title: Effects of air pollution on the risk of congenital anomalies: a systematic review and meta-analysis.
abstract: Congenital anomalies are the main causes of preterm and neonatal mortality and morbidity. We investigated the association between congenital anomalies and mothers' exposure to air pollution during pregnancy by combining risk estimates for a variety of air pollutants (SO2, NO2, PM10, PM2.5, CO and O3) and anomaly defect outcomes. Seventeen articles were included in the systematic review and thirteen studies were taken into account in the meta-analysis. Combined estimated were calculated separately according to whether the exposure metric was continuous or categorical. Only one significant combination was; NO2 concentrations were significantly associated with coarctation of the aorta (OR = 1.20 per 10 ppb, 95% CI, (1.02, 1.41)). This finding could stem from strong heterogeneity in study designs. Improved exposure assessment methods, in particular more accurate spatial measurements or modeling, standardized definition of cases and of better control of confounders are highly recommended for future congenital anomalies research in this area.
authors.affiliation: School of Public Health, EHESP, Sorbonne-Paris-Cité, Rennes, Cedex 35043, France. Esther.Chen@eleve.ehesp.fr.
authors.forename: Esther Kai-Chieh
authors.initials: EK
authors.lastname: Chen
authors.affiliation: School of Public Health, EHESP, Sorbonne-Paris-Cité, Rennes, Cedex 35043, France. denis.zmirou@ehesp.fr.
authors.forename: Denis
authors.initials: D
authors.lastname: Zmirou-Navier
authors.affiliation: School of Public Health, EHESP, Sorbonne-Paris-Cité, Rennes, Cedex 35043, France. cindy.padilla@ehesp.fr.
authors.forename: Cindy
authors.initials: C
authors.lastname: Padilla
authors.affiliation: School of Public Health, EHESP, Sorbonne-Paris-Cité, Rennes, Cedex 35043, France. severine.deguen@ehesp.fr.
authors.forename: Séverine
authors.initials: S
authors.lastname: Deguen
mesh_terms: D000393:Air Pollutants / Q000633:toxicity*; D000397:Air Pollution; D001017:Aortic Coarctation / Q000139:chemically induced / Q000453:epidemiology; D000013:Congenital Abnormalities / Q000453:epidemiology* / Q000209:etiology; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D008297:Male; D009585:Nitrogen Dioxide / Q000633:toxicity; D011247:Pregnancy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced / Q000453:epidemiology*; D012307:Risk Factors
chemical_list: D000393:Air Pollutants; D009585:Nitrogen Dioxide
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