School of Public Health, Zhengzhou University, Zhengzhou, China; School of Public Health, Sun Yat-sen University, Guangzhou, China.
The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Ecotoxicol Environ Saf. 2022 Jan 1;229:113070. doi: 10.1016/j.ecoenv.2021.113070. Epub 2021 Dec 14.
Association between ambient air pollution and congenital heart diseases (CHDs) remains inconclusive, and the critical exposure windows has not been well studied.
This case-control study aimed to assess the effect of ambient air pollution exposure on the risk of CHDs and the subtypes in Henan, China, and further to explore potential susceptible windows.
Daily average particulate matter with an aerodynamic diameter of ≤2.5 µm (PM) and ≤10 µm (PM), nitrogen dioxide (NO), sulfur dioxide (SO), carbon monoxide (CO) and ozone (O) were collected by Chinese Air Quality Reanalysis datasets. Binary logistic regression was used to examine trimester-specific associations between per 10 μg/m increase in air pollutants and CHDs as well as the major subtypes. Distributed lag models incorporating logistic regression were applied to explore weekly-specific associations.
A total of 196,069 singleton live births were included during 2013-2018, 643 CHDs were identified (3.3‰). We found that first and second trimester CO exposure increased overall CHDs risk, the adjusted odds ratio (aOR) and 95% confidence interval (CI) were 1.066 (1.010-1.125) and 1.065 (1.012-1.122). For CHDs subtypes, we observed that NO and CO in first trimester, PM and PM in the second trimester exposure were associated with the risk of atrial septal defect (ASD), the susceptible windows of air pollutants and ASD mainly occurred in the 1st- 6th gestational weeks. No positive association was observed for air pollution and tetralogy of Fallot.
Our findings suggest that ambient air pollution exposure is associated with the risk of CHDs especially for ASD, and the susceptible windows generally occurred in first trimester. Further well-designed longitudinal studies are warranted to confirm our findings.
环境空气污染与先天性心脏病（CHD）之间的关联仍不确定，关键暴露窗口尚未得到很好的研究。
本病例对照研究旨在评估环境空气污染暴露对中国河南 CHD 风险及亚型的影响，并进一步探讨潜在的易感窗口。
采用中国空气质量再分析数据集收集每日平均粒径≤2.5μm（PM）和≤10μm（PM）、二氧化氮（NO）、二氧化硫（SO）、一氧化碳（CO）和臭氧（O）。采用二元逻辑回归分析了每个污染物增加 10μg/m 与 CHD 以及主要亚型之间的特定妊娠期中的关联。应用包含逻辑回归的分布式滞后模型来探索每周特定的关联。
共纳入 2013-2018 年期间的 196069 例单胎活产，发现 643 例 CHD（3.3‰）。结果显示，第一和第二孕期 CO 暴露增加了整体 CHD 风险，调整后的比值比（aOR）和 95%置信区间（CI）分别为 1.066（1.010-1.125）和 1.065（1.012-1.122）。对于 CHD 亚型，我们发现第一孕期的 NO 和 CO 以及第二孕期的 PM 和 PM 暴露与房间隔缺损（ASD）的风险相关，易感窗口主要发生在妊娠第 1-6 周。未观察到空气污染与法洛四联症之间存在正相关。
我们的研究结果表明，环境空气污染暴露与 CHD 的风险相关，尤其是 ASD，易感窗口通常发生在第一孕期。需要进一步设计良好的纵向研究来证实我们的发现。
