Department of Echocardiography, Maternal-Fetal Medicine Research Consultation Center, Beijing Anzhen Hospital, Capital Medical University, Beijing, 100029, China.
Institute of Child and Adolescent Health, School of Public Health, Peking University; National Health Commission Key Laboratory of Reproductive Health, Beijing 100191, China.
Ecotoxicol Environ Saf. 2024 May;276:116328. doi: 10.1016/j.ecoenv.2024.116328. Epub 2024 Apr 17.
The relationships between maternal genetic and environmental exposure and conotruncal heart defects (CTDs) have been extensively investigated. Nevertheless, there is limited knowledge regarding the impact of ozone (O) on the risk of CTDs.
To explore the correlation between maternal exposure to O and CTDs in China.
Pregnant women who underwent fetal echocardiography at Beijing Anzhen Hospital between January 2013 and December 2021 were enrolled. Their sociodemographic characteristics and lifestyle information, along with fetal data, were systematically collected. Fetal echocardiography was used to detect CTDs. Maternal exposure to ambient O during the embryonic period, the first trimester, the three months preceding the last menstrual period, and the perinatal period was estimated using residential addresses or hospital addresses associated with prenatal visits. The concentration of O was divided by quartiles, with the first quartile serving as a reference. Adjusted logistic regression models were employed to examine the associations between every 10 μg/m increase or quartile increase in ambient O exposure and CTDs.
Among 24,278 subjects, 1069 exhibited fetuses with CTDs. Maternal exposure to ambient O during three pregnancy periods was associated with increased CTD risk. The adjusted odds ratio (OR) and 95% confidence interval (CI) were 1.271 (1.189-1.360) per 10 μg/m increase in O during the perinatal period. For each quartile of O the risk increased with increasing exposure concentration, particularly during the perinatal period (OR = 2.206 for quartile 2, 2.367 for quartile 3, and 3.378 for quartile 4, all P<0.05).
Elevated maternal exposure to O during pregnancy, particularly in the perinatal period, is linked to an increased risk of fetal CTDs. Further longitudinal analyses are needed to validate these results.
母体遗传和环境暴露与圆锥动脉干畸形（CTD）之间的关系已得到广泛研究。然而，关于臭氧（O）对 CTD 风险的影响知之甚少。
探讨中国孕妇暴露于臭氧与 CTD 的相关性。
本研究纳入了 2013 年 1 月至 2021 年 12 月在北京安贞医院进行胎儿超声心动图检查的孕妇。系统收集了她们的社会人口统计学特征和生活方式信息以及胎儿数据。使用胎儿超声心动图检测 CTD。通过孕妇住址或产前检查就诊医院地址评估胚胎期、妊娠早期、末次月经前三个月和围产期的环境 O 暴露。将 O 浓度分为四分位数，以第一四分位数为参照。采用调整后的 logistic 回归模型来检验 O 暴露每增加 10μg/m 或四分位间距与 CTD 之间的关系。
在 24278 例受试者中，有 1069 例胎儿患有 CTD。三个孕期的母体环境 O 暴露与 CTD 风险增加相关。围产期 O 每增加 10μg/m，调整后的比值比（OR）和 95%置信区间（CI）为 1.271（1.189-1.360）。O 暴露浓度每增加一个四分位间距，风险也随之增加，尤其是在围产期（OR=2.206 四分位 2，OR=2.367 四分位 3，OR=3.378 四分位 4，均 P<0.05）。
孕妇妊娠期间，尤其是围产期暴露于 O 水平升高，与胎儿 CTD 风险增加相关。需要进一步的纵向分析来验证这些结果。
