These results suggest that both maternal asthma status (controlled vs. uncontrolled; severe vs. mild) and asthma medication use, particularly bronchodilators, may play a role in cardiac malformations in offspring.

The authors used a case-control design to evaluate the risk of central nervous system and musculoskeletal birth defects relative to exposure to solvents, metal, and pesticide contaminants from hazardous waste sites. Cases included 473 central-nervous-system-defect births and 3305 musculoskeletal-defect births to residents of 18 counties in New York State; controls comprised 12,436 randomly chosen normal births. For each address at birth, the authors assigned a probability of exposure to solvents, metals, and pesticides from hazardous waste sites in the study area (n = 643). They also rated residences by proximity to air releases from industrial facilities and by contamination of community water supplies. Compared with individuals for whom a low probability of exposure existed, mothers who resided in areas assigned a medium or high probability of exposure to hazardous waste contaminants did not show an increased risk of either type of birth defects. After adjusting for mother's race and age, prenatal care initiation, and population density, the resulting relative risks were as follows: central nervous system defects and exposure to solvents, 0.8 (95% confidence interval [CI] = .4, .6); central nervous system and metals, 1.0 (95% CI = 0.7, 1.7); musculoskeletal defects and solvents, 0.9 (95% CI = 0.5, 1.3); and musculoskeletal defects and pesticides, .8 (95% CI = .5, 1.3). With respect to central nervous system defects, there was an elevated risk associated with living near industrial facilities that emitted solvents (odds ratio = 1.3 [95% CI = 1.0, 1.7]) or metals (OR = 1.4, [95% CI = 1.0, 1.8]) into the air. The low proportion of individuals who had a medium or high probability of residential exposure to hazardous waste-site contaminants limited the investigation of particular pathways, disease subgroups, and/or geographic areas. Associations between central nervous system defects and industrial releases of solvents and metals need to be investigated further.

Our study found no evidence for an appreciable teratogenic effect of caffeine with regard to CVMs.

The objective of this study was to determine whether there were increases in respiratory and cardiovascular hospital admissions among residents of lower Manhattan after the destruction of the World Trade Center. The authors used hospital admission records from 1991 to 2001 with a diagnosis of respiratory, cardiovascular, or cerebrovascular illness and a residential address in lower Manhattan or Queens. The authors assessed the change in admissions by comparing lower Manhattan to Queens (the control area) and before and after 9/11 admissions in lower Manhattan. They found the following significant increases in hospital admissions: for respiratory illnesses during the weeks of 9/11/01 and 10/16/01; asthma during the week of 9/11/01; cardiovascular during the weeks of 9/18/01 and 10/9/01; cerebrovascular during the weeks of 9/11/01, 9/18/01, 10/2/01, and 10/9/01. There was an immediate increase in respiratory admissions after the disaster and a delayed increase in cardiovascular and cerebrovascular admissions.

Congenital cardiovascular malformations (CCM) cause substantial neonatal morbidity and mortality. Known risk factors for CCM explain only 10-20% of all cases. Few studies have examined mothers' physical exposures during pregnancy and the risk of CCM in their offspring. This study examined the association between exposures to extreme temperatures, prolonged standing, and heavy lifting during early pregnancy and risk of CCM in offspring. Using a case-control study design, 502 cases and 1066 controls were drawn from the population of all liveborn infants born between January 1988 and June 1991 to mothers living in 14 counties in New York State. Cases were identified from a population-based registry of congenital malformations. Controls were randomly selected from birth certificate records. Interviews were conducted by telephone, using a structured questionnaire. Exposure estimates were based on women's self-reports of conditions in the residence and workplace. Eighty-three per cent of the mothers were white, and 66% were between 25 and 34 years old. After adjusting all results for known risk factors and confounding variables, we found no significant increased risk of CCM in subjects whose mothers reported being exposed during early pregnancy to extreme heat (OR = 1.13, 95% CI 0.59, 2.19), nor to extreme cold (OR = 1.19, 95% CI 0.66, 2.15). Mothers who reported ever using a hot tub, hot bath, or sauna during early pregnancy had no increased risk of CCM in their offspring (OR = 0.88, 95% CI 0.65, 1.18). Performing heavy lifting during early pregnancy did not increase the risk of CCM in offspring (OR = 0.80, 95% CI 0.57, 1.11). Prolonged standing during early pregnancy was not associated with an increased risk of CCM in children (OR = 1.03, 95% CI 0.82, 1.28). Thus if these maternal exposures have an adverse effect, it is unlikely to involve CCMs.