Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China
Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China
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DOI：
10.1016/j.ijheh.2021.113898
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发表时间：
2022-03-01
影响因子：
6
通讯作者：
Shu, Qiang
中科院分区：
文献类型：
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作者：
Li, Die;Xu, Weize;Shu, Qiang
目的：为探讨空气污染与新生儿先天性心脏病（CHD）的相关性，评估环境空气污染暴露超过一定水平所致CHD的累积负担。方法：选取2019年1月至2020年12月在中国东部11个城市先天性心脏病网络平台（NPCHD）中通过超声心动图诊断为CHD的新生儿。采用分布滞后非线性模型（DLNM）计算了大气污染物（PM2.5、PM10、SO2、NO2、CO和O3-）浓度与CHDs的暴露滞后响应关系。结果：共收集983，523名新生儿的5904例CHD病例。PM2.5、PM10、SO2、NO2、CO和O-3暴露量增加10 μ g/m3与妊娠晚期CHD发生率升高的风险相关，对于PM2.5，RR = 1.001，95%CI：1.016-1.038。孕晚期PM10为1.000-1.002，孕晚期NO2为1.020，95%CI：1.004-1.036，孕早期O-3为RR = 1.001，95%CI：1.000-1.002，P值均< 0.05）。PM2.5、PM10、SO2、NO2、CO和O-3的累积效应曲线呈亚线性，最大值分别为1.876（95%CI：1.220-2.886）、1.973（95%CI：1.477，2.637）、2.169（95%CI：1.347-3.493）、2.902（95%CI：1.859-4.530）、1.398（95%CI：1.080-1.809）、2.691（95%CI：1.705-4.248）。显着的协会，观察到空气污染物和冠心病在城市较高的平均教育年限和婴儿概念在寒冷的season.Conclusions：我们的研究结果可以提供越来越多的证据，空气污染对冠心病的不良健康影响，从而加强假设，空气污染物对心脏发育有有害影响。需要进一步的研究来验证这种关联。
Objective: To examine the association between air pollution and neonatal congenital heart disease (CHD), and evaluate the cumulative burden of CHD attributed to above certain level for ambient air pollution exposure.Methods: We identified newborns who were diagnosed as CHD by echocardiography in Network Platform for Congenital Heart Disease (NPCHD) from January 2019 to December 2020 in 11 cities eastern China. The exposure lag response relationship between air pollutants (PM2.5, PM10, SO2, NO2, CO, and O-3) concentration and CHDs was calculated by the distributed lag nonlinear model (DLNM). We further calculated the cumulative risk ratios (CRRs) of each air pollutant above reference concentrations on CHDs.Results: A total of 5904 CHDs from 983, 523 newborns were enrolled in this study. A 10 mu g/m(3) increase in PM2.5, PM10, SO2, NO2, CO and O-3 exposure was associated with an increased risk of higher CHD incident RR = 1.025, 95% CI: 1.016-1.038 for PM2.5 in the third trimester, RR = 1.001, 95% CI: 1.000-1.002 for PM10 in the third trimester, 1.020, 95%CI: 1.004-1.036 for NO2 in the third trimester, RR = 1.001, 95%CI: 1.000-1.002 for O-3 in the first trimester, all P value < 0.05). Cumulative effect curves of PM2.5, PM10, SO2, NO2, CO, and O-3 were observed as sub-linear with a maximum of 1.876 (95%CI:1.220-2.886), 1.973 (95%CI:1.477,2.637), 2.169 (95% CI:1.347-3.493), 2.902 (95%CI:1.859-4.530), 1.398 (95%CI:1.080-1.809), 2.691 (95%CI:1.705-4.248), respectively. Significant associations were observed for air pollutants and CHDs in cities with higher average education years and babies concepted in cold season.Conclusions: Our findings could provide growing evidence regarding the adverse health effects of air pollution on CHD, thereby strengthening the hypothesis that air pollutants have harmful impacts on cardiac development. Further studies are needed to verify the associations.