Prenatal exposure to PM2.5 and Congenital Heart Diseases in Taiwan

Sci Total Environ. 2019 Mar 10:655:880-886. doi: 10.1016/j.scitotenv.2018.11.284. Epub 2018 Nov 20.


Gestational exposure to ambient air pollution has been associated with Congenital Heart Diseases (CHDs). However, only a few studies, with inconsistent results, have investigated the effects of PM2.5 exposure during early pregnancy. This study aims to evaluate the association between prenatal exposure to PM2.5 and CHDs occurrence. We selected 782 births reported to have CHDs between 2007 and 2014 from the Taiwanese Birth Registry and randomly selected 4692 controls without any birth defects using a population-based case-control design. Data of exposure to ambient air pollutants, mainly PM2.5, PM10, CO, SO2, NO2, and O3 during weeks 3-8 of pregnancy were retrieved from air quality monitoring stations and interpolated to every township using ordinary kriging. We applied unconditional logistic regression models adjusted for potential confounders to evaluate the associations. The results revealed a positive correlation between increased PM2.5 exposure (adjusted odds ratio [aOR] = 1.21, 95% confidence interval [CI] = 1.03-1.42, per interquartile range change = 13.4 μg/m3) during early pregnancy and overall CHDs occurrence. Furthermore, we found that atrial septal defect (aOR = 1.43, 95% CI = 1.01-2.02), endocardial cushion defect (aOR = 2.37, 95% CI = 1.01-5.58), and pulmonary artery and valve stenosis (aOR = 1.71, 95% CI = 1.06-2.78) were significantly associated with PM2.5 exposures. No similar effects were observed for the other air pollutants. This study has demonstrated some positive associations between increased PM2.5 exposure during the critical period of cardiac embryogenesis and certain CHDs occurrence.

Keywords: Air pollution; Congenital Heart Disease; Kriging; PM(2.5); Pregnancy; Prenatal exposure.

MeSH terms

  • Air Pollutants / adverse effects*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Environmental Exposure / adverse effects*
  • Environmental Monitoring
  • Female
  • Heart Diseases / congenital
  • Heart Diseases / epidemiology*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Particulate Matter / adverse effects*
  • Pregnancy
  • Prenatal Exposure Delayed Effects / chemically induced
  • Prenatal Exposure Delayed Effects / epidemiology*
  • Prevalence
  • Taiwan / epidemiology


  • Air Pollutants
  • Particulate Matter