Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects - A large US population-based, case-control study.
Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects - A large US population-based, case-control study.
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DOI：
10.1016/j.envint.2018.04.043
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发表时间：
2018-09
影响因子：
11.8
通讯作者：
National Birth Defects Prevention Study
中科院分区：
文献类型：
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作者：
Lin S;Lin Z;Ou Y;Soim A;Shrestha S;Lu Y;Sheridan S;Luben TJ;Fitzgerald E;Bell E;Shaw GM;Reefhuis J;Langlois PH;Romitti P;Feldkamp ML;Malik S;Pantea C;Nayak S;Hwang SA;Browne M;National Birth Defects Prevention Study
很少有研究评估胎儿发育期间环境热量对先天性心脏缺陷（CHDs）的影响，特别是在过渡季节。我们检查并比较了夏季和春季极端高温与冠心病表型之间的关系，评估了它们的地理差异，并比较了不同的热量指标。我们从美国一项多中心、基于人群的病例对照研究——国家出生缺陷预防研究中筛选出5848例冠心病病例和5742例对照（无重大结构缺陷）。极端热事件（EHEs）的定义采用孕后3 ~ 8周每日最高气温的第95或90百分位及其发生频率和持续时间。我们使用两阶段贝叶斯层次模型来检查区域和研究范围的关联。在控制潜在混杂因素的情况下，使用多变量逻辑回归分析计算暴露优势比（ORs）。总体而言，我们观察到夏季大多数地区产妇EHE暴露与CHDs之间没有显着关系。然而，我们发现在夏季和春季3-11天的EHE90与研究范围内的室间隔缺损（VSDs）显著相关（or范围：2.17-3.24）。春季EHE95与南方锥体缺损和VSDs显著相关（or: 1.23-1.78）。春季大多数EHE指标与东北地区室间隔缺损（VSDs和房间隔缺损（ASDs））增加显著相关。虽然总体上没有发现任何结果，但长时间的非季节性高温与室性心血管疾病和自闭症的风险增加有关，主要发生在美国南部和东北部。需要进一步的研究来证实我们的发现。
Few studies have assessed the effect of ambient heat during the fetal development period on congenital heart defects (CHDs), especially in transitional seasons. We examined and compared the associations between extreme heat and CHD phenotypes in summer and spring, assessed their geographical differences, and compared different heat indicators. We identified 5848 CHD cases and 5742 controls (without major structural defects) from the National Birth Defects Prevention Study, a US multicenter, population-based case-control study. Extreme heat events (EHEs) were defined by using the 95th (EHE95) or 90th (EHE90) percentile of daily maximum temperature and its frequency and duration during postconceptional weeks 3–8. We used a two-stage Bayesian hierarchical model to examine both regional and study-wide associations. Exposure odds ratios (ORs) were calculated using multivariate logistic regression analyses, while controlling for potential confounding factors. Overall, we observed no significant relationships between maternal EHE exposure and CHDs in most regions during summer. However, we found that 3–11 days of EHE90 during summer and spring was significantly associated with ventricular septal defects (VSDs) study-wide (ORs ranged: 2.17–3.24). EHE95 in spring was significantly associated with conotruncal defects and VSDs in the South (ORs: 1.23–1.78). Most EHE indicators in spring were significantly associated with increased septal defects (both VSDs and atrial septal defects (ASDs)) in the Northeast. While generally null results were found, long duration of unseasonable heat was associated with the increased risks for VSDs and ASDs, mainly in South and Northeast of the US. Further research to confirm our findings is needed.
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影响因子：
14.9
作者：
Feng H;Conneely KN;Wu H
通讯作者：
Wu H
DOI：
10.1002/tera.1420310212
发表时间：
1985-01-01
期刊：
TERATOLOGY
影响因子：
--
作者：
GERMAIN, MA;WEBSTER, WS;EDWARDS, MJ
通讯作者：
EDWARDS, MJ
影响因子：
7.7
作者：
Greenland, Sander
通讯作者：
Greenland, Sander
影响因子：
5
作者：
Fitzgerald, Edward F.;Pantea, Cristian;Lin, Shao
通讯作者：
Lin, Shao
影响因子：
10.4
作者：
Auger N;Fraser WD;Sauve R;Bilodeau-Bertrand M;Kosatsky T
通讯作者：
Kosatsky T