Maternal air pollution exposure and neonatal congenital heart disease: A multi-city cross-sectional study in eastern China

Li, Die; Xu, Weize; Qiu, Yue; Pan, Feixia; Lou, Hongliang; Li, Jing; Jin, Yueqin; Wu, Ting; Pan, Lulu; An, Jing; Xu, Junqiu; Cheng, Wei; Tao, Linghua; Lei, Yongliang; Huang, Chengyin; Yin, Fei; Shu, Qiang

doi:10.1016/j.ijheh.2021.113898

Cited by 10 publications

(8 citation statements)

References 29 publications

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“…To interpret the role of socioeconomic and geographic modifiers, we executed city-specific indicators as meta-predictors accounting for the potential and presented by Cochran Q test and I -squared ( I 2 ) statistics. The source of other modifiers, namely, latitude (geographic index), urbanized population, and AYE (socioeconomic indexes), is consistent with our previous article (Li et al 2022 ).…”

Section: Methodssupporting

confidence: 90%

“…Gestational week and relative humidity were then adapted as continuous variables by natural cubic spline function. Our previous publication (Li et al 2022 ) based on the same material found positive associations between ambient air pollution and CHD. Hence, we further adjusted ambient PM 2.5 concentration level in GLM according to Mostofsky et al’s literature (Mostofsky et al 2012 ).…”

Section: Methodsmentioning

confidence: 63%

“…We collected time-series daily data, including CHD counts and weather variables, from 358 township medical institutions in 11 cities in eastern China. The geographical characteristics of the study area have been reported in our previous literature (Li et al 2022 ). The weather indicators in this study were derived from Shanghai Qingyue (http: //data.epmap.org) which has been introduced in an earlier study (Li et al 2022 ).…”

Section: Methodsmentioning

confidence: 99%

“…The geographical characteristics of the study area have been reported in our previous literature (Li et al 2022 ). The weather indicators in this study were derived from Shanghai Qingyue (http: //data.epmap.org) which has been introduced in an earlier study (Li et al 2022 ). Exposure assessments for all residents were represented by the mean daily temperature within a city.…”

Section: Methodsmentioning

confidence: 99%

“…The CHD case data were extracted from the NPCHD from Jan 1 st , 2019, to Dec 31 th , 2020, in 11 cities described in our previous article (Li et al 2022 ). In brief, approximately 90.19% of neonates born in the study region accomplished the two-step screening method according to the Chinese National Comprehensive Program for the Prevention and Treatment of Birth Defects during the study period: First, POX (pulse oximetry) plus cardiac auscultation method was used within 3 days after birth.…”

Section: Methodsmentioning

confidence: 99%

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The prenatal weekly temperature exposure and neonatal congenital heart disease: a large population-based observational study in China

Shao

et al. 2022

Environ Sci Pollut Res

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We aim to explore the link between maternal weekly temperature exposure and CHD in offspring and identify the relative contributions from heat and cold and from moderate and extreme atmospheric temperature. From January 2019 to December 2020, newborns who were diagnosed with CHD by echocardiography in the Network Platform for Congenital Heart Disease (NPCHD) from 11 cities in eastern China were enrolled in the present study. We appraised the exposure lag response relationship between temperature and CHDs in the distributed lag nonlinear model and further probed the pooled estimates by multivariate meta-analysis. We further performed the exposure–response curves in extreme temperature (5 th percentile for cold and 95 th for hot events). We also delve into the cumulative risk ratios (CRRs) of temperature on CHDs in general and subgroups. In this study, 5904 of 983, 523 infants were diagnosed with CHDs. The temperature-CHD combination performed positive significance in two exposure windows, gestational weeks 10–16 and 26–31, and reached the maximum effect in the 28th week. Compared with extreme cold (5 th , 6.14℃), these effects were higher in extreme heat (95 th , 29.26℃). The cumulative exposure–response curve showed a steep nonlinear rise in the hot tail but showed non-significance at low temperatures. In this range, the CRRs of temperature showed an increment to a ceiling of 3.781 (95% CI: 1.460–10.723). The temperature- CHD curves for both sex groups showed a general growth trend. No statistical significance was observed between these two groups ( P = 0.106). The cumulative effect of the temperature related CHD was significant in regions with lower education levels (maximum CRR was 9.282 (3.019–28.535)). A degree centigrade increase in temperature exposure was associated with the increment of CHD risk in the first and second trimesters, especially in extreme heat. Neonates born in lower education regions were more vulnerable to temperature-related CHDs. Supplementary Information The online version contains supplementary material available at 10.1007/s11356-022-24396-5.

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Section: Methodssupporting

confidence: 90%

Section: Methodsmentioning

confidence: 63%