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Environ Res. 2017 Feb;153:35-40. doi: 10.1016/j.envres.2016.11.007. Epub 2016 Nov 23.

Maternal exposure to ozone and PM2.5 and the prevalence of orofacial clefts in four U.S. states.

Author information

1
Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA. Electronic address: yzhou2@cdc.gov.
2
Birth Defects Branch, Division of Congenital and Developmental Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
3
New York State Department of Health, Center for Environmental Health, Albany, NY, USA; State University of New York at Albany, Department of Epidemiology and Biostatistics, Rensselaer, NY, USA.
4
Baylor College of Medicine, Department of Pediatrics, Section of Hematology-Oncology, Houston, TX, USA.
5
Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
6
Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
7
Environmental Health Tracking Branch, Division of Environmental Hazards and Health Effects, National Center for Environmental Health, Centers for Disease Control and Prevention, Atlanta, GA, USA.
8
Birth Defects Epidemiology and Surveillance Branch, Texas Department of State Health Services, Austin, TX, USA.
9
Department of Community and Family Health, College of Public Health, University of South Florida, Tampa, FL, USA.

Abstract

BACKGROUND:

While there is some evidence that maternal exposure to ambient air pollution is associated with orofacial clefts in offspring, the epidemiologic studies have been largely equivocal. We evaluated whether maternal exposure to elevated county-level ambient fine particulate matter with aerodynamic diameter ≤2.5µm (PM2.5) and ozone during early gestation was associated with a higher prevalence of orofacial clefts.

METHODS:

Birth data consisting of 4.7 million births from 2001 to 2007 were obtained from National Birth Defects Prevention Network for four states - Arizona, Florida, New York (excluding New York City), and Texas. The air pollution exposure assessment for gestational weeks 5-10 was based on county-level average concentrations of PM2.5 and ozone data generated using a Bayesian fusion model available through CDC's Environmental Public Health Tracking Network. Two outcomes were analyzed separately: cleft lip with or without cleft palate, cleft palate alone. In logistic regression analyses, we adjusted for factors that were suspected confounders or modifiers of the association between the prevalence of orofacial clefts and air pollution, i.e., infant sex, race-ethnicity, maternal education, smoking status during pregnancy, whether this was mother's first baby, maternal age.

RESULTS:

Each 10µg/m3 increase in PM2.5 concentration was significantly associated with cleft palate alone (OR =1.43, 95% CI: 1.11-1.86). There was no significant association between PM2.5 concentration and cleft lip with or without cleft palate. No associations were observed between ozone exposure and the two outcomes of orofacial clefts.

CONCLUSIONS:

Our study suggests that PM2.5 significantly increased the risk of cleft palate alone, but did not change the incidence of cleft lip with or without palate. Ozone levels did not correlate with incidence of orofacial clefts.

KEYWORDS:

Air pollution; Cleft lip; Cleft palate; Ozone; PM(2.5)

PMID:
27888746
PMCID:
PMC5612445
DOI:
10.1016/j.envres.2016.11.007
[Indexed for MEDLINE]
Free PMC Article

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