title: Congenital anomalies among live births in a high environmental risk area--a case-control study in Brindisi (southern Italy).
abstract: Maternal exposure to ambient pollution has been increasingly linked to the risk of congenital anomalies (CAs) in the fetus and newborns. Recently, a descriptive study in the high environmental risk city of Brindisi (Italy) revealed an increased prevalence of total CAs, especially congenital heart disease (CHD) and ventricular septal defects (VSDs), both at the local level and in comparison with the pool of EUROCAT registries. This paper concerns a population-based case control study to investigate the association between maternal exposure to air pollutants - sulfur dioxide (SO2) and total suspended particulate (TSP) matter - and the risk of CA. Cases were newborns up to 28 days of age, born to mothers resident in Brindisi between 2001 and 2010, and discharged with a diagnosis of CA. Cases and controls were individually matched according to sex, socio-economic status of the census area of residence of the mother, and year of beginning of pregnancy. Up to four controls were extracted for each case. Concentration data from monitoring stations were used to estimate air pollution exposure. Each case and control was assigned pollutant concentration values as mean and 90th percentile of the daily average values during weeks 3-8 of pregnancy. Exposure as both continuous and categorical variables was considered and a conditional logistic regression model was constructed to quantify the odds ratios of exposure to air pollutants and the occurrence of total CAs, CHDs and VSDs. We found exposure to the 90th percentile of SO2 to be associated with CHDs (p for trend =0.01) and VSDs (p for trend <0.05). Findings for TSP were less consistent. In conclusion, in the studied area, maternal exposure to sulfur dioxide increased risk of CHD.
authors.affiliation: National Research Council, Institute of Clinical Physiology, Lecce, Italy; der Johannes Gutenberg-Universität Mainz, Institut für Medizinische Biometrie, Epidemiologie und Informatik, Mainz, Germany. Electronic address: gianicolo@uni-mainz.de.
authors.forename: Emilio Antonio Luca
authors.initials: EA
authors.lastname: Gianicolo
authors.affiliation: National Research Council, Institute of Atmospheric Sciences and Climate, Lecce, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Mangia
authors.affiliation: National Research Council, Institute of Atmospheric Sciences and Climate, Bologna, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Cervino
authors.affiliation: National Research Council, Institute of Clinical Physiology, Lecce, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Bruni
authors.affiliation: National Research Council, Institute of Clinical Physiology, Pisa, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: Andreassi
authors.affiliation: National Research Council, Institute of Clinical Physiology, Lecce, Italy; Division of Neonatology, "A. Perrino" Hospital, Brindisi, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Latini
mesh_terms: D016022:Case-Control Studies; D002947:Cities / Q000453:epidemiology; D005260:Female; D006345:Heart Septal Defects, Ventricular / Q000453:epidemiology*; D006801:Humans; D007231:Infant, Newborn; D007558:Italy / Q000453:epidemiology; D018811:Maternal Exposure / Q000009:adverse effects* / Q000706:statistics & numerical data; D052638:Particulate Matter / Q000009:adverse effects; D011247:Pregnancy; D013458:Sulfur Dioxide / Q000009:adverse effects
chemical_list: D052638:Particulate Matter; D013458:Sulfur Dioxide
keywords: Air pollution; Brindisi; Congenital anomalies; Industrial exposure; Sulfur dioxide