Associations between fine particulate matter, extreme heat events, and congenital heart defects.
Associations between fine particulate matter, extreme heat events, and congenital heart defects.
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DOI：
10.1097/ee9.0000000000000071
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发表时间：
2019-12-01
期刊：
影响因子：
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通讯作者：
Lin, Shao
中科院分区：
文献类型：
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作者：
Stingone, Jeanette A;Luben, Thomas J;Lin, Shao
先前的研究报告了怀孕期间测量的空气污染与后代先天性心脏病（CHD）发生之间的关联。本研究的目的是评估是否暴露于极端高温事件（EHEs）在怀孕期间可能会修改此association.METHODS：研究人群包括4,033名对照和2,632例，分娩日期在1999年至2007年之间谁参加了国家出生缺陷预防研究，在美国的多站点病例对照研究。从最近的固定细颗粒物（PM2.5）监测仪在50公里内的产妇住所的每日数据平均在怀孕后3-8周。EHE定义为至少连续2天处于第95百分位数上限或连续3天处于第90百分位数上限的最高环境温度。Logistic回归模型根据母亲年龄、种族、教育程度和平均湿度进行调整。计算相互作用引起的相对超额风险（RERI）。与低PM2.5暴露且未暴露于EHE的女性相比，仅在经历EHE的女性中，与高PM2.5暴露相关的后代发生室间隔缺损的几率升高（比值比[OR] 2.14 95%置信区间[CI] 1.19，3.38 vs. OR 0.97 95% CI 0.49，1.95; RERI 0.82 95% CI-0.39，2.17）。大多数观察到的协会和其他心脏缺陷的相互作用是无效的和/或不确定的，由于缺乏precisions.CONCLUSIONS：这项研究提供了有限的证据表明，EHE可能会修改产前暴露于PM2.5和CHD发生之间的关联。
Previous research reports associations between air pollution measured during pregnancy and the occurrence of congenital heart defects (CHDs) in offspring. The objective of this research was to assess if exposure to extreme heat events (EHEs) during pregnancy may modify this association.METHODS: The study population consisted of 4,033 controls and 2,632 cases with dates of delivery between 1999 and 2007 who participated in the National Birth Defects Prevention Study, a multi-site case-control study in the United States. Daily data from the closest stationary fine particulate matter (PM2.5) monitor within 50 km from the maternal residence were averaged across weeks 3-8 post-conception. EHEs were defined as maximum ambient temperature in the upper 95th percentile for at least 2 consecutive days or the upper 90th percentile for 3 consecutive days. Logistic regression models were adjusted for maternal age, ethnicity, education, and average humidity. Relative excess risks due to interaction (RERI) were calculated.RESULTS: Compared with women with low PM2.5 exposure and no exposure to an EHE, the odds of a ventricular septal defect in offspring associated with high PM2.5 exposure was elevated only among women who experienced an EHE (odds ratio [OR] 2.14 95% confidence interval [CI] 1.19, 3.38 vs. OR 0.97 95% CI 0.49, 1.95; RERI 0.82 95% CI -0.39, 2.17). The majority of observed associations and interactions for other heart defects were null and/or inconclusive due to lack of precision.CONCLUSIONS: This study provides limited evidence that EHEs may modify the association between prenatal exposure to PM2.5 and CHD occurrence.