| ObjectiveTo investigate the relationship between maternal exposure to ambient inhalableparticulate matters (PM10) in the first trimester of pregnancy and the risk of fetalcardiovascular malformations.MethodsRelationship between exposure to airborne PM10during1,2,3and1-3months ofgestation and the risk of fetal cardiovascular malformations in pregnant women withdeformed fetuses, which was paralleled normal pregnant women with discrepancy ofconception date <30days as the control, were retrospectively analyzed by case-controlstudy from May2007to April2012. Ambient air quality measurements of the mean dailyPM10concentration from January1st,2007to April30ty,2012were provided by FujianProvincial Environmental Monitoring Center. Each individual PM10exposure wasdetermined by the latitude and longitude of every pregnant woman, which is calculated bytheir detailed home addresses. Multivariate Logistic regression adjusted for potentialconfounders including maternal age, gravidity and parity was performed for the dataanalysis.Results1The mean daily PM10concentration fluctuated wildly from7μg/m3to220μg/m3.PM10concentration was highest in the first quarter while lowest in the third quarter inFuzhou area.2From May2007to April2012, a total of80527fetuses were born in FuzhouGeneral Hospital of Nanjing Military Command and Fujian Provincial Maternal and ChildHealth Hospital, among which1206were subjected to deformity. The incidence of birth defects was14.98‰(1206/80527), and of fetal cardiovascular malformations7.36‰(593/80527). During the study period, the rate of birth defects showed an increasingtendency. The first four types of the birth defects were fetal cardiovascular malformations(593cases), facial-cervical anomalies (137cases), neurologic anomalies (116cases) andgenitourinary anomalies (94cases). Among typies of cardiovascular malformations, thefirst four types were ventricular septal defect (189cases), patent ductus arteriosus (174cases), atrial septal defects (113cases) and tetralogy of fallot (58cases). Maternal age≥35years has been investigated as a potential risk factor for cardiovascular malformations.3According to the inclusion and exclusion criteria,576pregnant women withcardiovascular malformations were enrolled. The average levels of PM10exposed in thepregnant women with fetal cardiovascular anomalies and atrial septal defect during1–3months of gestation were separately significantly higher than those in the controls[(70.80±13.09) μg/m3vs (69.61±12.25) μg/m3, t=2.066, P=0.040;(72.98±13.19) μg/m3vs (70.30±13.35) μg/m3，t=2.147，P=0.035], but PM10exposure in the1st,2nd and3rdmonth of pregnancy was comparable between the observed and control groups (P>0.05)[(71.01±17.50) μg/m3vs (69.62±16.36) μg/m3,(70.74±17.12) μg/m3vs (69.78±16.68)μg/m3,(69.00±16.37) μg/m3vs (68.75±15.87) μg/m3;(71.54±17.15) μg/m3vs(70.26±16.06) μg/m3,(71.36±17.06) μg/m3vs (70.79±18.05) μg/m3,(67.53±16.32) μg/m3vs (68.31±15.15) μg/m3]. There were no significant differences of PM10exposure levelswhen compared between the groups of ventricular septal defect, patent ductus arteriosusand tetralogy of fallot and their corresponding controls (P>0.05). The results of logisticregression, which adjusted for potential confounders including maternal age, gravidity andparity, showed that maternal exposure to airborne PM10during1–3months of gestationincreased the the risk of fetal cardiovascular malformations and atrial septal defects.Meanwhile there was no relationship between maternal age, gravidity, parity and the risk offetal cardiovascular malformations. The higher of PM10exposure levels during1–3monthsof gestation was, the higher risk of fetal cardiovascular malformations and atrial septaldefects was. Each increased quartile of the PM10exposure levels was associated with anelevated risk of fetal cardiovascular anomalies by1.034folds (B=0.034, OR=1.034, 95%CI:1.008~1.061, P=0.010) and atrial septal defect by1.045folds (B=0.044, OR=1.045,95%CI:1.001~1.092, P=0.047).ConclusionsBased on the condition of PM10levels in Fuzhou area, maternal exposure to airbornePM10in the first trimester of pregnancy exerts negative effects on the pathogenesis of fetalcardiovascular anomalies. |
PDF Full Text Request