{"title":"臭氧和父亲吸烟对高危孕妇胎儿先天性心脏缺陷的影响：一项多中心母胎医学研究。","authors":"Huan Wang, Yan-Ping Ruan, Sheng Ma, Ya-Qi Wang, Xiao-Yu Wan, Yi-Hua He, Jing Li, Zhi-Yong Zou","doi":"10.1007/s12519-023-00755-1","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Evidence remains limited on the association between maternal ozone (O<sub>3</sub>) exposure and congenital heart defects (CHDs) in offspring, and few studies have investigated the interaction and modification of paternal smoking on this association.</p><p><strong>Methods: </strong>Using a sample including pregnant women at high risk of fetal CHD (with metabolic disease, first-trimester viral infection, family history of CHD, etc.) from a maternal-fetal medicine study covering 1313 referral hospitals in China during 2013-2021, we examined the associations between maternal O<sub>3</sub> exposure during 3-8 weeks of gestational age and fetal CHD in offspring and investigated the interaction and modification of paternal smoking on this association. CHD was diagnosed by fetal echocardiograms, maximum daily 8-hour average O<sub>3</sub> exposure data at a 10 km × 10 km spatial resolution came from the Tracking Air Pollution in China dataset, and paternal smoking was collected using questionnaires. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 27,834 pregnant women at high risk of fetal CHD, 17.4% of fetuses were diagnosed with CHD. Each 10 μg/m<sup>3</sup> increase in maternal O<sub>3</sub> exposure was associated with a 17% increased risk of CHD in offspring (OR = 1.17, 95% CI = 1.14-1.20). Compared with paternal nonsmoking and maternal low O<sub>3</sub> exposure, the ORs (95% CI) of CHD for smoking and low O<sub>3</sub> exposure, nonsmoking and high O<sub>3</sub> exposure, and smoking and high O<sub>3</sub> exposure were 1.25 (1.08-1.45), 1.81 (1.56-2.08), and 2.23 (1.84-2.71), respectively. Paternal smoking cessation seemingly mitigated the increased risk of CHD.</p><p><strong>Conclusions: </strong>Maternal O<sub>3</sub> exposure and paternal smoking were interactively associated with an increased risk of fetal CHD in offspring, which calls for effective measures to decrease maternal exposure to O<sub>3</sub> pollution and secondhand smoke for CHD prevention.</p>","PeriodicalId":23883,"journal":{"name":"World Journal of Pediatrics","volume":" ","pages":"621-632"},"PeriodicalIF":6.1000,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interaction between ozone and paternal smoking on fetal congenital heart defects among pregnant women at high risk: a multicenter maternal-fetal medicine study.\",\"authors\":\"Huan Wang, Yan-Ping Ruan, Sheng Ma, Ya-Qi Wang, Xiao-Yu Wan, Yi-Hua He, Jing Li, Zhi-Yong Zou\",\"doi\":\"10.1007/s12519-023-00755-1\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Evidence remains limited on the association between maternal ozone (O<sub>3</sub>) exposure and congenital heart defects (CHDs) in offspring, and few studies have investigated the interaction and modification of paternal smoking on this association.</p><p><strong>Methods: </strong>Using a sample including pregnant women at high risk of fetal CHD (with metabolic disease, first-trimester viral infection, family history of CHD, etc.) from a maternal-fetal medicine study covering 1313 referral hospitals in China during 2013-2021, we examined the associations between maternal O<sub>3</sub> exposure during 3-8 weeks of gestational age and fetal CHD in offspring and investigated the interaction and modification of paternal smoking on this association. CHD was diagnosed by fetal echocardiograms, maximum daily 8-hour average O<sub>3</sub> exposure data at a 10 km × 10 km spatial resolution came from the Tracking Air Pollution in China dataset, and paternal smoking was collected using questionnaires. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Among 27,834 pregnant women at high risk of fetal CHD, 17.4% of fetuses were diagnosed with CHD. Each 10 μg/m<sup>3</sup> increase in maternal O<sub>3</sub> exposure was associated with a 17% increased risk of CHD in offspring (OR = 1.17, 95% CI = 1.14-1.20). Compared with paternal nonsmoking and maternal low O<sub>3</sub> exposure, the ORs (95% CI) of CHD for smoking and low O<sub>3</sub> exposure, nonsmoking and high O<sub>3</sub> exposure, and smoking and high O<sub>3</sub> exposure were 1.25 (1.08-1.45), 1.81 (1.56-2.08), and 2.23 (1.84-2.71), respectively. Paternal smoking cessation seemingly mitigated the increased risk of CHD.</p><p><strong>Conclusions: </strong>Maternal O<sub>3</sub> exposure and paternal smoking were interactively associated with an increased risk of fetal CHD in offspring, which calls for effective measures to decrease maternal exposure to O<sub>3</sub> pollution and secondhand smoke for CHD prevention.</p>\",\"PeriodicalId\":23883,\"journal\":{\"name\":\"World Journal of Pediatrics\",\"volume\":\" \",\"pages\":\"621-632\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2024-06-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"World Journal of Pediatrics\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s12519-023-00755-1\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2023/9/4 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q1\",\"JCRName\":\"PEDIATRICS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"World Journal of Pediatrics","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s12519-023-00755-1","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/4 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"PEDIATRICS","Score":null,"Total":0}
引用次数: 0
摘要
背景：关于母体臭氧（O3）暴露与后代先天性心脏缺陷（CHDs）之间关系的证据仍然有限，很少有研究调查了父亲吸烟对这种关系的相互作用和影响：我们利用2013-2021年中国1313家转诊医院的母胎医学研究样本，其中包括胎儿先天性心脏病高风险孕妇（患有代谢性疾病、一胎病毒感染、有先天性心脏病家族史等），研究了孕龄3-8周的母体臭氧暴露与后代胎儿先天性心脏病之间的关联，并探讨了父亲吸烟对这一关联的影响。胎儿先天性心脏病是通过胎儿超声心动图诊断的，10 km × 10 km空间分辨率的最大日均8小时臭氧暴露数据来自中国空气污染追踪数据集，父亲吸烟情况是通过问卷调查收集的。采用逻辑回归模型估算调整后的几率比（OR）和 95% 的置信区间（CI）：结果：在27834名胎儿先天性心脏病高危孕妇中，17.4%的胎儿被确诊为先天性心脏病。母体的臭氧暴露量每增加 10 μg/m3 ，后代患先天性心脏病的风险就会增加 17%（OR = 1.17，95% CI = 1.14-1.20）。与父亲不吸烟和母亲暴露于低浓度臭氧相比，吸烟和暴露于低浓度臭氧、不吸烟和暴露于高浓度臭氧以及吸烟和暴露于高浓度臭氧的子代患心脏病的OR值（95% CI）分别为1.25（1.08-1.45）、1.81（1.56-2.08）和2.23（1.84-2.71）。父亲戒烟似乎减轻了心脏病风险的增加：结论：母体暴露于臭氧污染和父亲吸烟与后代胎儿罹患先天性心脏病的风险增加存在相互作用，因此需要采取有效措施减少母体暴露于臭氧污染和二手烟，以预防先天性心脏病。
Interaction between ozone and paternal smoking on fetal congenital heart defects among pregnant women at high risk: a multicenter maternal-fetal medicine study.
Background: Evidence remains limited on the association between maternal ozone (O3) exposure and congenital heart defects (CHDs) in offspring, and few studies have investigated the interaction and modification of paternal smoking on this association.
Methods: Using a sample including pregnant women at high risk of fetal CHD (with metabolic disease, first-trimester viral infection, family history of CHD, etc.) from a maternal-fetal medicine study covering 1313 referral hospitals in China during 2013-2021, we examined the associations between maternal O3 exposure during 3-8 weeks of gestational age and fetal CHD in offspring and investigated the interaction and modification of paternal smoking on this association. CHD was diagnosed by fetal echocardiograms, maximum daily 8-hour average O3 exposure data at a 10 km × 10 km spatial resolution came from the Tracking Air Pollution in China dataset, and paternal smoking was collected using questionnaires. Logistic regression models were used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CIs).
Results: Among 27,834 pregnant women at high risk of fetal CHD, 17.4% of fetuses were diagnosed with CHD. Each 10 μg/m3 increase in maternal O3 exposure was associated with a 17% increased risk of CHD in offspring (OR = 1.17, 95% CI = 1.14-1.20). Compared with paternal nonsmoking and maternal low O3 exposure, the ORs (95% CI) of CHD for smoking and low O3 exposure, nonsmoking and high O3 exposure, and smoking and high O3 exposure were 1.25 (1.08-1.45), 1.81 (1.56-2.08), and 2.23 (1.84-2.71), respectively. Paternal smoking cessation seemingly mitigated the increased risk of CHD.
Conclusions: Maternal O3 exposure and paternal smoking were interactively associated with an increased risk of fetal CHD in offspring, which calls for effective measures to decrease maternal exposure to O3 pollution and secondhand smoke for CHD prevention.
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The World Journal of Pediatrics, a monthly publication, is dedicated to disseminating peer-reviewed original papers, reviews, and special reports focusing on clinical practice and research in pediatrics.
We welcome contributions from pediatricians worldwide on new developments across all areas of pediatrics, including pediatric surgery, preventive healthcare, pharmacology, stomatology, and biomedicine. The journal also covers basic sciences and experimental work, serving as a comprehensive academic platform for the international exchange of medical findings.
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