Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects – A large US population-based, case-control study

Shao Lin; Ziqiang Lin; Yanqiu Ou; Aida Soim; Srishti Shrestha; Yi Lu; Scott Sheridan; Thomas J Luben; Edward Fitzgerald; Erin Bell; Gary M Shaw; Jennita Reefhuis; Peter H Langlois; Paul Romitti; Marcia L Feldkamp; Sadia Malik; Cristian Pantea; Seema Nayak; Syni-An Hwang; Marilyn Browne; the National Birth Defects Prevention Study

doi:10.1016/j.envint.2018.04.043

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Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects – A large US population-based, case-control study

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Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects – A large US population-based, case-control study

Shao Lin, Ziqiang Lin, Yanqiu Ou, Aida Soim, Srishti Shrestha, Yi Lu, Scott Sheridan, Thomas J Luben, Edward Fitzgerald, Erin Bell, …

Environment international, Vol.118, pp.211-221

09/2018

DOI: 10.1016/j.envint.2018.04.043

PMCID: PMC6045445

PMID: 29886237

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https://doaj.org/article/0717b04d0d524e0891469c827bc17968View

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Abstract

Few studies have assessed the effect of ambient heat during the fetal development period on congenital heart defects (CHDs), especially in transitional seasons. We examined and compared the associations between extreme heat and CHD phenotypes in summer and spring, assessed their geographical differences, and compared different heat indicators. We identified 5848 CHD cases and 5742 controls (without major structural defects) from the National Birth Defects Prevention Study, a US multicenter, population-based case-control study. Extreme heat events (EHEs) were defined by using the 95th (EHE95) or 90th (EHE90) percentile of daily maximum temperature and its frequency and duration during postconceptional weeks 3–8. We used a two-stage Bayesian hierarchical model to examine both regional and study-wide associations. Exposure odds ratios (ORs) were calculated using multivariate logistic regression analyses, while controlling for potential confounding factors. Overall, we observed no significant relationships between maternal EHE exposure and CHDs in most regions during summer. However, we found that 3–11 days of EHE90 during summer and spring was significantly associated with ventricular septal defects (VSDs) study-wide (ORs ranged: 2.17–3.24). EHE95 in spring was significantly associated with conotruncal defects and VSDs in the South (ORs: 1.23–1.78). Most EHE indicators in spring were significantly associated with increased septal defects (both VSDs and atrial septal defects (ASDs)) in the Northeast. While generally null results were found, long duration of unseasonable heat was associated with the increased risks for VSDs and ASDs, mainly in South and Northeast of the US. Further research to confirm our findings is needed. •Exposure to extreme heat in summer was not consistently related to heart defects.•Conotruncal and septal defects were associated with long duration of heat in spring.•The adverse effects of unseasonable heat were found in the South and Northeast US.•Cumulative number of heat days was the most sensitive indicator.•It is critical to issue early warnings against heat's impact in transitional season.

Pregnancy

Heat waves

Cardiovascular defects

Extreme heat indicators

Seasonal effects

Maternal environmental exposure

Details

Title: Subtitle: Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects – A large US population-based, case-control study
Creators: Shao Lin - Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, United States
Ziqiang Lin - Department of Mathematics, University at Albany, Albany, NY, United States
Yanqiu Ou - Department of Epidemiology, Guangdong Cardiovascular Institute, Guangdong Provincial Key Laboratory of South China Structural Heart Disease, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China
Aida Soim - Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, United States
Srishti Shrestha - National Institute of Environmental Health Sciences
Yi Lu - Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, United States
Scott Sheridan - Department of Geography, Kent State University, Kent, OH, United States
Thomas J Luben - Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, United States
Edward Fitzgerald - Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, United States
Erin Bell - Department of Environmental Health Sciences, University at Albany, Rensselaer, NY, United States
Gary M Shaw - Stanford School of Medicine, Stanford, CA, United States
Jennita Reefhuis - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United States
Peter H Langlois - Texas Department of State Health Services, Austin, TX, United States
Paul Romitti - Department of Epidemiology, The University of Iowa, Iowa City, IA, United States
Marcia L Feldkamp - University of Utah School of Medicine, Salt Lake City, UT, United States
Sadia Malik - University of Arkansas for Medical Sciences, Little Rock, AR, United States
Cristian Pantea - New York State Department of Health, Albany, NY, United States
Seema Nayak - New York State Department of Health, Albany, NY, United States
Syni-An Hwang - Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, United States
Marilyn Browne - Department of Epidemiology and Biostatistics, University at Albany, Rensselaer, NY, United States
the National Birth Defects Prevention Study
Resource Type: Journal article
Publication Details: Environment international, Vol.118, pp.211-221
DOI: 10.1016/j.envint.2018.04.043
PMID: 29886237
PMCID: PMC6045445
NLM abbreviation: Environ Int
ISSN: 0160-4120
eISSN: 1873-6750
Publisher: Elsevier Ltd
Grant note: DOI: 10.13039/100000002, name: NIH, award: R21ES021359; DOI: 10.13039/100000030, name: CDC, award: U01EH000396
Language: English
Date published: 09/2018
Academic Unit: Epidemiology; Biostatistics
Record Identifier: 9983996194602771

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