Journal article
Maternal exposure to outdoor air pollution and congenital limb deficiencies in the National Birth Defects Prevention Study
Environmental research, Vol.179(Pt A), pp.108716-108716
12/2019
DOI: 10.1016/j.envres.2019.108716
PMCID: PMC6842662
PMID: 31546130
Abstract
Congenital limb deficiencies (CLDs) are a relatively common group of birth defects whose etiology is mostly unknown. Recent studies suggest maternal air pollution exposure as a potential risk factor.
To investigate the relationship between ambient air pollution exposure during early pregnancy and offspring CLDs.
The study population was identified from the National Birth Defects Prevention Study, a population-based multi-center case-control study, and consisted of 615 CLD cases and 5,701 controls with due dates during 1997 through 2006. Daily averages and/or maxima of six criteria air pollutants (particulate matter <2.5 μm [PM2.5], particulate matter <10 μm [PM10], nitrogen dioxide [NO2], sulfur dioxide [SO2], carbon monoxide [CO], and ozone [O3]) were averaged over gestational weeks 2–8, as well as for individual weeks during this period, using data from EPA air monitors nearest to the maternal address. Logistic regression was used to estimate odds ratios (aORs) and 95% confidence intervals (CIs) adjusted for maternal age, race/ethnicity, education, and study center. We estimated aORs for any CLD and CLD subtypes (i.e., transverse, longitudinal, and preaxial). Potential confounding by co-pollutant was assessed by adjusting for one additional air pollutant. Using the single pollutant model, we further investigated effect measure modification by body mass index, cigarette smoking, and folic acid use. Sensitivity analyses were conducted restricting to those with a residence closer to an air monitor.
We observed near-null aORs for CLDs per interquartile range (IQR) increase in PM10, PM2.5, and O3. However, weekly averages of the daily average NO2 and SO2, and daily max NO2, SO2, and CO concentrations were associated with increased odds of CLDs. The crude ORs ranged from 1.03 to 1.12 per IQR increase in these air pollution concentrations, and consistently elevated aORs were observed for CO. Stronger associations were observed for SO2 and O3 in subtype analysis (preaxial). In co-pollutant adjusted models, associations with CO remained elevated (aORs: 1.02–1.30); but aORs for SO2 and NO2 became near-null. The aORs for CO remained elevated among mothers who lived within 20 km of an air monitor. The aORs varied by maternal BMI, smoking status, and folic acid use.
We observed modest associations between CLDs and air pollution exposures during pregnancy, including CO, SO2, and NO2, though replication through further epidemiologic research is warranted.
•Potential link between ambient air pollution during pregnancy and congenital limb deficiencies.•Elevated concentrations of CO, NO2, and SO2 during gestational weeks 2-8 were associated with increased odds of CLDs in single-pollutant models.•Association between CO and CLDs was robust to co-pollutant adjustment.•Effect estimates for NO2 and SO2 were attenuated towards the null when adjusting for CO.•Additionally analyses by subtypes and investigation of modification by maternal folic acid supplement, pre-pregnancy BMI, and smoking status.
Details
- Title: Subtitle
- Maternal exposure to outdoor air pollution and congenital limb deficiencies in the National Birth Defects Prevention Study
- Creators
- Giehae Choi - Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United StatesJeanette A Stingone - Department of Epidemiology, Columbia University, New York, NY, United StatesTania A Desrosiers - Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United StatesAndrew F Olshan - Department of Epidemiology, University of North Carolina, Chapel Hill, NC, United StatesWendy N Nembhard - Department of Epidemiology, Fay Boozman College of Public Health, University of Arkansas for Medical Sciences, Little Rock, AR, United StatesGary M Shaw - Stanford School of Medicine, Stanford, CA, United StatesShannon Pruitt - National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, United StatesPaul A Romitti - Department of Epidemiology, The University of Iowa, Iowa City, IA, United StatesMahsa M Yazdy - Massachusetts Department of Health, Boston, MA, United StatesMarilyn L Browne - New York State Department of Health, Albany, NY, United StatesPeter H Langlois - Texas Department of State Health Services, Austin, TX, United StatesLorenzo Botto - Division of Medical Genetics, Department of Pediatrics, University of Utah, Salt Lake City, UT, USAThomas J Luben - Office of Research and Development, U.S. Environmental Protection Agency, RTP, NC, United StatesNational Birth Defects Prevention Study
- Resource Type
- Journal article
- Publication Details
- Environmental research, Vol.179(Pt A), pp.108716-108716
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.envres.2019.108716
- PMID
- 31546130
- PMCID
- PMC6842662
- ISSN
- 0013-9351
- eISSN
- 1096-0953
- Grant note
- DOI: 10.13039/100000030, name: Centers for Disease Control and Prevention; name: North Carolina Center for Birth Defects Research and Prevention), award: U01DD001231; name: Centers for Birth Defects Research and Prevention, award: PA #96043, PA #02081, FOA #DD09-001, FOA #DD13-003, NOFO #DD18-001; DOI: 10.13039/100000066, name: National Institute of Environmental Health Sciences, award: T32ES007018
- Language
- English
- Date published
- 12/2019
- Academic Unit
- Epidemiology; Biostatistics
- Record Identifier
- 9984214949002771
Metrics
10 Record Views