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

the National Birth Defects Prevention Study

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background/objective: 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. Methods: 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. Results: 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. Conclusion: 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.

Original languageEnglish (US)
Pages (from-to)211-221
Number of pages11
JournalEnvironment International
Volume118
DOIs
StatePublished - Sep 1 2018

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pregnancy
defect
summer
exposure
phenotype
logistics

Keywords

  • Cardiovascular defects
  • Extreme heat indicators
  • Heat waves
  • Maternal environmental exposure
  • Pregnancy
  • Seasonal effects

ASJC Scopus subject areas

  • Environmental Science(all)

Cite this

Maternal ambient heat exposure during early pregnancy in summer and spring and congenital heart defects – A large US population-based, case-control study. / the National Birth Defects Prevention Study.

In: Environment International, Vol. 118, 01.09.2018, p. 211-221.

Research output: Contribution to journalArticle

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abstract = "Background/objective: 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. Methods: 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. Results: 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. Conclusion: 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.",
keywords = "Cardiovascular defects, Extreme heat indicators, Heat waves, Maternal environmental exposure, Pregnancy, Seasonal effects",
author = "{the National Birth Defects Prevention Study} and Shao Lin and Ziqiang Lin and Yanqiu Ou and Aida Soim and Srishti Shrestha and Yi Lu and Scott Sheridan and Luben, {Thomas J.} and Edward Fitzgerald and Erin Bell and Shaw, {Gary M.} and Jennita Reefhuis and Langlois, {Peter H.} and Paul Romitti and Feldkamp, {Marcia L.} and Sadia Malik and Cristian Pantea and Seema Nayak and Hwang, {Syni An} and Marilyn Browne",
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AU - the National Birth Defects Prevention Study

AU - Lin, Shao

AU - Lin, Ziqiang

AU - Ou, Yanqiu

AU - Soim, Aida

AU - Shrestha, Srishti

AU - Lu, Yi

AU - Sheridan, Scott

AU - Luben, Thomas J.

AU - Fitzgerald, Edward

AU - Bell, Erin

AU - Shaw, Gary M.

AU - Reefhuis, Jennita

AU - Langlois, Peter H.

AU - Romitti, Paul

AU - Feldkamp, Marcia L.

AU - Malik, Sadia

AU - Pantea, Cristian

AU - Nayak, Seema

AU - Hwang, Syni An

AU - Browne, Marilyn

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KW - Extreme heat indicators

KW - Heat waves

KW - Maternal environmental exposure

KW - Pregnancy

KW - Seasonal effects

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