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空气污染与先天性心脏病。

Air pollution and congenital heart defects.

机构信息

University of Haifa, School of Public Health, Faculty of Social Welfare and Health sciences, Mount Carmel, Haifa 31905, Israel.

出版信息

Environ Res. 2013 Jul;124:28-34. doi: 10.1016/j.envres.2013.03.005. Epub 2013 Apr 25.

Abstract

Environmental factors such as ambient air pollution have been associated with congenital heart defects. The aim of this study was to investigate the association between gestational exposure to air pollution and the risk of congenital heart defects. We conducted a registry-based cohort study with a total of 135,527 live- and still-births in the Tel-Aviv region during 2000-2006. We used a Geographic Information System-based spatiotemporal approach with weekly inverse distance weighting modeling to evaluate associations between gestational exposure to ambient air pollution during weeks 3-8 of pregnancy and the risk for congenital heart defects. The following pollutants were studied: carbon monoxide, nitrogen-dioxide, ozone, sulfur-dioxide and particulate matter with aerodynamic diameter smaller than 10 μm and 2.5 μm (PM10, PM2.5 respectively). Logistic models, adjusted for socio-demographic covariates were used to evaluate the associations. We found that maternal exposure to increased concentrations of PM10 was associated with multiple congenital heart defects (adjusted OR 1.05, 95% CI: 1.01 to 1.10 for 10 μg/m(3) increment). An inverse association was observed between concentrations of PM2.5 and isolated patent ductus arteriosus (adjusted OR 0.78, 95% CI: 0.68 to 0.91 for 5 µg/m(3) increment). Sensitivity analyses showed that results were consistent. Generally there were no evidence for an association between gaseous air pollutants and congenital heart defects.Our results for PM10 and congenital heart defects confirm results from previous studies. The results for PM2.5 need further investigations.

摘要

环境因素,如大气污染,与先天性心脏病有关。本研究旨在探讨妊娠期暴露于空气污染与先天性心脏病风险之间的关系。我们进行了一项基于登记的队列研究,共纳入了 2000-2006 年在特拉维夫地区的 135527 例活产和死产。我们使用基于地理信息系统的时空方法,每周采用倒数距离加权模型来评估妊娠第 3-8 周暴露于环境空气污染与先天性心脏病风险之间的关系。研究了以下污染物:一氧化碳、二氧化氮、臭氧、二氧化硫和粒径小于 10μm 和 2.5μm 的颗粒物(分别为 PM10 和 PM2.5)。使用调整社会人口学协变量的逻辑回归模型来评估关联。我们发现,母亲暴露于 PM10 浓度增加与多种先天性心脏病有关(调整后的比值比为 1.05,95%置信区间:10μg/m3 增加时为 1.01 至 1.10)。PM2.5 浓度与孤立的动脉导管未闭呈负相关(调整后的比值比为 0.78,95%置信区间:5μg/m3 增加时为 0.68 至 0.91)。敏感性分析表明结果一致。一般来说,没有证据表明气态空气污染物与先天性心脏病之间存在关联。我们关于 PM10 和先天性心脏病的结果证实了以前研究的结果。PM2.5 的结果需要进一步研究。

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