Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study.
Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study.
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产前早期接触空气污染物与先天性心脏病：一项巢式病例对照研究
DOI：
10.1265/ehpm.22-00138
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发表时间：
2023
影响因子：
4.7
通讯作者：
Leng, Junhong
中科院分区：
文献类型：
--
作者：
Ma, Zhao;Li, Weiqin;Yang, Jicui;Qiao, Yijuan;Cao, Xue;Ge, Han;Wang, Yue;Liu, Hongyan;Tang, Naijun;Yang, Xueli;Leng, Junhong
关键词：
背景先天性心脏病（CHD）是人类最常见的先天性畸形之一。现有的关于空气污染与先天性心脏病之间关系的研究出现了不一致的结果。本研究的目的是评估妊娠期空气污染物暴露与先天性心脏病的关系，并探讨先天性心脏病的关键暴露窗口。方法采用巢式病例对照法，收集天津市妇女儿童保健中心出生记录及以下健康资料。选取2013 - 2015年所有先天性心脏病病例，每个病例匹配5名健康对照。根据每日空气污染数据，使用反向距离加权来估计个人暴露。此外，采用分布滞后非线性模型进行条件logistic回归，以确定妊娠期空气污染暴露与先天性心脏病的关系。结果共纳入8748对母婴，其中先天性心脏病患儿1458例。妊娠期PM2.5暴露量每增加10µg/m3，妊娠1 - 2周的or（95%可信区间，95% ci）范围为1.008（1.001-1.016）至1.013（1.001-1.024）。同样微弱但增加的先天性心脏病风险与妊娠第1周暴露于O3和妊娠第6 - 7周暴露于SO2有关，而与其他空气污染物没有显著关系。结论本研究强调，妊娠期暴露于PM2.5、O3和SO2对先天性心脏病有滞后效应。我们的研究结果支持孕妇在早期阶段减少空气污染暴露的潜在益处，特别是当空气污染物暴露的关键时间窗口可能先于心脏发育时。补充信息在线版本包含补充资料，可在https://doi.org/10.1265/ehpm.22-00138获取。
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 PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001–1.016) to 1.013 (1.001–1.024) during the 1st–2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th–7th weeks in the first trimester, while no significant findings for other air pollutants. Conclusions This study highlighted that gestational exposure to PM2.5, 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. Supplementary information The online version contains supplementary material available at https://doi.org/10.1265/ehpm.22-00138.
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