Category: Epidemiology
Poster Session III
Because the relationship between pollution and congenital anomalies is biologically plausible but not well explored, our aim was to examine the association between air pollution exposure in pregnancy and fetal anomalies within a publicly-insured, large inner-city population. We hypothesized that higher exposure to the air pollutant Nitrogen Dioxide (NO2) would be associated with a higher rate of major fetal anomalies.
Study Design:
This was a retrospective cohort study of singleton pregnancies residing in a metropolitan area. Daily average NO2 concentrations were obtained using strategically located monitors across the county from the Environmental Protection Agency Air Quality System database. Average daily NO2 exposure was estimated for individual patients’ pregnancy for patients living within 10 miles of a monitoring station. Pediatrician postnatal diagnosis of a major fetal anomaly was obtained from an obstetric quality database. Logistic regression models were used to assess the effect of NO2 exposure on fetal anomalies while controlling for maternal age, race, parity, season of conception, diabetes, habitus, registered Social Needs Index and NO2 monitor region. Adjusted odds ratios and 95% confidence intervals were calculated for an interquartile increase in daily NO2 exposure.
Results:
Between 1 Nov 2010 and 31 Dec 2021, 118,783 patients delivered, of which 62,189 had measured exposure to NO2 due to proximity to a monitoring station. Of these, 1606 (2.6%) were diagnosed with a major anomaly. Higher average daily NO2 exposure was significantly associated with major fetal anomalies (aOR 1.28, 95%CI: 1.06, 1.54) (Figure). The most commonly affected organ system was the neurologic system (n=370, 23% of anomalies), with the most reported anomaly being microcephaly (n=264, 16% of anomalies) (Table).
Conclusion:
Greater exposure to the air pollutant NO2 is significantly associated with major fetal anomalies. In contrast to prior studies, we find that the neurologic system was most commonly affected, with microcephaly being the most reported anomaly.
Sara I. Jones, MD (she/her/hers)
University of Texas Southwestern Medical Center
Dallas, Texas, United States
Jessica E. Pruszynski, PhD
UT Southwestern Medical Center
Dallas, Texas, United States
Catherine Y. Spong, MD
Professor and Chair
University of Texas Southwestern Medical Center
Dallas, Texas, United States
David B. Nelson, MD
Associate Professor
University of Texas Southwestern Medical Center
Dallas, Texas, United States