Liu Chao-Bin, Hong Xin-Ru, Shi Miao, Chen Xiao-Qiu, Huang Hui-Juan, Chen Jin-Hua, Yang Kai, Chen Su-Qing, Chen Han-Qiang, Kan Hai-Dong, Sun Qing-Hua
Department of Obstetrics and Gynecology, Fujian Maternity and Child Health Hospital, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, China
Department of Obstetrics and Gynecology, Fuzhou General Hospital, Fuzhou, Fujian, China
Environ Health Perspect. 2017 May 25;125(5):057001. doi: 10.1289/EHP289.
Maternal exposure to ambient air pollution has been associated with an increased risk of congenital heart defects in offspring; however, the results are inconsistent.
We investigated whether there is an association between prenatal exposure to particulate matter with diameter ≤10μm (PM) during early pregnancy and fetal cardiovascular malformations.
The gravidae from a hospital-based case–control study in Fuzhou, China, during 2007–2013 were assigned 10-d or 1-mo averages of daily PM using an air monitor–based inverse distance weighting method during early pregnancy. A total of 662 live-birth or selectively terminated cases and 3,972 live-birth controls were enrolled. The exposure was considered as a categorical variable. A multivariable logistic regression model was constructed to quantify the adjusted odds ratios (aORs) of the exposure to PM and the risks of fetal cardiovascular malformations.
PM levels were positively associated with the risks of atrial septal defect (aORs ranging from 1.29 to 2.17), patent ductus arteriosus [aORs = 1.54, 1.63; 95% confidence intervals (CIs): 1.17, 2.23; 1.06, 3.24], overall fetal cardiovascular malformations (aOR = 1.28; 95% CI: 1.03, 1.61), ventricular septal defect (aOR = 1.19; 95% CI: 1.00, 1.43), and tetralogy of Fallot (aOR = 1.44; 95% CI: 1.01, 2.19) in the various observed periods scaled by 10 d or 1 mo in the first and second gestation months. The strongest associations were observed for exposure to PM in the second quartile, whereas the associations were attenuated when higher concentrations of PM in the third and fourth quartiles of the exposure were evaluated. No correlations of PM levels with these cardiovascular malformations in the other time periods of gestation were observed.
Our findings suggest some positive associations between maternal exposure to ambient PM during the first two months of pregnancy and fetal cardiovascular malformations. https://doi.org/10.1289/EHP289.
母亲暴露于环境空气污染与后代先天性心脏缺陷风险增加有关；然而，结果并不一致。
我们调查了妊娠早期暴露于直径≤10μm的颗粒物（PM）与胎儿心血管畸形之间是否存在关联。
在2007 - 2013年期间，对中国福州一项基于医院的病例对照研究中的孕妇，使用基于空气监测器的反距离加权法，计算其妊娠早期10天或1个月的每日PM平均值。共纳入662例活产或选择性终止妊娠的病例以及3972例活产对照。暴露被视为分类变量。构建多变量逻辑回归模型，以量化PM暴露的调整优势比（aOR）和胎儿心血管畸形风险。
在妊娠前两个月按10天或1个月划分的不同观察期内，PM水平与房间隔缺损风险（aOR范围为1.29至2.17）、动脉导管未闭[aOR = 1.54, 1.63；95%置信区间（CI）：1.17, 2.23；1.06, 3.24]、总体胎儿心血管畸形（aOR = 1.28；95% CI：1.03, 1.61）、室间隔缺损（aOR = 1.19；95% CI：1.00, 1.43）以及法洛四联症（aOR = 1.44；95% CI：1.01, 2.19）呈正相关。在第二四分位数的PM暴露中观察到最强的关联，而当评估暴露的第三和第四四分位数中更高浓度的PM时，关联减弱。在妊娠的其他时间段未观察到PM水平与这些心血管畸形之间的相关性。
我们的研究结果表明，妊娠前两个月母亲暴露于环境PM与胎儿心血管畸形之间存在一些正相关。https://doi.org/10.1289/EHP289
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