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波兰空气污染背景下左心发育不全综合征和单心室心脏的季节性特征

Seasonality of Hypoplastic Left Heart Syndrome and Single Ventricle Heart in Poland in the Context of Air Pollution.

作者信息

Strzelecka Iwona, Biedrzycka Małgorzata, Karuga Filip Franciszek, Szmyd Bartosz, Batarowicz Katarzyna, Respondek-Liberska Maria

机构信息

Department for Diagnoses and Prevention, Medical University of Lodz, 93-338 Łódź, Poland.

Student's Scientific Association Prenatal Cardiology, Medical University of Lodz, 93-338 Łódź, Poland.

出版信息

J Clin Med. 2021 Jul 21;10(15):3207. doi: 10.3390/jcm10153207.

Abstract

Hypoplastic left heart syndrome (HLHS) and single ventricle (SV) remain a significant cause of cardiac deaths occurring in the first week of life. Their pathogenesis and seasonal frequency are still unknown. Therefore, we attempt to look at the genesis of the HLHS and SV in the context of territorial distribution as well as seasonality. A total of 193 fetuses diagnosed with HLHS and 92 with SV were selected. The frequency was analyzed depending on the year, calendar month, quarter and season (fall-winter vs. spring-summer). The spatial distribution of HLHS and SV in Poland was analyzed. We observed a statistically significant overrepresentation of HLHS formation frequency in March: 27 (14.00%) in comparison to a monthly median of 15 (IQR: 13.75-16.25; = 0.039), as well as a significantly higher frequency of HLHS in 2007-2009: 65 cases (33.68%) in comparison to the annual mean of 13.79 ± 6.36 ( < 0.001). We noted a higher frequency of SV among parous with the last menstrual period reported in the fall/winter season of 58 vs. 34 in the spring/summer season ( = 0.014). The performed analysis also revealed significant SV overrepresentation in 2008: 11 cases (12.00%) in comparison to the annual mean of 6.57 ± 2.71 ( = 0.016). Every single case of HLHS was observed when the concentration of benzo(a)pyrene and/or PM10 exceeded the acceptable/target level. Our research indicates that both the season and the level of pollution are significant factors affecting the health of parous women and their offspring. The reason why HLHS and SV develop more frequently at certain times of the year remains unclear, therefore research on this topic should be continued, as well as on the effects of PM10 and benzo(a)pyrene exposure.

摘要

左心发育不全综合征(HLHS)和单心室(SV)仍是出生后第一周内心脏死亡的重要原因。它们的发病机制和季节性频率仍然未知。因此,我们试图从地域分布和季节性的角度来研究HLHS和SV的成因。总共选取了193例诊断为HLHS的胎儿和92例诊断为SV的胎儿。根据年份、日历月、季度和季节(秋冬与春夏)分析频率。分析了波兰HLHS和SV的空间分布。我们观察到3月份HLHS形成频率在统计学上显著过高:27例(14.00%),而每月中位数为15例(四分位间距:13.75 - 16.25;P = 0.039),并且2007 - 2009年HLHS的频率显著更高:65例(33.68%),而年平均为13.79 ± 6.36例(P < 0.001)。我们注意到,末次月经报告在秋冬季节的经产妇中SV的频率更高,为58例,而春夏季节为34例(P = 0.014)。所进行的分析还显示2008年SV显著过高:11例(12.00%),而年平均为6.57 ± 2.71例(P = 0.016)。每一例HLHS都是在苯并(a)芘和/或PM10浓度超过可接受/目标水平时观察到的。我们的研究表明,季节和污染水平都是影响经产妇及其后代健康的重要因素。HLHS和SV在一年中的某些时候更频繁发生的原因仍不清楚,因此应继续对该主题进行研究,以及对PM10和苯并(a)芘暴露的影响进行研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8be8/8347882/a801cb87069f/jcm-10-03207-g001.jpg

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