Maternal exposure to ambient air pollution and congenital heart defects in China

Bo-Yi Yang; Yanji Qu; Yuming Guo; Iana Markevych; Joachim Heinrich; Michael S. Bloom; Zhipeng Bai; Luke C. Knibbs; Shanshan Li; Gongbo Chen; Bin Jalaludin; Lidia Morawska; Meng Gao; Bin Han; Yunjiang Yu; Xiao-Xuan Liu; Yanqiu Ou; Jinzhuang Mai; Xiangmin Gao; Yong Wu; Zhiqiang Nie; Xiao-Wen Zeng; Li-Wen Hu; Xubo Shen; Yuanzhong Zhou; Shao Lin; Xiaoqing Liu; Guang-Hui Dong

Environment International (Aug 2021)

Maternal exposure to ambient air pollution and congenital heart defects in China

Bo-Yi Yang,
Yanji Qu,
Yuming Guo,
Iana Markevych,
Joachim Heinrich,
Michael S. Bloom,
Zhipeng Bai,
Luke C. Knibbs,
Shanshan Li,
Gongbo Chen,
Bin Jalaludin,
Lidia Morawska,
Meng Gao,
Bin Han,
Yunjiang Yu,
Xiao-Xuan Liu,
Yanqiu Ou,
Jinzhuang Mai,
Xiangmin Gao,
Yong Wu,
Zhiqiang Nie,
Xiao-Wen Zeng,
Li-Wen Hu,
Xubo Shen,
Yuanzhong Zhou,
Shao Lin,
Xiaoqing Liu,
Guang-Hui Dong

Affiliations

Bo-Yi Yang: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Yanji Qu: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Yuming Guo: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
Iana Markevych: Institute of Psychology, Jagiellonian University, Poland
Joachim Heinrich: Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Ziemssenstraße 1, 80336 Munich, Germany; Comprehensive Pneumology Center Munich, German Center for Lung Research, Ziemssenstraße 1, 80336 Munich, Germany
Michael S. Bloom: Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA
Zhipeng Bai: State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
Luke C. Knibbs: School of Public Health, The University of Queensland, Herston, Queensland 4006, Australia
Shanshan Li: Department of Epidemiology and Preventive Medicine, School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC 3004, Australia
Gongbo Chen: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Bin Jalaludin: Centre for Air Quality and Health Research and Evaluation, Glebe, NSW 2037, Australia; Population Health, South Western Sydney Local Health District, Liverpool, NSW 2170, Australia; Ingham Institute for Applied Medical Research, Liverpool, NSW 2170, Australia; School of Public Health and Community Medicine, The University of New South Wales, Kensington, NSW 2052, Australia
Lidia Morawska: International Laboratory for Air Quality and Health, Queensland University of Technology (QUT), GPO Box 2434, Brisbane, Queensland 4001, Australia
Meng Gao: Department of Geography, Hong Kong Baptist University, Hong Kong Special Administrative Region
Bin Han: State Key Laboratory of Environmental Criteria and Risk Assessment, Chinese Research Academy of Environmental Sciences, Beijing, China
Yunjiang Yu: State Environmental Protection Key Laboratory of Environmental Pollution Health Risk Assessment, South China Institute of Environmental Sciences, Ministry of Environmental Protection, Guangzhou, China
Xiao-Xuan Liu: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Yanqiu Ou: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Jinzhuang Mai: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Xiangmin Gao: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Yong Wu: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Zhiqiang Nie: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China
Xiao-Wen Zeng: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Li-Wen Hu: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China
Xubo Shen: School of Public Health, Zunyi Medical University, Zunyi 563060, China
Yuanzhong Zhou: School of Public Health, Zunyi Medical University, Zunyi 563060, China
Shao Lin: Departments of Environmental Health Sciences and Epidemiology and Biostatics, University at Albany, State University of New York, Rensselaer, NY 12144, USA; Corresponding authors.at: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (Guang-Hui Dong). Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences (Xiaoqing Liu). Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York 12144-3445, USA (Shao Lin).
Xiaoqing Liu: Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong General Hospital, China; Corresponding authors.at: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (Guang-Hui Dong). Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences (Xiaoqing Liu). Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York 12144-3445, USA (Shao Lin).
Guang-Hui Dong: Guangdong Provincial Engineering Technology Research Center of Environmental and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China; Corresponding authors.at: Guangzhou Key Laboratory of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, 74 Zhongshan 2nd Road, Yuexiu District, Guangzhou 510080, China (Guang-Hui Dong). Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial People’s Hospital, Guangdong Academy of Medical Sciences (Xiaoqing Liu). Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, State University of New York, Albany, New York 12144-3445, USA (Shao Lin).

Journal volume & issue: Vol. 153
p. 106548

Abstract

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Background: Evidence of maternal exposure to ambient air pollution on congenital heart defects (CHD) has been mixed and are still relatively limited in developing countries. We aimed to investigate the association between maternal exposure to air pollution and CHD in China. Method: This longitudinal, population-based, case-control study consecutively recruited fetuses with CHD and healthy volunteers from 21 cities, Southern China, between January 2006 and December 2016. Residential address at delivery was linked to random forests models to estimate maternal exposure to particulate matter with an aerodynamic diameter of ≤ 1 µm (PM1), ≤2.5 µm, and ≤10 µm as well as nitrogen dioxides, in three trimesters. The CHD cases were evaluated by obstetrician, pediatrician, or cardiologist, and confirmed by cardia ultrasound. The CHD subtypes were coded using the International Classification Diseases. Adjusted logistic regression models were used to assess the associations between air pollutants and CHD and its subtypes. Results: A total of 7055 isolated CHD and 6423 controls were included in the current analysis. Maternal air pollution exposures were consistently higher among cases than those among controls. Logistic regression analyses showed that maternal exposure to all air pollutants during the first trimester was associated with an increased odds of CHD (e.g., an interquartile range [13.3 µg/m3] increase in PM1 was associated with 1.09-fold ([95% confidence interval, 1.01–1.18]) greater odds of CHD). No significant associations were observed for maternal air pollution exposures during the second trimester and the third trimester. The pattern of the associations between air pollutants and different CHD subtypes was mixed. Conclusions: Maternal exposure to greater levels of air pollutants during the pregnancy, especially the first trimester, is associated with higher odds of CHD in offspring. Further longitudinal well-designed studies are warranted to confirm our findings.

Published in Environment International

ISSN: 0160-4120 (Print)
Publisher: Elsevier
Country of publisher: United Kingdom
LCC subjects: Geography. Anthropology. Recreation: Environmental sciences
Website: https://www.journals.elsevier.com/environment-international

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