| Objectives The aims of this study were to know the incidence of birth defects and air pollution status of a city from 2010 to 2013, and to investigate the association between the air pollutions and birth defects. To provide a scientific basis for the development of relevant interventions, which reduce the incidence of birth defects and perinatal mortality and improve the quality of population.Methods This study used a retrospective cohort study. Collecting,sorting and analyzing the birth defects monitoring data, meteorological data and air pollution data of a city. Perinatal and maternal data from the city Maternal and Child Health, which were collected by each hospital reported "birth defects registration card" and "perinatal quarters Reports". Meteorological data obtained from China Meteorological Data Sharing Service System, including monthly average of atmospheric pressure, wind speed, temperature and relative humidity for the duration between 2010 and 2013. Air pollution data were obtained from the city Environmental Monitoring Center. Air pollutants obtain sulfur dioxide(SO2), nitrogen dioxide(NO2) and PM10. We used logistic regression analyses to examine the association between air pollution and birth defects with SPSS 17.0 software.Results1 Characteristics of birth defects:Perinatal monitoring for 22639 cases with 530 cases children with birth defects, and the total incidence of birth defects was 23.41‰ during 2010 and 2013. In different ages of pregnant women, different family income and maternal education level, the incidencesof birth defects were no significant difference. Men in the higher incidence of birth defects than women, rates were 27.14‰, 18.45‰, and the difference was statistically significant(χ2=18.89,P<0.01).2 Results of meteorological dataChanges in the magnitude of the mean monthly air pressure is not big, mean 101.23 ± 0.85 k Pa, and the difference between the mean pressure was statistically significant(F= 40.01, P<0.01) in different years. Changes in wind speed range 1.70~3.70m/s, monthly mean 2.36±0.46m/s, the difference was statistically significant(F=753.00, P<0.01). Monthly mean temperature was 16.94±9.04℃, the difference was not statistically significant(F=0.13, P=0.94). Relative humidity fluctuation, and monthly mean of 69.60%±6.27%, the average difference was statistically significant(F=115.61, P<0.01).3 Results of air pollution dataMonthly average concentration of SO2 was 39.82±14.65μg/m3, and the difference was statistically significant(F=87.16, P<0.01). Monthly average concentration of NO2 was 39.82±14.65μg/m3, and the difference was statistically significant(F=10.22, P<0.01). Monthly average concentration of PM10 was 88.78±29.75μg/m3, and the difference was statistically significant(F=40.36, P<0.01).4 SO2 and birth defectsIn single pollutant model, the odds ratios(RR) of birth defects was 1.09,with 95%CI 1.03-1.16, for exposure to SO2 10μg/m3 increase in the first month of preconception, which was statistically significant(P<0.01). The odds ratios(RR) of birth defects were 1.12(1.05-1.18), 1.09(1.03-1.16)and 1.12(1.04-1.18) respectively, in the first three months of pregnancy, with statistically significant(P<0.01). The RR values of birth defects were 1.07(1.02-1.14), 1.12(1.06-1.18) and 1.08(1.02-1.15), in the three months before delivery, which was statistically significant(P<0.01).In multiple pollutants model, the association between SO2 and birth defects wasstatistically significant(RR=1.08, 95%CI: 1.02-1.16, P<0.01), for exposure to SO2 10μg/m3 increase in the first month before pregnancy. The association between SO2 and birth defects was statistically significant(RR=1.08, 95%CI: 1.02-1.15, P<0.05), for exposure to SO2 10μg/m3 increase in the third month of pregnancy. The association between SO2 and birth defects was statistically significant(RR=1.07, 95%CI: 1.01-1.14, P<0.05), for exposure to SO2 10μg/m3 increase in the first month before delivery. The association between SO2 and birth defects was statistically significant(RR=1.12, 95%CI: 1.05-1.18, P<0.01), for exposure to SO2 10μg/m3 increase in the second month before delivery.Multivariate Logistic regression analysis of different gestational exposure to SO2 at different seasons of birth defects affect the results show: the first month and the second month before pregnancy in the winter when exposed to SO2 can increase the risk of birth defects, increased by 10μg/m3 for birth defects,and the RR values were 1.47 and 1.16, respectively, 95%CI:(1.31-1.64) and(1.03-1.31), and there was statistically significant(P<0.01); the first month of pregnant in the fall when exposed to SO2 the risk is increased by 10μg /μg/m3 increase in birth defects 1.35 times(RR =1.35, 95%CI:1.29-2.11); the third month before delivery SO2 exposure is increased in the fall when 10μg/m3 increase in birth defects 1.56 times(RR=1.56, 95%CI: 1.48-2.65).5 NO2 and birth defectsSingle factor analysis of birth defects, exposure to NO2 increased by 10μg/m3 can increase the risk of birth defects 1.23 times(RR=1.23, 95%CI: 1.07-1.42) and 1.27 times(RR=1.27,95%CI:1.10-1.47) in the first and second month before pregnancy, and there were statistical significance(P<0.01). Increasing the risk of birth defects 1.32 times for exposure to NO2 increased by 10μg/m3 in the second month of conception, with the RR 1.32 and 95%CI 1.14-1.52. Increasing the risk of congenital malformation 1.17 and 1.16 times for exposure to NO2 increased by 10μg/m3 in the first and third month of pregnancy, with the RR 1.17(1.02-1.37) and RR 1.16(1.00-1.36), and therelationship have statistical significance(P<0.05). Increasing the risk of congenital anomaly 1.24 times for exposure to NO2 increased by 10μg/m3 in the third month before delivery and was statistically significant(P<0.01), with RR 1.24(1.07-1.42). In multiple factors analysis, exposure to NO2 increased by 10μg/m3 can increase the risk of birth defects 1.21 times in second month before pregnancy(RR 1.21, 95%CI: 1.01-1.44), with statistically significant(P<0.05). Increasing the risk of congenital anomaly 1.20 times for exposure to NO2 increased by 10μg/m3 in the second month of pregnancy, with the RR 1.20, 95%CI: 1.01-1.41, and the association was statistically significant(P<0.05).Multivariate Logistic regression analysis of different gestational exposure to NO2 at different seasons of birth defects affect the results show: the second month before pregnancy in the summer when exposed to NO2 increased by 10μg/m3 for birth defects(RR=1.71, 95%CI:1.09-2.67), with statistical significance(P<0.05); the first month of pregnant and the third month before delivery in the fall when exposed to NO2 can increase the risk of birth defects, increased by 10μg/m3, the RR values were 2.08 and 3.94, respectively, 95%CI(1.60-2.71)and(2.81-5.55), and were statistically significant(P<0.01).6 PM10 and birth defectsIn single factor analysis, the odds ratios(RR) of congenital malformation were 1.09(1.04-1.15), 1.07(1.02-1.12) and 1.07(1.02-1.13), for exposure to PM10 in the three months before pregnancy, and there were statistical significance(P<0.01). The association between PM10 and birth defects was statistically significant(RR=1.08, 95%CI: 1.03-1.14, P<0.01; RR=1.09, 95%CI: 1.04-1.15, P<0.01 and RR=1.09, 95%CI: 1.04-1.14, P<0.01, respectively) in the first three months of pregnancy. The odds ratios(RR) of congenital anomaly were 1.05(1.01-1.08), 1.06(1.02-1.09) and 1.08(1.03-1.13), in the three months before delivery, with statistically significant(P<0.01).In multiple factors analysis, the association between PM10 and congenital anomaly wasstatistically significant(RR=1.07, 95%CI: 1.01-1.14, P<0.05), for exposure to PM10 10μg/m3 increase in the first month before pregnancy. Increasing the risk of birth defects for exposure to PM10 increased by 10μg/m3 in the first and second month of pregnancy, with the RR 1.06(1.01-1.12) and RR 1.06(1.00-1.12), and the association was statistically significant(P<0.05). The odds ratios(RR) of birth defects was 1.07, with 95%CI 1.02-1.13, for exposure to PM10 10μg/m3 increase in the second month of pregnancy, and there was statistical significance(P<0.01). The associations between PM10 and congenital malformation were statistically significant(RR=1.05, 95%CI: 1.01-1.08, P<0.01; RR=1.06, 95%CI: 1.02-1.10, P<0.01 and RR=1.05, 95%CI: 1.00-1.10, P<0.05, respectively) in the three months before delivery.Multivariate Logistic regression analysis of different gestational exposure to PM10 at different seasons of birth defects affect the results show: the first month pregnant in the fall during the exposure to PM10 increased risk of birth defects per 10μg/m3 increase occurred 1.95 times(RR=1.95, 95%CI:1.66-2.28), was statistically significant(P<0.01).Conclusions The incidence of birth defects was 23.41‰ in Anqing City during 2010-2013, lower than the national and global levels. The incidence of birth defects in male males higher than females. Different seasons of pregnancy impact on birth defects. Exposure to SO2, NO2 and PM10 increased the risk of birth defects in preconception period, the first trimester and the third trimester pregnant. |
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