Maternal exposure to ambient air pollution and congenital heart defects in China

Bo Yi Yang; Yanji Qu; Yuming Guo; Iana Markevych; Joachim Heinrich; Michael S. Bloom; Zhipeng Bai; Luke C. Knibbs; Shanshan Li; Gongbo Chen; Bin Jalaludin; Lidia Morawska; Meng Gao; Bin Han; Yunjiang Yu; Xiao Xuan Liu; Yanqiu Ou; Jinzhuang Mai; Xiangmin Gao; Yong Wu; Zhiqiang Nie; Xiao Wen Zeng; Li Wen Hu; Xubo Shen; Yuanzhong Zhou; Shao Lin; Xiaoqing Liu; Guang Hui Dong

doi:10.1016/j.envint.2021.106548

Maternal exposure to ambient air pollution and congenital heart defects in China

Bo Yi Yang, Yanji Qu, Yuming Guo, Iana Markevych, Joachim Heinrich, Michael S. Bloom, Zhipeng Bai, Luke C. Knibbs, Shanshan Li, Gongbo Chen, Bin Jalaludin, Lidia Morawska, Meng Gao, Bin Han, Yunjiang Yu, Xiao Xuan Liu, Yanqiu Ou, Jinzhuang Mai, Xiangmin Gao, Yong WuZhiqiang Nie, Xiao Wen Zeng, Li Wen Hu, Xubo Shen, Yuanzhong Zhou, Shao Lin^*, Xiaoqing Liu^*, Guang Hui Dong^*

^*Corresponding author for this work

Research output: Contribution to journal › Journal article › peer-review

40 Citations (Scopus)

Abstract

Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM₁), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m³] increase in PM₁ was associated with 1.09-fold ([95% confidence interval, 1.01–1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.

Original language	English
Article number	106548
Number of pages	8
Journal	Environment International
Volume	153
Early online date	7 Apr 2021
DOIs	https://doi.org/10.1016/j.envint.2021.106548
Publication status	Published - Aug 2021

Scopus Subject Areas

General Environmental Science

User-Defined Keywords

Case-control study
Congenital heart defects
NO
Particulate matter
PM

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Yang, B. Y., Qu, Y., Guo, Y., Markevych, I., Heinrich, J., Bloom, M. S., Bai, Z., Knibbs, L. C., Li, S., Chen, G., Jalaludin, B., Morawska, L., Gao, M., Han, B., Yu, Y., Liu, X. X., Ou, Y., Mai, J., Gao, X., ... Dong, G. H. (2021). Maternal exposure to ambient air pollution and congenital heart defects in China. Environment International, 153, Article 106548. https://doi.org/10.1016/j.envint.2021.106548

@article{defd8cccb80c4e458592bb3230697659,

title = "Maternal exposure to ambient air pollution and congenital heart defects in China",

abstract = "Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01–1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.",

keywords = "Case-control study, Congenital heart defects, NO, Particulate matter, PM",

author = "Yang, {Bo Yi} and Yanji Qu and Yuming Guo and Iana Markevych and Joachim Heinrich and Bloom, {Michael S.} and Zhipeng Bai and Knibbs, {Luke C.} and Shanshan Li and Gongbo Chen and Bin Jalaludin and Lidia Morawska and Meng Gao and Bin Han and Yunjiang Yu and Liu, {Xiao Xuan} and Yanqiu Ou and Jinzhuang Mai and Xiangmin Gao and Yong Wu and Zhiqiang Nie and Zeng, {Xiao Wen} and Hu, {Li Wen} and Xubo Shen and Yuanzhong Zhou and Shao Lin and Xiaoqing Liu and Dong, {Guang Hui}",

note = "Funding Information: The research was funded by the National Key Research and Development Program of China (No. 2018YFC1004300; No. 2018YFC1004302); the National Natural Science Foundation of China (No.81972992; No.81703179; No.91543208; No.81803196; No.81673128; No. 81872582); and Science and Technology Program of Guangzhou, China (No.202002030440). Iana Markevych is supported from the “NeuroSmog: Determining the impact of air pollution on the developing brain” (Nr. POIR.04.04.00-1763/18-00) which is implemented as part of the TEAM-NET Programme of the Foundation for Polish Science, co-financed from EU resources, obtained from the European Regional Development Fund under the Smart Growth Operational Programme. The authors acknowledge the cooperation of participants in this study who have been very generous with their time and assistance. Copyright {\textcopyright} 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.",

year = "2021",

month = aug,

doi = "10.1016/j.envint.2021.106548",

language = "English",

volume = "153",

journal = "Environment International",

issn = "0160-4120",

publisher = "Elsevier Ltd.",

}

Yang, BY, Qu, Y, Guo, Y, Markevych, I, Heinrich, J, Bloom, MS, Bai, Z, Knibbs, LC, Li, S, Chen, G, Jalaludin, B, Morawska, L, Gao, M, Han, B, Yu, Y, Liu, XX, Ou, Y, Mai, J, Gao, X, Wu, Y, Nie, Z, Zeng, XW, Hu, LW, Shen, X, Zhou, Y, Lin, S, Liu, X & Dong, GH 2021, 'Maternal exposure to ambient air pollution and congenital heart defects in China', Environment International, vol. 153, 106548. https://doi.org/10.1016/j.envint.2021.106548

TY - JOUR

T1 - Maternal exposure to ambient air pollution and congenital heart defects in China

AU - Yang, Bo Yi

AU - Qu, Yanji

AU - Guo, Yuming

AU - Markevych, Iana

AU - Heinrich, Joachim

AU - Bloom, Michael S.

AU - Bai, Zhipeng

AU - Knibbs, Luke C.

AU - Li, Shanshan

AU - Chen, Gongbo

AU - Jalaludin, Bin

AU - Morawska, Lidia

AU - Gao, Meng

AU - Han, Bin

AU - Yu, Yunjiang

AU - Liu, Xiao Xuan

AU - Ou, Yanqiu

AU - Mai, Jinzhuang

AU - Gao, Xiangmin

AU - Wu, Yong

AU - Nie, Zhiqiang

AU - Zeng, Xiao Wen

AU - Hu, Li Wen

AU - Shen, Xubo

AU - Zhou, Yuanzhong

AU - Lin, Shao

AU - Liu, Xiaoqing

AU - Dong, Guang Hui

N1 - Funding Information: The research was funded by the National Key Research and Development Program of China (No. 2018YFC1004300; No. 2018YFC1004302); the National Natural Science Foundation of China (No.81972992; No.81703179; No.91543208; No.81803196; No.81673128; No. 81872582); and Science and Technology Program of Guangzhou, China (No.202002030440). Iana Markevych is supported from the “NeuroSmog: Determining the impact of air pollution on the developing brain” (Nr. POIR.04.04.00-1763/18-00) which is implemented as part of the TEAM-NET Programme of the Foundation for Polish Science, co-financed from EU resources, obtained from the European Regional Development Fund under the Smart Growth Operational Programme. The authors acknowledge the cooperation of participants in this study who have been very generous with their time and assistance. Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.

PY - 2021/8

Y1 - 2021/8

N2 - Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01–1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.

AB - Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01–1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.

KW - Case-control study

KW - Congenital heart defects

KW - NO

KW - Particulate matter

KW - PM

UR - http://www.scopus.com/inward/record.url?scp=85103976082&partnerID=8YFLogxK

U2 - 10.1016/j.envint.2021.106548

DO - 10.1016/j.envint.2021.106548

M3 - Journal article

C2 - 33838617

AN - SCOPUS:85103976082

SN - 0160-4120

VL - 153

JO - Environment International

JF - Environment International

M1 - 106548

ER -

Maternal exposure to ambient air pollution and congenital heart defects in China

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