Children's Health Advance Publication
Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study
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Citation: Stingone JA, Luben TJ, Daniels JL, Fuentes M, Richardson DB, Aylsworth AS, Herring AH, Anderka M, Botto L, Correa A, Gilboa SM, Langlois PH, Mosley B, Shaw GM, Siffel C, Olshan AF, National Birth Defects Prevention Study. Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study. Environ Health Perspect; http://dx.doi.org/10.1289/ehp.1307289.
Received: 28 June 2013
Accepted: 9 April 2014
Advance Publication: 11 April 2014
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Background: Epidemiologic literature suggests exposure to air pollutants is associated with fetal development.
Objectives: To investigate maternal exposures to air pollutants during weeks two through eight of pregnancy and congenital heart defects.
Methods: Mothers from the National Birth Defects Prevention Study, a nine-state case-control study, were assigned one-week and seven-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hour measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending upon the pollutant, a maximum of 4632 live-birth controls and 3328 live-birth, fetal-death or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics, tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context.
Results: Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the seven-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels.
Conclusions: Utilizing daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy.
CEHN July 2014 Article of the Month
“Outdoor Formaldehyde and NO2 Exposures and Markers of Genotoxicity in Children Living Near Chipboard Industries” (Environ Health Perspect; DOI:10.1289/ehp.1307259) has been selected by the Children’s Environmental Health Network (CEHN) as its July 2014 Article of the Month. These CEHN summaries discuss the potential policy implications of current children’s environmental health research.
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