Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study.

Zhao MA; Weiqin LI; Jicui YANG; Yijuan QIAO; Xue CAO; Han GE; Yue WANG; Hongyan LIU; Naijun TANG; Xueli YANG; Junhong LENG

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Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study.

Author: Zhao MA ¹ ; Weiqin LI ² ; Jicui YANG ¹ ; Yijuan QIAO ² ; Xue CAO ¹ ; Han GE ¹ ; Yue WANG ² ; Hongyan LIU ² ; Naijun TANG ¹ ; Xueli YANG ¹ ; Junhong LENG ²
Author Information

1. Department of Occupational and Environmental Health, School of Public Health, Tianjin Medical University.
2. Tianjin Women and Children's Health Center.
Publication Type:Journal Article
Keywords: Air pollution; Congenital heart disease; Exposure windows; Gestational exposure; Lag effect; Nested case-control study
MeSH: Infant; Pregnancy; Child; Humans; Female; Air Pollutants/analysis*; Case-Control Studies; Prenatal Exposure Delayed Effects/epidemiology*; Heart Defects, Congenital/etiology*; China/epidemiology*; Particulate Matter/adverse effects*; Maternal Exposure/adverse effects*
From:Environmental Health and Preventive Medicine 2023;28():4-4
CountryJapan
Language:English
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 PM_2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1^st-2^nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O₃ exposure during the 1^st week and SO₂ exposure during 6^th-7^th weeks in the first trimester, while no significant findings for other air pollutants.
CONCLUSIONS:This study highlighted that gestational exposure to PM_2.5, 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.