Ambient Air Pollution and Risk of Congenital Anomalies: A Systematic Review and Meta-analysis

Abstract

ObjectiveWe systematically reviewed epidemiologic studies on ambient air pollution and congenital anomalies and conducted meta-analyses for a number of air pollutant–anomaly combinations.Data sources and extractionFrom bibliographic searches we extracted 10 original epidemiologic studies that examined the association between congenital anomaly risk and concentrations of air pollutants. Meta-analyses were conducted if at least four studies published risk estimates for the same pollutant and anomaly group. Summary risk estimates were calculated for a) risk at high versus low exposure level in each study and b) risk per unit increase in continuous pollutant concentration.Data synthesisEach individual study reported statistically significantly increased risks for some combinations of air pollutants and congenital anomalies, among many combinations tested. In meta-analyses, nitrogen dioxide (NO2) and sulfur dioxide (SO2) exposures were related to increases in risk of coarctation of the aorta [odds ratio (OR) per 10 ppb NO2 = 1.17; 95% confidence interval (CI), 1.00–1.36; OR per 1 ppb SO2 = 1.07; 95% CI, 1.01–1.13] and tetralogy of Fallot (OR per 10 ppb NO2 = 1.20; 95% CI, 1.02–1.42; OR per 1 ppb SO2 = 1.03; 95% CI, 1.01–1.05), and PM10 (particulate matter ≤ 10 μm) exposure was related to an increased risk of atrial septal defects (OR per 10 μg/m3 = 1.14; 95% CI, 1.01–1.28). Meta-analyses found no statistically significant increase in risk of other cardiac anomalies and oral clefts.ConclusionsWe found some evidence for an effect of ambient air pollutants on congenital cardiac anomaly risk. Improvements in the areas of exposure assessment, outcome harmonization, assessment of other congenital anomalies, and mechanistic knowledge are needed to advance this field.

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“…Air pollutants in diesel exhaust include NO 2 , SO 2 , PM, and PAHs. A meta-analysis of four studies suggested associations of maternal NO 2 and SO 2 exposures with coarctation of the aorta and tetralogy of Fallot, and of maternal PM 10 exposure with arterial septal defects (Vrijheid et al 2011). Two casecontrol studies in China reported positive associations between PAH concentrations in maternal blood and the placenta and NTDs Naufal et al 2010).…”

A rapid assessment of the impact of hazard reduction burning around Sydney, May 2016

“…A recent and thorough review concluded that SO 2 was associated with preterm birth, but not consistently with low birth weight or small for gestational age births (Shah & Balkhair, 2011). A review by Vrijheid et al (2011) found some evidence for an association between SO 2 and congenital cardiac anomalies. A thorough veterinary epidemiology SO 2 study in Western Canada examined whether emissions from the oil and gas industry (including SO 2 ) were associated with effects on the reproduction and health of beef cattle.…”

Ambient and household air pollution: complex triggers of disease

“…The impact of air pollution exposure and its negative effect on fetal growth continue to be a focus of current research. Studies have shown associations between exposure and negative birth outcomes including, but not limited to, LBW, preterm birth, reduced birth length, and congenital anomalies (71,80). These studies, with varying methods and results, hypothesized that exposure to air pollution has a direct, negative effect on fetal health and growth.…”