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Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence

International journal of environmental research and public health, 2018-09, Vol.15 (10), p.2096 [Peer Reviewed Journal]

2018 by the author. 2018 ;ISSN: 1660-4601 ;ISSN: 1661-7827 ;EISSN: 1660-4601 ;DOI: 10.3390/ijerph15102096 ;PMID: 30257432

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  • Title:
    Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence
  • Author: Nicoll, Rachel
  • Subjects: air pollution ; congenital heart defects ; disinfectant byproducts ; Environmental Exposure - adverse effects ; Environmental Pollutants - analysis ; Environmental Pollutants - toxicity ; environmental toxins ; Female ; Heart Defects, Congenital - diagnosis ; Heart Defects, Congenital - etiology ; Humans ; Male ; persistent organic pollutants ; pesticides ; Pregnancy ; Review ; Risk Factors ; smoking ; toxic metals ; waste tes
  • Is Part Of: International journal of environmental research and public health, 2018-09, Vol.15 (10), p.2096
  • Description: Congenital heart defects (CHDs) are a common birth defect of largely unknown etiology, with high fetal and neonatal mortality. A review of CHDs and environmental contaminant exposure found that meta-analyses showed only modest associations for smoking, vehicle exhaust components, disinfectant by-products and proximity to incinerators, with stronger results from the newer, larger and better quality studies masked by the typical absence of effect in older studies. Recent studies of exposure to agricultural pesticides, solvents, metals and landfill sites also showed associations. Certain contaminants have been associated with certain CHDs, with septal defects being the most common. Frequent methodological problems include failure to account for potential confounders or maternal/paternal preconception exposure, differences in diagnosing, defining and classifying CHDs, grouping of defects to increase power, grouping of contaminants with dissimilar mechanisms, exclusion of pregnancies that result in death or later life diagnosis, and the assumption that maternal residence at birth is the same as at conception. Furthermore, most studies use measurement estimates of one exposure, ignoring the many additional contaminant exposures in daily life. All these problems can distort and underestimate the true associations. Impaired methylation is a common mechanism, suggesting that supplementary folate may be protective for any birth defect.
  • Publisher: Switzerland: MDPI
  • Language: English
  • Identifier: ISSN: 1660-4601
    ISSN: 1661-7827
    EISSN: 1660-4601
    DOI: 10.3390/ijerph15102096
    PMID: 30257432
  • Source: GFMER Free Medical Journals
    MEDLINE
    PubMed Central
    SWEPUB Freely available online
    ProQuest Central
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