang Z, Yan B. Fine particle-induced birth defects: Impacts of size, payload, and beyond. ACTA ACUST UNITED AC 2016; 108:196-206. [PMID: 27581067 DOI: 10.1002/bdrc.21136] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2016] [Accepted: 08/16/2016] [Indexed: 11/09/2022]
Abstract
Worldwide epidemiological studies have shown that exposures to particulate matters (PMs), such as PM2.5 or PM10 , during pregnancy cause birth defects in the newborn. Although mechanistic understanding of such effects are not available, recent research using murine models highlights some key progress: (1) toxicity caused by PMs is a combined effects of particles and the adsorbed toxic pollutants, such as heavy metals, persistent organic pollutants, bacteria, and virus. Fine particles may hold on to pollutants and, therefore, reduce their toxicity or enhance the toxicity by carrying pollutants crossing the placental barrier; (2) smaller size, certain particle surface chemistry modifications, early developmental stage of placenta, and maternal diseases all aggravate PM-induced birth defects; (3) molecular events involved in such toxicity are begin to emerge: induction of oxidative stress, DNA damage, and alteration of molecular signaling or epigenetic events are some possible causes. Despite this progress, a clear understanding of PM-induced birth defects awaits further breakthroughs on many fronts, including epidemiological studies, animal models, nanotoxicity, and molecular mechanism investigations. Birth Defects Research (Part C) 108:196-206, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Chuanfeng Teng
- Chuanfeng Teng and Bing Yan are from the School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, China
| | - Zhiping Wang
- Chuanfeng Teng and Bing Yan are from the School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, China.,Zhiping Wang is from the School of Public Health, Shandong University, Jinan, 250100, China
| | - Bing Yan
- Chuanfeng Teng and Bing Yan are from the School of Chemistry and Chemical Engineering, Shandong University, Jinan, 250100, China.
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Liu Y, Wang B, Li Z, Zhang L, Liu J, Ren A. Indoor air pollution and the risk of orofacial clefts in a rural population in Shanxi province, China. ACTA ACUST UNITED AC 2016; 106:708-15. [PMID: 27227359 DOI: 10.1002/bdra.23522] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Revised: 04/19/2016] [Accepted: 04/19/2016] [Indexed: 11/08/2022]
Abstract
BACKGROUND Shanxi Province is a region in China with a high incidence of orofacial clefts (OFCs). Our objective is to investigate the effect of maternal exposure to indoor air pollution (IAP) from coal combustion and tobacco smoke on the risk of an infant being born with orofacial clefts. METHODS Data were derived from an ongoing population-based case-control study of major external structural birth defects in Shanxi Province. Subjects included 213 cases with OFCs and 1319 healthy babies born between November 2002 and December 2014 in four rural counties. Exposure information was collected by face-to-face interview with mothers within 1 week of delivery or pregnancy termination. The authors derived an exposure index by integrating a series of IAP-related characteristics concerning dwelling and lifestyle. RESULTS Increased odds of OFC were associated with IAP exposure from heating (adjusted odds ratio [aOR] = 2.4; 95% confidence interval [CI], 1.2-4.5) and from smoking (aOR = 1.8; 95% CI: 1.3, 2.5), but not with exposure from cooking (aOR = 0.9; 95% CI, 0.6-1.4). Compared with women without IAP exposure, the aORs of OFC for children of women with exposure indices of 1, 2, 3 and ≥ 4 were 1.1 (95% CI, 0.6-1.8), 1.4 (95% CI, 0.8-2.4), 1.8 (95% CI, 1.0-3.2), and 3.4 (95% CI, 1.6-7.4), respectively, demonstrating a clear dose-response trend (p < 0.001). CONCLUSION Periconceptional exposure to IAP from coal combustion and tobacco smoking may increase the risk of OFCs in offsprings of women in Shanxi Province. Birth Defects Research (Part A) 106:708-715, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Yingying Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
| | - Bin Wang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
| | - Zhiwen Li
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
| | - Le Zhang
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
| | - Jufen Liu
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
| | - Aiguo Ren
- Institute of Reproductive and Child Health/Ministry of Health Key Laboratory of Reproductive Health, Peking University, China.,Department of Epidemiology and Biostatistics, School of Public Health, Peking University, China
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Tanner JP, Salemi JL, Stuart AL, Yu H, Jordan MM, DuClos C, Cavicchia P, Correia JA, Watkins SM, Kirby RS. Uncertainty in maternal exposures to ambient PM2.5 and benzene during pregnancy: Sensitivity to exposure estimation decisions. Spat Spatiotemporal Epidemiol 2016; 17:117-29. [PMID: 27246278 DOI: 10.1016/j.sste.2016.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 04/12/2016] [Accepted: 04/27/2016] [Indexed: 01/17/2023]
Abstract
We investigate uncertainty in estimates of pregnant women's exposure to ambient PM2.5 and benzene derived from central-site monitoring data. Through a study of live births in Florida during 2000-2009, we discuss the selection of spatial and temporal scales of analysis, limiting distances, and aggregation method. We estimate exposure concentrations and classify exposure for a range of alternatives, and compare impacts. Estimated exposure concentrations were most sensitive to the temporal scale of analysis for PM2.5, with similar sensitivity to spatial scale for benzene. Using 1-12 versus 3-8 weeks of gestational age as the exposure window resulted in reclassification of exposure by at least one quartile for up to 37% of mothers for PM2.5 and 27% for benzene. The largest mean absolute differences in concentration resulting from any decision were 0.78 µg/m(3) and 0.44 ppbC, respectively. No bias toward systematically higher or lower estimates was found between choices for any decision.
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Affiliation(s)
- Jean Paul Tanner
- Birth Defects Surveillance Program, Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
| | - Jason L Salemi
- Birth Defects Surveillance Program, Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA; Department of Family and Community Medicine, Baylor College of Medicine, 3701 Kirby Dr. Suite 600, Houston, TX 77098, USA.
| | - Amy L Stuart
- Department of Environmental and Occupational Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA; Department of Civil and Environmental Engineering, University of South Florida, 4202 E. Fowler Avenue, Tampa, FL 33620, USA.
| | - Haofei Yu
- Department of Environmental and Occupational Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
| | - Melissa M Jordan
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA.
| | - Chris DuClos
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA.
| | - Philip Cavicchia
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA.
| | - Jane A Correia
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA.
| | - Sharon M Watkins
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, 4052 Bald Cypress Way, Tallahassee, FL 32399 USA.
| | - Russell S Kirby
- Birth Defects Surveillance Program, Department of Community and Family Health, University of South Florida, 13201 Bruce B. Downs Blvd. MDC 56, Tampa, FL 33612, USA.
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Rao A, Ahmed MK, Taub PJ, Mamoun JS. The Correlation between Maternal Exposure to Air Pollution and the Risk of Orofacial Clefts in Infants: a Systematic Review and Meta-Analysis. EJOURNAL OF ORAL MAXILLOFACIAL RESEARCH 2016; 7:e2. [PMID: 27099696 PMCID: PMC4837606 DOI: 10.5037/jomr.2016.7102] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2016] [Accepted: 02/26/2016] [Indexed: 01/06/2023]
Abstract
OBJECTIVES The authors performed a systematic review and meta-analysis to investigate the possible correlation between ambient air pollution and orofacial cleft anomalies in newborns. MATERIAL AND METHODS A literature search was performed using the PubMed and Google Scholar, using the keywords "air pollution", "cleft lip", "cleft palate", "carbon monoxide", "ozone", "sulfur dioxide", "nitrogen oxide", "nitrogen dioxide", and "aerodynamic diameter". Eight epidemiologic articles met the criteria of correlating either carbon monoxide (CO), ozone (O3), nitrogen oxides (NOx), airborne particulate matter of less than 10 µm in diameter (PM10), or sulfur dioxide (SO2) exposures with clefting of the palate alone, clefting of the lip alone, or clefting of the lip and palate. Odds ratios were extracted from the eight studies and tabulated in this meta-analysis. Quality analysis showed six high quality, one medium quality, and one low quality study. RESULTS Meta-analysis of the combined data confirmed the association of O3 exposure and risk of orofacial cleft anomalies (OR = 1.08; P = 0.02). NOx was consistently associated with decreased risk of cleft lip with or without palate and cleft palate. CONCLUSIONS Ozone showed the strongest correlation with cleft lip and cleft palate anomalies. However, the studies overall showed an inconsistent correlation between orofacial clefts and air pollutants.
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Affiliation(s)
- Ajit Rao
- Department of Vascular Surgery, Mount Sinai Cleft & Craniofacial Center, Icahn School of Medicine at Mount Sinai, New York USA
| | - Mairaj K Ahmed
- Department of Dentistry/Oral and Maxillofacial Surgery, Division of Plastic Surgery, Mount Sinai Cleft & Craniofacial Center, Icahn School of Medicine at Mount Sinai, New York USA
| | - Peter J Taub
- Departments of Dentistry, Pediatrics, Surgery and Medical Education, Mount Sinai Cleft & Craniofacial Center, Icahn School of Medicine at Mount Sinai, New York USA
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Vinceti M, Malagoli C, Malavolti M, Cherubini A, Maffeis G, Rodolfi R, Heck JE, Astolfi G, Calzolari E, Nicolini F. Does maternal exposure to benzene and PM10 during pregnancy increase the risk of congenital anomalies? A population-based case-control study. THE SCIENCE OF THE TOTAL ENVIRONMENT 2016; 541:444-450. [PMID: 26410719 PMCID: PMC4656073 DOI: 10.1016/j.scitotenv.2015.09.051] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Revised: 09/11/2015] [Accepted: 09/11/2015] [Indexed: 05/21/2023]
Abstract
A few studies have suggested an association between maternal exposure to ambient air pollution from vehicular traffic and risk of congenital anomalies in the offspring, but epidemiologic evidence is neither strong nor entirely consistent. In a population-based case-control study in a Northern Italy community encompassing 228 cases of birth defects and 228 referent newborns, we investigated if maternal exposure to PM10 and benzene from vehicular traffic during early pregnancy, as estimated through a dispersion model, was associated with excess teratogenic risk. In conditional logistic regression analysis, and with adjustment for the other pollutant, we found that higher exposure to PM10 but not benzene was associated with increased risk of birth defects overall. Anomaly categories showing the strongest dose-response relation with PM10 exposure were musculoskeletal and chromosomal abnormalities but not cardiovascular defects, with Down syndrome being among the specific abnormalities showing the strongest association, though risk estimates particularly for the less frequent defects were statistically very unstable. Further adjustment in the regression model for potential confounders did not considerably alter the results. All the associations were stronger for average levels of PM10 than for their maximal level. Findings of this study give some support for an excess teratogenic risk following maternal exposure during pregnancy to PM10, but not benzene. Such association appears to be limited to some birth defect categories.
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Affiliation(s)
- Marco Vinceti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Campus San Lazzaro, Padiglione De Sanctis, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy.
| | - Carlotta Malagoli
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Campus San Lazzaro, Padiglione De Sanctis, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy
| | - Marcella Malavolti
- CREAGEN, Environmental, Genetic and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Campus San Lazzaro, Padiglione De Sanctis, Via Giovanni Amendola 2, 42122 Reggio Emilia, Italy
| | - Andrea Cherubini
- TerrAria s.r.l., Via Melchiorre Gioia 132, 20125 Milano Milan, Italy
| | - Giuseppe Maffeis
- TerrAria s.r.l., Via Melchiorre Gioia 132, 20125 Milano Milan, Italy
| | | | - Julia E Heck
- Department of Epidemiology, UCLA Fielding School of Public Health, Box 951772, Los Angeles, CA, United States
| | - Gianni Astolfi
- IMER Registry, Department of Biomedical and Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy
| | - Elisa Calzolari
- IMER Registry, Department of Biomedical and Surgical Sciences, University of Ferrara, Corso Giovecca 203, 44121 Ferrara, Italy
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The impact of environmental factors on the occurrence of congenital heart disease in the form of hypoplastic left heart syndrome. POLISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2015; 12:204-7. [PMID: 26702275 PMCID: PMC4631911 DOI: 10.5114/kitp.2015.54455] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Revised: 08/18/2015] [Accepted: 08/25/2015] [Indexed: 11/30/2022]
Abstract
Introduction Congenital heart defects are the most common abnormalities in neonatal age. Congenital heart defects occur with a frequency of 3-12/1000 births. A special group is constituted by children with hypoplastic left heart syndrome because their treatment is extremely complex, requiring three-stage surgery and the involvement of various specialists. Material and methods We analysed 100 infants with congenital heart defects in the form of hypoplastic left heart syndrome (HLHS). They were compared with a control group of 100 newborns without structural heart defects. The children's parents were asked to fill out a questionnaire consisting of 10 simple questions. It had been constructed in consultation with a psychologist in order not to offend the feelings of the parents affected by the illness of their offspring. Results Congenital heart defects were present in the family medical histories of 16 HLHS children and 11 healthy children (p = 0.4). Genetic disorders were present in the family medical histories of 13 HLHS children and 15 healthy children (p = 0.73). In the HLHS group, the mothers smoked cigarettes or were exposed to tobacco smoke in 32% of cases; in the control group, this proportion amounted to 23% (p = 0.76). Conclusions The study found no relationship between the occurrence of hypoplastic left heart syndrome in children and the parents’ age, the presence of genetic disorders, or heart defects in the family medical histories.
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Abstract
Previous epidemiologic studies have assessed the role of the exposure to ambient air pollution in the development of cardiac birth defects, but they have provided somewhat inconsistent results. To assess the associations between exposure to ambient air pollutants and the risk of cardiac defects, a population-based case-control study was conducted using 1087 cases of cardiac defects and a random sample of 10,870 controls from 1,533,748 Taiwanese newborns in 2001 to 2007.Logistic regression was performed to calculate odds ratios for 10 ppb increases in O3 and 10 μg/m increases in PM10. In addition, we compared the risk of cardiac defects in 4 categories-high exposure (>75th percentile); medium exposure (75th to 50th percentile); low exposure (<50th-25th percentile); reference (<25th percentile) based on the distribution of each pollutant. The risks of ventricular septal defects (VSD), atrial septal defects (ASD), and patent ductus arteriosus (PDA) were associated with 10 ppb increases in O3 exposure during the first 3 gestational months among term and preterm babies. In comparison between high PM10 exposure and reference category, there were statistically significant elevations in the effect estimates of ASD for all and terms births. In addition, there was a negative or weak association between SO2, NO2, CO, and cardiac defects.The study proved that exposure to outdoor air O3 and PM10 during the first trimester of gestation may increase the risk of VSD, ASD, and PDA.
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Affiliation(s)
- Bing-Fang Hwang
- From the Department of Occupational Safety and Health, College of Public Health, China Medical University, Taichung (B-FH); Institute of Epidemiology and Preventive Medicine and Research Center for Genes, Environment and Human Health, College of Public Health, National Taiwan University, Taipei, Taiwan (YLL); and Center for Environmental and Respiratory Health Research, Institute of Health Sciences, University of Oulu, Oulu, Finland (JJKJ)
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47
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Tanner JP, Salemi JL, Stuart AL, Yu H, Jordan MM, DuClos C, Cavicchia P, Correia JA, Watkins SM, Kirby RS. Associations between exposure to ambient benzene and PM(2.5) during pregnancy and the risk of selected birth defects in offspring. ENVIRONMENTAL RESEARCH 2015; 142:345-353. [PMID: 26196779 DOI: 10.1016/j.envres.2015.07.006] [Citation(s) in RCA: 63] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 07/06/2015] [Accepted: 07/07/2015] [Indexed: 05/21/2023]
Abstract
OBJECTIVE A growing number of studies have investigated the association between air pollution and the risk of birth defects, but results are inconsistent. The objective of this study was to examine whether maternal exposure to ambient PM2.5 or benzene increases the risk of selected birth defects in Florida. METHODS We conducted a retrospective cohort study of singleton infants born in Florida from 2000 to 2009. Isolated and non-isolated birth defect cases of critical congenital heart defects, orofacial clefts, and spina bifida were identified from the Florida Birth Defects Registry. Estimates of maternal exposures to PM2.5 and benzene for all case and non-case pregnancies were derived by aggregation of ambient measurement data, obtained from the US Environmental Protection Agency Air Quality System, during etiologically relevant time windows. Multivariable Poisson regression was used to estimate adjusted prevalence ratios (aPRs) and 95% confidence intervals (CIs) for each quartile of air pollutant exposure. RESULTS Compared to the first quartile of PM2.5 exposure, higher levels of exposure were associated with an increased risk of non-isolated truncus arteriosus (aPR4th Quartile, 8.80; 95% CI, 1.11-69.50), total anomalous pulmonary venous return (aPR2nd Quartile, 5.00; 95% CI, 1.10-22.84), coarctation of the aorta (aPR4th Quartile, 1.72; 95% CI, 1.15-2.57; aPR3rd Quartile, 1.60; 95% CI, 1.07-2.41), interrupted aortic arch (aPR4th Quartile, 5.50; 95% CI, 1.22-24.82), and isolated and non-isolated any critical congenital heart defect (aPR3rd Quartile, 1.13; 95% CI, 1.02-1.25; aPR4th Quartile, 1.33; 95% CI, 1.07-1.65). Mothers with the highest level of exposure to benzene were more likely to deliver an infant with an isolated cleft palate (aPR4th Quartile, 1.52; 95% CI, 1.13-2.04) or any orofacial cleft (aPR4th Quartile, 1.29; 95% CI, 1.08-1.56). An inverse association was observed between exposure to benzene and non-isolated pulmonary atresia (aPR4th Quartile, 0.19; 95% CI, 0.04-0.84). CONCLUSION Our results suggest a few associations between exposure to ambient PM2.5 or benzene and specific birth defects in Florida. However, many related comparisons showed no association. Hence, it remains unclear whether associations are clinically significant or can be causally related to air pollution exposures.
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Affiliation(s)
- Jean Paul Tanner
- Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Jason L Salemi
- Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA; Department of Family and Community Medicine, Baylor College of Medicine, Houston, TX, USA.
| | - Amy L Stuart
- Department of Environmental and Occupational Health, College of Public Health, University of South Florida, Tampa, FL, USA; Department of Civil and Environmental Engineering, College of Engineering, University of South Florida, Tampa, FL, USA.
| | - Haofei Yu
- Department of Environmental and Occupational Health, College of Public Health, University of South Florida, Tampa, FL, USA.
| | - Melissa M Jordan
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Chris DuClos
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Philip Cavicchia
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Jane A Correia
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Sharon M Watkins
- Bureau of Epidemiology, Division of Disease Control and Health Protection, Florida Department of Health, Tallahassee, FL, USA.
| | - Russell S Kirby
- Birth Defects Surveillance Program, Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.
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48
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Jin L, Qiu J, Zhang Y, Qiu W, He X, Wang Y, Sun Q, Li M, Zhao N, Cui H, Liu S, Tang Z, Chen Y, Yue L, Da Z, Xu X, Huang H, Liu Q, Bell ML, Zhang Y. Ambient air pollution and congenital heart defects in Lanzhou, China. ENVIRONMENTAL RESEARCH LETTERS : ERL [WEB SITE] 2015; 10:074005. [PMID: 31555342 PMCID: PMC6760856 DOI: 10.1088/1748-9326/10/7/074005] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Congenital heart defects are the most prevalent type of birth defects. The association of air pollution with congenital heart defects is not well understood. We investigated a cohort of 8,969 singleton live births in Lanzhou, China during 2010-2012. Using inverse distance weighting, maternal exposures to particulate matter with diameter ≤10μm (PM10), nitrogen dioxide (NO2), and sulfur dioxide (SO2) were estimated as a combination of monitoring station levels for the time spent at home and the work location. We used logistic regression to estimate the associations, adjusting for maternal age, education, income, BMI, disease, folic acid intake and therapeutic drug use, and smoking; season of conception; fuels for cooking; and temperature. We found significant positive associations of Patent Ductus Arteriosus (PDA) with PM10 during the 1st trimester, 2nd trimester and the entire pregnancy (OR 1st trimester=3.96, 95% Confidence Interval (CI): 1.36, 11.53; OR 2nd trimester=3.59, 95% Confidence Interval (CI): 1.57, 8.22; OR entire pregnancy=2.09, 95% CI: 1.21, 3.62, per interquartile range (IQR) increment for PM10 (IQR=71.2, 61.6, and 27.4 μg/m3 respectively)), and associations with NO2 during 2nd trimester and entire pregnancy (OR 2nd trimester= 1.92, 95% CI: 1.11, 3.34; OR entire pregnancy=2.32, 95% Cl: 1.14, 4.71, per IQR increment for NO2 (IQR=13.4 and 10.9 μg/m3 respectively)). The associations for congenital malformations of the great arteries and pooled cases showed consistent patterns. We also found positive associations for congenital malformations of cardiac septa with PM10 exposures in the 2nd trimester and the entire pregnancy, and SO2 exposures in the entire pregnancy. Results indicate a health burden from maternal exposures to air pollution, with increased risk of congenital heart defects.
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Affiliation(s)
- Lan Jin
- Yale University, School of Forestry and Environmental Studies, New Haven, CT, U.S
| | - Jie Qiu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Yaqun Zhang
- Gansu Provincial Design and Research Institute of Environmental Science, Lanzhou, Gansu, China
| | - Weitao Qiu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Xiaochun He
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Yixuan Wang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Qingmei Sun
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Min Li
- Gansu Provincial Environmental Monitoring Central Station, Lanzhou, Gansu, China
| | - Nan Zhao
- Yale University, School of Public Health, New Haven, CT, U.S
| | - Hongmei Cui
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Sufen Liu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Zhongfeng Tang
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Ya Chen
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Li Yue
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Zhenqiang Da
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Xiaoying Xu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Huang Huang
- Yale University, School of Public Health, New Haven, CT, U.S
| | - Qing Liu
- Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Michelle L. Bell
- Yale University, School of Forestry and Environmental Studies, New Haven, CT, U.S
| | - Yawei Zhang
- Yale University, School of Public Health, New Haven, CT, U.S
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49
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Zhu Y, Zhang C, Liu D, Grantz KL, Wallace M, Mendola P. Maternal ambient air pollution exposure preconception and during early gestation and offspring congenital orofacial defects. ENVIRONMENTAL RESEARCH 2015; 140:714-20. [PMID: 26099933 PMCID: PMC4498658 DOI: 10.1016/j.envres.2015.06.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Revised: 05/08/2015] [Accepted: 06/02/2015] [Indexed: 05/09/2023]
Abstract
BACKGROUND Maternal air pollution exposure has been related to orofacial clefts but the literature is equivocal. Potential chronic preconception effects have not been studied. OBJECTIVES Criteria air pollutant exposure during three months preconception and gestational weeks 3-8 was studied in relation to orofacial defects. METHODS Among 188,102 live births and fetal deaths from the Consortium on Safe Labor (2002-2008), 63 had isolated cleft palate (CP) and 159 had isolated cleft lip with or without cleft palate (CL ±CP). Exposures were estimated using a modified Community Multiscale Air Quality model. Logistic regression with generalized estimating equations adjusted for site/region and maternal demographic, lifestyle and clinical factors calculated the odds ratio (OR) and 95% CI per interquartile increase in each pollutant. RESULTS Preconception, carbon monoxide (CO; OR=2.24; CI: 1.21, 4.16) and particulate matter (PM) ≤10 µm (OR=1.72; CI: 1.12, 2.66) were significantly associated with CP, while sulfur dioxide (SO2) was associated with CL ±CP (OR=1.93; CI: 1.16, 3.21). During gestational weeks 3-8, CO remained a significant risk for CP (OR=2.74; CI: 1.62, 4.62) and nitrogen oxides (NOx; OR=3.64; CI: 1.73, 7.66) and PM ≤2.5 µm (PM2.5; OR=1.74; CI: 1.15, 2.64) were also related to the risk. Analyses by individual week revealed that positive associations of NOx and PM2.5 with CP were most prominent from weeks 3-6 and 3-5, respectively. CONCLUSIONS Exposure to several criteria air pollutants preconception and during early gestation was associated with elevated odds for CP, while CL ±CP was only associated with preconception SO2 exposure.
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Affiliation(s)
- Yeyi Zhu
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Cuilin Zhang
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Danping Liu
- Biostatistics and Bioinformatics Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Katherine L Grantz
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Maeve Wallace
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA
| | - Pauline Mendola
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Rockville, MD, USA.
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Abstract
BACKGROUND Gene-environment interactions have been implicated in the development of neural tube defects (NTDs). METHODS We conducted a case-control study to investigate (1) the association of aryl hydrocarbon receptor (AHR) genetic variants and phase I metabolic enzymes with the risk of NTDs and (2) the interaction of these variants with maternal exposure to indoor air pollution from smoking and coal combustion or with placental polycyclic aromatic hydrocarbons (PAHs). Blood samples were collected from 534 mothers of fetuses or newborns with NTDs and 534 control mothers who had healthy term newborns and were assayed for 12 polymorphisms in the AHR and cytochrome P450 (CYP) genes. Information on maternal exposure was collected, and placental levels of PAHs were analyzed. RESULTS Maternal exposure to indoor air pollution was associated with an increased NTD risk. However, no increased NTD risk was observed for individual genetic variants. For mothers with the CYP1B1 rs2855658 GG variant, exposure to indoor air pollution led to a dose-response relationship for NTD risk, with odds ratios (ORs) of 3.0 (95% confidence interval = 1.6-5.7) and 8.1 (3.8-17) for medium and high levels of exposure, respectively. For mothers with GA or AA genotypes, this trend was less apparent. Placental PAHs were associated with an increased risk of NTDs, with an OR of 16 (3.3-75) for high levels compared with low levels of exposure among mothers with the GG genotype; there was no association for mothers with GA or AA genotypes. CONCLUSIONS The CYP1B1 variant modifies the effect of indoor air pollution on NTD risk.
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