Modeling complex effects of exposure to particulate matter and extreme heat during pregnancy on congenital heart defects: A U.S. population-based case-control study in the National Birth Defects Prevention Study

Details

• Alternative Title:
  Sci Total Environ
• Personal Author:
  Simmons, Will ; Lin, Shao ; Luben, Thomas J. ; Sheridan, Scott C. ; Langlois, Peter H. ; Shaw, Gary M. ; Reefhuis, Jennita ; Romitti, Paul A. ; Feldkamp, Marcia L. ; Nembhard, Wendy N. ; Desrosiers, Tania A. ; Browne, Marilyn L. ; Stingone, Jeanette A.
• Corporate Authors:
  National Birth Defects Prevention Study
• Description:
  Background/Objective.
  
  Research suggests gestational exposure to particulate matter ≤ 2.5 μm (PM2.5) and extreme heat may independently increase risk of birth defects. We investigated whether duration of gestational extreme heat exposure modifies associations between PM2.5 exposure and specific congenital heart defects (CHDs). We also explored nonlinear exposure-outcome relationships.
  
  Methods.
  
  We identified CHD case children (n = 2,824) and non-malformed live-birth control children (n = 4,033) from pregnancies ending between 1999 and 2007 in the National Birth Defects Prevention Study, a U.S. population-based multicenter case-control study. We assigned mothers 6-week averages of PM2.5 exposure during the cardiac critical period (postconceptional weeks 3–8) using the closest monitor within 50 kilometers of maternal residence. We assigned a count of extreme heat days (EHDs, days above the 90th percentile of daily maximum temperature for year, season, and weather station) during this period using the closest weather station. Using generalized additive models, we explored logit-nonlinear exposure-outcome relationships, concluding logistic models were reasonable. We estimated joint effects of PM2.5 and EHDs on six CHDs using logistic regression models adjusted for mean dewpoint and maternal age, education, and race/ethnicity. We assessed multiplicative and additive effect modification.
  
  Results.
  
  Conditional on the highest observed EHD count (15) and at least one critical period day during spring/summer, each 5 μg/m³ increase in average PM2.5 exposure was significantly associated with perimembranous ventricular septal defects (VSDpm; OR: 1.54 [95% CI: 1.01, 2.41]). High EHD counts (8+) in the same population were positively, but non-significantly, associated with both overall septal defects and VSDpm. Null or inverse associations were observed for lower EHD counts. Multiplicative and additive effect modification estimates were consistently positive in all septal models.
  
  Conclusions.
  
  Results provide limited evidence that duration of extreme heat exposure modifies the PM2.5-septal defects relationship. Future research with enhanced exposure assessment and modeling techniques could clarify these relationships.
  
  
• Subjects:
  Air Pollutants Case-Control Studies Child Extreme Heat Female Heart Defects, Congenital Humans Maternal Exposure Particulate Matter Pregnancy
• Keywords:
  Birth Outcomes Chlorination Congenital Heart Defects Household Water Treatment Particulate Matter Safe Water Storage Temperature Extremes
• Source:
  Sci Total Environ. 808:152150
• Pubmed ID:
  34864029
• Pubmed Central ID:
  PMC8758551
• Document Type:
  Journal Article
• Funding:
  R00 ES027022/ES/NIEHS NIH HHSUnited States/ ; U01 DD001223/DD/NCBDD CDC HHSUnited States/ ; U01 DD001231/DD/NCBDD CDC HHSUnited States/ ; U01DD001231/ACL/ACL HHSUnited States/ ; R21 ES021359/ES/NIEHS NIH HHSUnited States/ ; U01 DD001227/DD/NCBDD CDC HHSUnited States/ ; P30 ES023515/ES/NIEHS NIH HHSUnited States/ ; R15 ES028000/ES/NIEHS NIH HHSUnited States/ ; EP-D-18-001/EPA/EPAUnited States/ ; CDP 13-003/HX/HSRD VAUnited States/ ; P30 ES005605/ES/NIEHS NIH HHSUnited States/ ; K99 ES027022/ES/NIEHS NIH HHSUnited States/ ; P30 ES009089/ES/NIEHS NIH HHSUnited States/
• Volume:
  808
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:d9035f1ed897700371dc661593e57b845d80db674c842aaa956542250f8db184
• Download URL:
  https://stacks.cdc.gov/view/cdc/113372/cdc_113372_DS1.pdf
• File Type:
  [PDF - 868.88 KB ]