Dataset Information

Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study.

ABSTRACT:

Background

Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development.

Objectives

We investigated maternal exposures to air pollutants during weeks 2-8 of pregnancy and their associations with congenital heart defects.

Methods

Mothers from the National Birth Defects Prevention Study, a nine-state case-control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context.

Results

Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels.

Conclusions

Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy.

SUBMITTER: Stingone JA

PROVIDER: S-EPMC4123026 | biostudies-literature | 2014 Aug

REPOSITORIES: biostudies-literature

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Publications

Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study.

Stingone Jeanette A JA Luben Thomas J TJ Daniels Julie L JL Fuentes Montserrat M Richardson David B DB Aylsworth Arthur S AS Herring Amy H AH Anderka Marlene M Botto Lorenzo L Correa Adolfo A Gilboa Suzanne M SM Langlois Peter H PH Mosley Bridget B Shaw Gary M GM Siffel Csaba C Olshan Andrew F AF

Environmental health perspectives 20140411 8

<h4>Background</h4>Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development.<h4>Objectives</h4>We investigated maternal exposures to air pollutants during weeks 2-8 of pregnancy and their associations with congenital heart defects.<h4>Methods</h4>Mothers from the National Birth Defects Prevention Study, a nine-state case-control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone ...[more]

PMID: 24727555

Similar Datasets

Project description:BackgroundCongenital limb deficiencies (CLDs) are a relatively common group of birth defects whose etiology is mostly unknown. Recent studies suggest maternal air pollution exposure as a potential risk factor.AimTo investigate the relationship between ambient air pollution exposure during early pregnancy and offspring CLDs.MethodsThe study population was identified from the National Birth Defects Prevention Study, a population-based multi-center case-control study, and consisted of 615 CLD cases and 5,701 controls with due dates during 1997 through 2006. Daily averages and/or maxima of six criteria air pollutants (particulate matter <2.5 μm [PM2.5], particulate matter <10 μm [PM10], nitrogen dioxide [NO2], sulfur dioxide [SO2], carbon monoxide [CO], and ozone [O3]) were averaged over gestational weeks 2-8, as well as for individual weeks during this period, using data from EPA air monitors nearest to the maternal address. Logistic regression was used to estimate odds ratios (aORs) and 95% confidence intervals (CIs) adjusted for maternal age, race/ethnicity, education, and study center. We estimated aORs for any CLD and CLD subtypes (i.e., transverse, longitudinal, and preaxial). Potential confounding by co-pollutant was assessed by adjusting for one additional air pollutant. Using the single pollutant model, we further investigated effect measure modification by body mass index, cigarette smoking, and folic acid use. Sensitivity analyses were conducted restricting to those with a residence closer to an air monitor.ResultsWe observed near-null aORs for CLDs per interquartile range (IQR) increase in PM10, PM2.5, and O3. However, weekly averages of the daily average NO2 and SO2, and daily max NO2, SO2, and CO concentrations were associated with increased odds of CLDs. The crude ORs ranged from 1.03 to 1.12 per IQR increase in these air pollution concentrations, and consistently elevated aORs were observed for CO. Stronger associations were observed for SO2 and O3 in subtype analysis (preaxial). In co-pollutant adjusted models, associations with CO remained elevated (aORs: 1.02-1.30); but aORs for SO2 and NO2 became near-null. The aORs for CO remained elevated among mothers who lived within 20 km of an air monitor. The aORs varied by maternal BMI, smoking status, and folic acid use.ConclusionWe observed modest associations between CLDs and air pollution exposures during pregnancy, including CO, SO2, and NO2, though replication through further epidemiologic research is warranted.

Dataset Information

Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study.

Background

Objectives

Methods

Results

Conclusions

Publications

Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the national birth defects prevention study.

Similar Datasets

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