Association Between Maternal Exposure to Ambient Air Pollution and Congenital Heart Disease: A Register-based Spatiotemporal Analysis
Association Between Maternal Exposure to Ambient Air Pollution and Congenital Heart Disease: A Register-based Spatiotemporal Analysis
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DOI：
10.1093/aje/kwq342
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发表时间：
2011-01-15
影响因子：
5
通讯作者：
Pless-Mulloli, Tanja
中科院分区：
文献类型：
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作者：
Dadvand, Payam;Rankin, Judith;Pless-Mulloli, Tanja
最近的研究表明，母亲暴露在空气污染中与一系列不良妊娠结局有关。然而，将这种暴露与先天性畸形联系起来的现有证据仍然有限，也存在争议。目前的病例对照研究测试了母亲暴露于周围黑烟和二氧化硫是先天性心脏病发生的风险因素的假设。作者使用了1985-1996年间英格兰东北部人口的先天性心脏病登记数据。开发了一个两阶段时空模型来预测每个母亲居住地每周的黑烟和二氧化硫水平。对照组与出生年份的病例频率匹配(对照与病例的比率为4：1)。进行了两组分析，使用预测的暴露平均值和1000个模拟暴露情景。分析根据出生年份、社会经济地位、婴儿性别、受孕季节和城市化程度进行了调整。作者发现，只有当接触黑烟作为连续变量时，母亲暴露于黑烟与先天性心腔和心脏连接畸形之间存在微弱关联。当作者使用四分位数的暴露时，优势比没有显示出连续四分位数的剂量-反应关系。对于二氧化硫，这些结果并不表明有任何联系。
Recent studies have linked maternal exposure to air pollution with a range of adverse pregnancy outcomes. However, the available evidence linking this exposure to congenital anomalies is still limited and controversial. The present case-control study tested the hypothesis that maternal exposure to ambient black smoke and sulfur dioxide is a risk factor for the occurrence of congenital heart disease. The authors used registry-based data on congenital heart disease for the population of the northeast of England in 1985-1996. A 2-stage spatiotemporal model was developed to predict weekly black smoke and sulfur dioxide levels at each maternal place of residence. Controls were frequency-matched to cases by year of birth (control-to-case ratio of 4:1). Two sets of analyses were performed, using predicted mean values of exposure and 1,000 simulated scenarios of exposure. The analyses were adjusted for birth year, socioeconomic status, infant sex, season of conception, and degree of urbanity. The authors found a weak association between maternal exposure to black smoke and congenital malformations of cardiac chambers and connections only when using exposure as a continuous variable. When the authors used quartiles of exposure, odds ratios did not show a dose-response relation for consecutive quartiles. For sulfur dioxide, the results were not indicative of any association.