Interaction of maternal medication use with ambient heat exposure on congenital heart defects in the National Birth Defects Prevention Study

Yanqiu Ou; Eleni A. Papadopoulos; Sarah C. Fisher; Marilyn L. Browne; Ziqiang Lin; Aida Soim; Yi Lu; Scott Sheridan; Jennita Reefhuis; Peter H. Langlois; Paul A. Romitti; Erin M. Bell; Marcia L. Feldkamp; Sadia Malik; Shao Lin; National Birth Defects Prevention Study

doi:10.1016/j.envres.2022.114217

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Interaction of maternal medication use with ambient heat exposure on congenital heart defects in the National Birth Defects Prevention Study

Journal article

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Interaction of maternal medication use with ambient heat exposure on congenital heart defects in the National Birth Defects Prevention Study

Yanqiu Ou, Eleni A. Papadopoulos, Sarah C. Fisher, Marilyn L. Browne, Ziqiang Lin, Aida Soim, Yi Lu, Scott Sheridan, Jennita Reefhuis, Peter H. Langlois, …

Environmental research, Vol.215 Part 1, 114217

12/2022

DOI: 10.1016/j.envres.2022.114217

PMCID: PMC10947356

PMID: 36041539

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https://pmc.ncbi.nlm.nih.gov/articles/PMC10947356/pdf/nihms-1971017.pdfView

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Abstract

Maternal exposure to weather-related extreme heat events (EHEs) has been associated with congenital heart defects (CHDs) in offspring. Certain medications may affect an individual's physiologic responses to EHEs. We evaluated whether thermoregulation-related medications modified associations between maternal EHE exposure and CHDs. We linked geocoded residence data from the U.S. National Birth Defects Prevention Study, a population-based case-control study, to summertime EHE exposures. An EHE was defined using the 90th percentile of daily maximum temperature (EHE90) for each of six climate regions during postconceptional weeks 3–8. Adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for associations between EHE90 and the risk of CHDs were estimated by strata of maternal thermoregulation-related medication use and climate region. Interaction effects were evaluated on multiplicative and additive scales. Over 45% of participants reported thermoregulation-related medication use during the critical period of cardiogenesis. Overall, these medications did not significantly modify the association between EHEs and CHDs. Still, medications that alter central thermoregulation increased aORs (95% CI) of EHE90 from 0.73 (0.41, 1.30) among non-users to 5.09 (1.20, 21.67) among users in the Southwest region, U.S. This effect modification was statistically significant on the multiplicative (P = 0.03) and additive scales, with an interaction contrast ratio (95% CI) of 1.64 (0.26, 3.02). No significant interaction was found for the maternal use of thermoregulation-related medications with EHEs on CHDs in general, while medications altering central thermoregulation significantly modified the association between EHEs and CHDs in Southwest U.S. This finding deserves further research. •The first study assessing how maternal medication use interacts with EHE on CHDs.•Over 45% pregnant women used thermoregulation medications during critical period.•Specific thermoregulation medicine amplified EHE's effect on CHDs in Southwest, U.S.•The medicine-EHE interaction was significant on multiplicative and additive scales.•Large geographic difference in modification of medicine on EHE-CHDs association.

Thermoregulation

Extreme heat events

Heart defects

Medication use during pregnancy

NBDPS

Details

Title: Subtitle: Interaction of maternal medication use with ambient heat exposure on congenital heart defects in the National Birth Defects Prevention Study
Creators: Yanqiu Ou - Guangdong Academy of Medical Sciences
Eleni A. Papadopoulos - Birth Defects Registry, New York State Department of Health, Albany, NY, USA
Sarah C. Fisher - Birth Defects Registry, New York State Department of Health, Albany, NY, USA
Marilyn L. Browne - Birth Defects Registry, New York State Department of Health, Albany, NY, USA
Ziqiang Lin - Department of Preventive Medicine, School of Basic Medicine and Public Health, Jinan University, Guangzhou, 510632, China
Aida Soim - Birth Defects Registry, New York State Department of Health, Albany, NY, USA
Yi Lu - Health Effects Institute
Scott Sheridan - Kent State University
Jennita Reefhuis - National Center on Birth Defects and Developmental Disabilities
Peter H. Langlois - Texas Department of State Health Services, Austin, TX, USA
Paul A. Romitti - Department of Epidemiology, The University of Iowa, Iowa City, IA, USA
Erin M. Bell - University at Albany, State University of New York
Marcia L. Feldkamp - University of Utah
Sadia Malik - University of Arkansas for Medical Sciences
Shao Lin - University at Albany, State University of New York
National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: Environmental research, Vol.215 Part 1, 114217
DOI: 10.1016/j.envres.2022.114217
PMID: 36041539
PMCID: PMC10947356
NLM abbreviation: Environ Res
ISSN: 0013-9351
eISSN: 1096-0953
Publisher: Elsevier Inc
Language: English
Date published: 12/2022
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9984293312602771

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