Liao Lihui, Xiang Liangcheng, Li Na, Li Shan
Department of Rehabilitation Medicine Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan, People's Republic of China.
J Air Waste Manag Assoc. 2025 Sep;75(9):757-766. doi: 10.1080/10962247.2025.2542158. Epub 2025 Aug 29.
Recent epidemiological studies conducted over the past ten years have increasingly investigated the association between ambient air pollution exposure and the risk of congenital heart defects, yet the findings have shown considerable inconsistency across different research populations and methodological approaches. This study sought to examine the association between maternal exposure to fine particulate matter (PM) during the critical first eight weeks of gestation and the risk of septal defects in offspring. A population-based case-control study in Beijing, China (2008-2012) was conducted to assess the association between maternal exposure to PM during the first eight weeks of pregnancy and the risk of septal defects in offspring. Multi-variable logistic regression regression models were used to estimated adjusted odds ratio (aOR) and corresponding 95% confidence intervals (CIs) for exposure-risk association, and the exposure-response association was investigated using restricted cubic spline analysis. Maternal exposure to PM were positively associated with the risk of overall septal defects in the 10-50 percentile (aOR = 2.415; 95%CI: 1.424 to 4.359), 51-90 percentile (aOR = 2.539; 95%CI: 1.472 to 4.643), and >90 percentile (aOR = 2.991; 95%CI: 1.601 to 5.832) groups during the fourth week, and in the 10-50 percentile (aOR = 1.432; 95%CI: 0.899 to 2.362), 51-90 percentile (aOR = 1.874; 95%CI: 1.162 to 3.128), and > 90 percentile (aOR = 2.468; 95%CI: 1.398 to 4.453) groups during the fifth week, all compared with the < 10 percentile group. Non-isolated atrial septal defect demonstrated the strongest association with PM exposure during these weeks (aOR range: 1.882 to 4.382). Individual characteristics showed no meaningful effect modification. Furthermore, PM exposure exhibited a linear dose-response association with overall septal defects. This study identified a significant positive association between maternal exposure to ambient PM during the first eight gestational weeks and fetal septal defects.: This study demonstrates that maternal PM2.5 exposure, especially in the first trimester, increases congenital septal defect risk. The findings support stricter air quality policies for vulnerable populations and highlight a critical susceptibility window. Clinically, prenatal care should incorporate PM exposure reduction strategies, such as real-time air quality monitoring for pregnant individuals. Further research should explore PM's mechanistic pathways (e.g., oxidative stress, placental inflammation) in cardiac malformations. These results align with A&WMA's focus on air pollution management and its health impacts.
过去十年开展的近期流行病学研究越来越多地探究了环境空气污染暴露与先天性心脏缺陷风险之间的关联，但研究结果显示，在不同研究人群和方法学途径中存在相当大的不一致性。本研究旨在探讨孕期头八周孕妇暴露于细颗粒物（PM）与后代患间隔缺损风险之间的关联。在中国北京开展了一项基于人群的病例对照研究（2008 - 2012年），以评估孕期头八周孕妇暴露于PM与后代患间隔缺损风险之间的关联。使用多变量逻辑回归模型估计暴露 - 风险关联的调整优势比（aOR）及相应的95%置信区间（CI），并使用受限立方样条分析研究暴露 - 反应关联。与<10百分位数组相比，在第四周时，孕妇暴露于PM的10 - 50百分位数组（aOR = 2.415；95%CI：1.424至4.359）、51 - 90百分位数组（aOR = 2.539；95%CI：1.472至4.643）和>90百分位数组（aOR = 2.991；95%CI：1.601至5.832），以及在第五周时，10 - 50百分位数组（aOR = 1.432；95%CI：0.899至2.362）、51 - 90百分位数组（aOR = 1.874；95%CI：1.162至3.128）和>90百分位数组（aOR = 2.468；95%CI：1.398至4.453）与总体间隔缺损风险呈正相关。非孤立性房间隔缺损在这些周与PM暴露的关联最强（aOR范围：1.882至4.382）。个体特征未显示出有意义的效应修饰作用。此外，PM暴露与总体间隔缺损呈现线性剂量 - 反应关联。本研究确定了孕期头八周孕妇暴露于环境PM与胎儿间隔缺损之间存在显著正相关。：本研究表明，孕妇暴露于PM2.5，尤其是在孕早期，会增加先天性间隔缺损风险。这些发现支持针对弱势群体制定更严格的空气质量政策，并突出了一个关键的易感窗口。临床上，产前护理应纳入减少PM暴露的策略，如为孕妇进行实时空气质量监测。进一步研究应探索PM在心脏畸形中的作用机制途径（如氧化应激、胎盘炎症）。这些结果与美国空气与废弃物管理协会对空气污染管理及其健康影响的关注相一致。
