Maternal occupational exposure to polycyclic aromatic hydrocarbons and congenital heart defects among offspring in the national birth defects prevention study

Lupo, Philip J.; Symanski, Elaine; Langlois, Peter H.; Lawson, Christina C.; Malik, Sadia; Gilboa, Suzanne M.; Lee, Laura; Agopian, A. J.; Desrosiers, Tania A.; Waters, Martha A.; Romitti, Paul A.; Correa, Adolfo; Shaw, Gary M.; Mitchell, Laura E.

doi:10.1002/bdra.23071

Cited by 41 publications

(22 citation statements)

References 29 publications

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“…According to the search strategy, a total of 20 citations were included in the meta-analysis. 4,14,15,19,[24][25][26][27][28][29][30][31][32][33][34][35][36][37][38][39] The characteristics and information of the eligible studies are shown in Supplemental Table I. Nine articles were written in English and 11 in Chinese.…”

Section: Resultsmentioning

confidence: 99%

A Meta-Analysis of the Relationship Between Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects

Cao

et al. 2016

Int. Heart J.

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SummaryControversial opinions exist with respect to the relationship between maternal folic acid (FA) supplementation and birth prevalence of congenital heart defects (CHDs).Eligible articles were retrieved by searching databases, including PubMed, Cochrane library, EMBASE, CNKI, and WanFang up to September 2015. A meta-analysis was performed to evaluate the effects of FA on CHDs. Odds ratios (ORs) and 95% confidence interval (CIs) were merged using STATA 12.0. Meta-regression analysis was used to explore the possible sources of heterogeneity. Subgroup analysis according to the selected sources was also performed. Publication bias was assessed by Egger's test.Twenty studies were included in the meta-analysis. The overall analysis showed that FA supplementation was significantly associated with decreased risk of CHDs. The meta-regression analysis showed that geographical area could be an important source of heterogeneity. The subgroup analysis based on the geographical area revealed that FA supplementation during pregnancy was a protective factor against CHDs in Chinese and European patients, but not in American patients. Subgroup analysis according to literature quality also displayed positive associations between FA supplementation and the decreased risk of CHDs of China.FA supplementation during pregnancy significantly decreases the risk of CHDs in newborns in China and Europe. (Int Heart J 2016; 57: 725-728) Key words: Literature search, Meta-regression analysis, Geographical area, Pregnancy C ongenital heart defects (CHDs) are the most common structural abnormalities presenting at birth, and they are also one of the leading causes of perinatal and infant mortality.1) It is reported that the prevalence of CHDs accounts for 6% of all neonatal death factors, and also accounts for 46% of all congenital lethal factors.2-4) Recently, the survival of newborns with CHDs has increased due to massive breakthroughs in cardiovascular diagnostics and cardiothoracic surgery, 5,6) however, this trend consequently generates a completely novel and steady increasing population with grown-up congenital heart disease (GUCH). Patients with GUCH often need long-term expert medical care with high healthcare-related costs. 7) Moreover, recently, an increasing number of women have postponed conception to an older age, which consequently results in a higher birth prevalence of congenital defects. 8,9) These defects lead to great economic pressure and mental burdens on society and the families, therefore, searching for effective prevention measures for CHDs is of great practical significance.Folic acid (FA) is an essential nutrient and plays an important role in the development of the cardiovascular system.10-12) The association of FA or multivitamins containing FA supplementation during the critical periods of organ formation with the risk of the occurrence of CHDs has been recognized in past decades. [13][14][15] Several studies have reported that FA or multivitamins containing FA supplementation taken during pregnancy could signifi...

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Section: Resultsmentioning

confidence: 99%

A Meta-Analysis of the Relationship Between Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects

Cao

et al. 2016

Int. Heart J.

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“…The association between PAH exposure with elevated risk of NTDs and other congenital malformations has been reported in several epidemiological studies [6-9, 25, 26], as well as in animal experiments [5, 27]. Few prior studies have reported any association between congenital malformations with level of PAH-DNA adducts, which represent DNA damage from exposure to PAHs.…”

Section: Discussionmentioning

confidence: 99%

Levels of PAH–DNA adducts in placental tissue and the risk of fetal neural tube defects in a Chinese population

Yuan¹,

Jin²,

Wang³

et al. 2013

Reproductive Toxicology

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We examined the relationship between PAH-DNA adduct levels in the placental tissue, measured by a highly sensitive 32P-postlabeling assay, and the risk of fetal neural tube defects (NTDs). We further explored the interaction between PAH-DNA adducts and placental PAHs with respect to NTD risk. Placental tissues from 80 NTD-affected pregnancies and 50 uncomplicated normal pregnancies were included in this case-control study. Levels of PAH-DNA adducts were lower in the NTD group (8.12 per 108 nucleotides) compared to controls (9.92 per 108 nucleotides). PAH-DNA adduct concentrations below the median was associated with a 3-fold increased NTD risk. Women with a low PAH-DNA adduct level in concert with a high placental PAH level resulted in a 10-fold elevated risk of having an NTD-complicated pregnancy. A low level of placental PAH-DNA adducts was associated with an increased risk of NTDs; this risk increased dramatically when a low adduct level was coupled with a high placental PAH concentration.

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“…Maternal occupational exposure to PAHs was associated with increased risks of congenital heart defects (Lupo et al, 2012b), gastroschisis (Lupo et al, 2012a) and NTDs (Langlois, Hoyt, 2012). In our previous study, maternal passive smoking and exposure to indoor coal combustion had been shown to be associated with an elevated NTD risk.…”

Section: Discussionmentioning

confidence: 99%

Levels of PAH–DNA adducts in cord blood and cord tissue and the risk of fetal neural tube defects in a Chinese population

Yuan

Jin

et al. 2015

NeuroToxicology

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Introduction Maternal exposure to polycyclic aromatic hydrocarbons (PAHs) has been shown to be associated with an elevated risk for neural tube defects (NTDs). In the human body, PAHs are bioactivated and the resultant reactive epoxides can covalently bind to DNA to form PAH-DNA adducts, which may, in turn, cause transcription errors, changes in gene expression or altered patterns of apoptosis. During critical developmental phases, these changes can result in abnormal morphogenesis. Objectives We aimed to examine the relationship between the levels of PAH-DNA adducts in cord blood and cord tissue and the risk of NTDs. Methods From 2010 to 2012, sixty NTD cases and 60 healthy controls were recruited from a population-based birth defects surveillance system in five counties of Shanxi Province in Northern China, where the emission of PAHs remains one of the highest in the country and PAHs exposure is highly prevalent. PAH-DNA adducts in cord blood of 15 NTD cases and 15 control infants, and in cord tissue of 60 NTD cases and 60 control infants were measured using the 32P-postlabeling method. Results PAH-DNA adduct levels in cord blood tend to be higher in the NTD group (28.5 per 108 nucleotides) compared with controls (19.7 per 108 nucleotides), although the difference was not statistically significant (P=0.377). PAH-DNA adducts in cord tissue were significantly higher in the NTD group (24.6 per 106 nucleotides) than in the control group (15.3 per 106 nucleotides), P=0.010. A positive dose-response relationship was found between levels of PAH-DNA adducts in cord tissue and the risk of NTDs (P=0.009). When the lowest tertile was used as the referent and potential confounding factors were adjusted for, a 1.03-fold (95% CI, 0.37–2.89) and 2.96-fold (95% CI, 1.16–7.58) increase in the risk of NTDs was observed for fetuses whose cord tissue PAH-DNA adduct levels were in the second and highest tertile, respectively. Conclusions High levels of PAH-DNA adducts in fetal tissues were associated with increased risks of NTDs.

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Maternal occupational exposure to polycyclic aromatic hydrocarbons and congenital heart defects among offspring in the national birth defects prevention study

Cited by 41 publications

References 29 publications

A Meta-Analysis of the Relationship Between Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects

A Meta-Analysis of the Relationship Between Maternal Folic Acid Supplementation and the Risk of Congenital Heart Defects

Levels of PAH–DNA adducts in placental tissue and the risk of fetal neural tube defects in a Chinese population

Levels of PAH–DNA adducts in cord blood and cord tissue and the risk of fetal neural tube defects in a Chinese population

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