Risk of Congenital Heart Defects after Ambient Heat Exposure Early in Pregnancy.
Risk of Congenital Heart Defects after Ambient Heat Exposure Early in Pregnancy.
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妊娠早期环境热暴露后先天性心脏缺陷的风险。
DOI：
10.1289/ehp171
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发表时间：
2017-01
影响因子：
10.4
通讯作者：
Kosatsky T
中科院分区：
文献类型：
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作者：
Auger N;Fraser WD;Sauve R;Bilodeau-Bertrand M;Kosatsky T
先天性心脏缺陷可能与环境有关，但与环境温度升高的关联很少受到关注。我们研究了怀孕前三个月室外高温与先天性心脏病风险之间的关系。我们对1988年至2012年4月至9月期间在加拿大魁北克受孕后2至8周的704，209名胎儿进行了回顾性队列研究。我们根据女性暴露于最高温度≥ 30°C的天数计算出生时先天性心脏缺陷的患病率。在对数二项回归模型中，我们估计了温度与7种危重和8种非危重心脏缺陷之间关系的患病率（PR）和95%置信区间（CI），并对妊娠特征进行了调整。先天性心脏病的患病率为979.5/100，000，持续10天或更长时间的温度≥ 30°C，而暴露0天的患病率为878.9/100，000。温度与非关键缺陷的相关性更精确，而非关键缺陷的患病率更低。相对于0天，在妊娠后2 - 8周暴露于温度≥ 30°C 15天的胎儿的关键缺陷风险为1.06倍（95% CI：0.67，1.67），非关键缺陷风险为1.12倍（95% CI：0.98，1.29）。房间隔缺损（PR 1.37，95% CI：1.10，1.70）的相关性高于其他非危重缺陷。对于房间隔缺损，与温度升高的关联开始于受孕后第3周。妊娠早期的极度热暴露可能与非危重性心脏缺陷有关，特别是房间隔。杨文龙，杨文龙. 2017.妊娠早期环境热暴露后先天性心脏缺陷的风险。环境健康展望125：8-14; http：dx.doi.org/10.1289/EHP171
Congenital heart defects may be environmentally related, but the association with elevated ambient temperature has received little attention. We studied the relationship between outdoor heat during the first trimester of pregnancy and risk of congenital heart defects. We carried out a retrospective cohort study of 704,209 fetuses between 2 and 8 weeks postconception from April to September in Quebec, Canada, 1988–2012. We calculated the prevalence of congenital heart defects at birth according to the number of days women were exposed to maximum temperature ≥ 30°C. In log-binomial regression models, we estimated prevalence ratios (PR) and 95% confidence intervals (CI) for the relationship of temperature with seven critical and eight noncritical heart defects, adjusted for pregnancy characteristics. Prevalence of congenital heart defects was 979.5 per 100,000 for 10 days or more of temperature ≥ 30°C compared with 878.9 per 100,000 for 0 days of exposure. Temperature was more precisely associated with noncritical than critical defects, which had lower prevalence. Fetuses exposed to 15 days of temperature ≥ 30°C between 2 and 8 weeks postconception had 1.06 times the risk of critical defects (95% CI: 0.67, 1.67) and 1.12 times the risk of noncritical defects (95% CI: 0.98, 1.29) relative to 0 days. Associations were higher for atrial septal defects (PR 1.37, 95% CI: 1.10, 1.70) than for other noncritical defects. For atrial septal defects, associations with elevated temperatures began the 3rd week postconception. Extreme heat exposure during the first trimester may be associated with noncritical heart defects, especially of the atrial septum. Auger N, Fraser WD, Sauve R, Bilodeau-Bertrand M, Kosatsky T. 2017. Risk of congenital heart defects after ambient heat exposure early in pregnancy. Environ Health Perspect 125:8–14; http://dx.doi.org/10.1289/EHP171