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

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  • Rachel Nicoll

    (Department of Public Health and Clinical Medicine, Umeå University, SE 901-87 Umeå, Sweden)

Abstract

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.

Suggested Citation

  • Rachel Nicoll, 2018. "Environmental Contaminants and Congenital Heart Defects: A Re-Evaluation of the Evidence," IJERPH, MDPI, vol. 15(10), pages 1-23, September.
  • Handle: RePEc:gam:jijerp:v:15:y:2018:i:10:p:2096-:d:171806
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    References listed on IDEAS

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    1. Esther Kai-Chieh Chen & Denis Zmirou-Navier & Cindy Padilla & Séverine Deguen, 2014. "Effects of Air Pollution on the Risk of Congenital Anomalies: A Systematic Review and Meta-Analysis," IJERPH, MDPI, vol. 11(8), pages 1-27, July.
    2. Chuan Wang & Liang Xie & Kaiyu Zhou & Yalan Zhan & Yifei Li & Huaying Li & Lina Qiao & Fang Wang & Yimin Hua, 2013. "Increased Risk for Congenital Heart Defects in Children Carrying the ABCB1 Gene C3435T Polymorphism and Maternal Periconceptional Toxicants Exposure," PLOS ONE, Public Library of Science, vol. 8(7), pages 1-10, July.
    3. Jihye Kim & Michael D. Swartz & Peter H. Langlois & Paul A. Romitti & Peter Weyer & Laura E. Mitchell & Thomas J. Luben & Anushuya Ramakrishnan & Sadia Malik & Philip J. Lupo & Marcia L. Feldkamp & Ro, 2017. "Estimated Maternal Pesticide Exposure from Drinking Water and Heart Defects in Offspring," IJERPH, MDPI, vol. 14(8), pages 1-17, August.
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    Cited by:

    1. Ronald B. Brown, 2022. "Transdisciplinary model for environmental protection and primordial prevention of disease," Journal of Environmental Studies and Sciences, Springer;Association of Environmental Studies and Sciences, vol. 12(4), pages 898-904, December.

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