Early prenatal exposure to air pollutants and congenital heart disease: a nested case-control study

BACKGROUND@#Congenital heart disease (CHD) is one of the most common congenital malformations in humans. Inconsistent results emerged in the existed studies on associations between air pollution and congenital heart disease. The purpose of this study was to evaluate the association of gestational exposure to air pollutants with congenital heart disease, and to explore the critical exposure windows for congenital heart disease.@*METHODS@#The nested case-control study collected birth records and the following health data in Tianjin Women and Children's Health Center, China. All of the cases of congenital heart disease from 2013 to 2015 were selected matching five healthy controls for each case. Inverse distance weighting was used to estimate individual exposure based on daily air pollution data. Furthermore, the conditional logistic regression with distributed lag non-linear model was performed to identify the association between gestational exposure to air pollution and congenital heart disease.@*RESULTS@#A total of 8,748 mother-infant pairs were entered into the analysis, of which 1,458 infants suffered from congenital heart disease. For each 10 µg/m3 increase of gestational exposure to PM2.5, the ORs (95% confidence interval, 95%CI) ranged from 1.008 (1.001-1.016) to 1.013 (1.001-1.024) during the 1st-2nd gestation weeks. Similar weak but increased risks of congenital heart disease were associated with O3 exposure during the 1st week and SO2 exposure during 6th-7th weeks in the first trimester, while no significant findings for other air pollutants.@*CONCLUSIONS@#This study highlighted that gestational exposure to PM2.5, O3, and SO2 had lag effects on congenital heart disease. Our results support potential benefits for pregnancy women to the mitigation of air pollution exposure in the early stage, especially when a critical exposure time window of air pollutants may precede heart development.

Air pollution and children's health-a review of adverse effects associated with prenatal exposure from fine to ultrafine particulate matter

BACKGROUND@#Particulate matter (PM), a major component of ambient air pollution, accounts for a substantial burden of diseases and fatality worldwide. Maternal exposure to PM during pregnancy is particularly harmful to children's health since this is a phase of rapid human growth and development.@*METHOD@#In this review, we synthesize the scientific evidence on adverse health outcomes in children following prenatal exposure to the smallest toxic components, fine (PM@*RESULTS@#Maternal exposure to fine and ultrafine PM directly and indirectly yields numerous adverse birth outcomes and impacts on children's respiratory systems, immune status, brain development, and cardiometabolic health. The biological mechanisms underlying adverse effects include direct placental translocation of ultrafine particles, placental and systemic maternal oxidative stress and inflammation elicited by both fine and ultrafine PM, epigenetic changes, and potential endocrine effects that influence long-term health.@*CONCLUSION@#Policies to reduce maternal exposure and health consequences in children should be a high priority. PM

Maternal metal concentration during gestation and pediatric morbidity in children: an exploratory analysis

BACKGROUND@#The majority of studies linking exposure to metals with certain health outcomes focus on known toxic metals. Alternatively, this study assesses the extent to which exposure to a wider range of metals during gestation is associated with childhood morbidity.@*METHODS@#We analyzed the concentrations of 25 metals found in urine samples of 111 pregnant women of Arab-Bedouin origin collected prior to birth. In addition, we collected medical records on their offspring for six years following birth, including every interaction with HMOs, local hospitals, and pharmacies.@*RESULTS@#The main types of morbidities diagnosed and treated during this period were preterm births, malformations, asthma-like morbidity, cardiovascular and behavioral problems, and obesity. Multivariable analysis showed that offspring born before term were more likely to have been exposed to elevated maternal concentrations of zinc, thallium, aluminum, manganese, and uranium, all with adjusted relative risk above 1.40 for an increase by each quintile. Likewise, children with asthma had been exposed to higher levels of magnesium, strontium, and barium at gestation, while behavioral outcomes were associated with elevated biometals, i.e., sodium, magnesium, calcium, selenium, and zinc, as well as higher levels of lithium, cobalt, nickel, strontium, cadmium, vanadium, arsenic, and molybdenum. A heatmap of adjusted relative risk estimates indicates the considerable implications that exposure to metals may have for preterm birth and developmental outcomes.@*CONCLUSIONS@#The current study shows that perinatal exposure to metals is adversely associated with pediatric morbidity. Further such analyses on additional samples are warranted.

Association between tobacco and/or alcohol consumption during pregnancy and infant development: BRISA Cohort

Fetuses exposed to alcohol and/or tobacco are at risk for perinatal adversities. However, little is currently known about the association of the separate or concomitant use of alcohol and tobacco with infant motor and cognitive development. Thus, the objective of the present study was to investigate the association between maternal consumption of alcohol and/or tobacco during pregnancy and the motor and cognitive development of children starting from the second year of life. The study included 1006 children of a cohort started during the prenatal period (22-25 weeks of pregnancy), evaluated at birth and reevaluated during the second year of life in 2011/2013. The children were divided into four groups according to the alcohol and/or tobacco consumption reported by their mothers at childbirth: no consumption (NC), separate alcohol consumption (AC), separate tobacco consumption (TC), and concomitant use of both (ACTC). The Bayley Scale of Infant and Toddler Development Third Edition screening tool was used for the assessment of motor and cognitive development. Adjusted Poisson regression models were used to determine the association between groups and delayed development. The results indicated that only the ACTC group showed a higher risk of motor delay, specifically regarding fine motor skills, compared to the NC group (RR=2.81; 95%CI: 1.65; 4.77). Separate alcohol or tobacco consumption was not associated with delayed gross motor or cognitive development. However, the concomitant use of the two substances increased the risk of delayed acquisition of fine motor skills.

Burden of Mild Mental Retardation attributed to prenatal methylmercury exposure in Amazon: local and regional estimates / Carga de Retardo Mental Leve atribuída à exposição pré-natal ao metilmercúrio na Amazônia: estimativas local e regional

Abstract The gold rush in the Amazon Region caused an increase of mercury (Hg) levels in the environment, and, consequently, raised human exposure. Once released into aquatic systems, Hg could generate methylmercury (MeHg), an extremely toxic compound, which is accumulated through trophic chains. Several studies have provided evidences of the brain sensitivity to MeHg, as well as, of the fetus vulnerability during pregnancy. The main objective of this study was to estimate the Mild Mental Retardation (MMR) in Amazonian populations, caused by prenatal exposure to MeHg, using the methodology proposed by Poulin (2008), which quantifies the environmental burden of disease. The estimates of the MMR burden, attributed to prenatal MeHg exposure, were based on the calculation of Disability-Adjusted Life Years (DALY), which were obtained from MMR incidence rate in the studied populations. At the local level, the MMR incidence rate calculations were based on primary data of MeHg exposure of riverine women at childbearing age. The MMR incidence rate was equal to 5.96/1,000 infants, which would result in 2.0 IQ points loss in 34.31% of the newborns. The estimated DALY/1,000 infants was equal to 71.2, while the DALY was 576. For the regional estimates, different exposure scenarios were created. The calculated DALY varied from 3,256 to 65,952 per year.

Resumo A corrida pelo ouro na Amazônia elevou os níveis de mercúrio (Hg) no ambiente e, consequentemente, aumentou a exposição humana. Uma vez liberado em sistemas aquáticos, o Hg pode gerar metilmercúrio (MeHg), um composto tóxico que se acumula ao longo de cadeias tróficas. Vários estudos têm gerado evidências sobre a sensibilidade do cérebro ao MeHg, bem como sobre a vulnerabilidade do feto durante a gravidez. O principal objetivo deste trabalho foi estimar a carga de Retardo Mental Leve (RML) em populações amazônicas, causada pela exposição pré-natal ao MeHg, utilizando a metodologia proposta por Poulin (2008). As estimativas de RML, atribuída à exposição ao MeHg pré-natal, foram baseadas no cálculo dos Anos de Vida Ajustados por Incapacidade (DALY), que foi desenvolvido a partir de taxa de incidência RML nas populações estudadas. Em nível local, o cálculo da taxa de incidência RML baseou-se em dados primários sobre a exposição ao MeHg em mulheres ribeirinhas em idade fértil. A taxa de incidência RML foi igual a 5,96/1.000 nascidos, o que resulta na perda de 2,0 pontos de QI em 34,31% dos nascidos. A estimativa de DALY/1.000 nascidos foi igual a 71,2, enquanto o DALY foi de 576. Para as estimativas regionais, foram criados diferentes cenários de exposição. Os DALYs calculados variaram de 3.256 a 65.952 por ano.

Tabaquismo materno como un factor posiblemente implicado en el desarrollo de la obesidad infantil / Possible effects of maternal smoking during pregnancy on the development of childhood obesity

El tabaquismo es la adicción al tabaco provocada principalmente por diversos componentes activos y tóxicos como la nicotina. El consumo de cigarrillo durante la gestación puede provocar desprendimiento de placenta, placenta previa, embarazo ectópico y aborto espontáneo, como también inducir alteraciones en el feto. En la presente revisión de la literatura se recopiló información en bases de datos como Pub-Med, Embase y Google Académico, concerniente a los posibles efectos del tabaquismo materno durante la gestación sobre el desarrollo de la obesidad infantil. Fueron seleccionados 38 artículos escritos en el idioma inglés y español, publicados a partir de año de 1988 hasta el año 2015, que incluyeron metaanálisis, artículos originales, y revisiones de tema. Se encontró que la exposición al humo del tabaco durante la gestación ha sido ampliamente descrita como un factor de riesgo para la manifestación de alteraciones en el desarrollo fetal como retardo del crecimiento intrauterino y bajo peso al nacer. Además, se ha asociado ampliamente con trastornos del desarrollo infantil en etapas avanzadas, como preescolares y escolares, manifestados en un aumento del índice de masa corporal con respecto al percentil adecuado para la edad; incremento de la incidencia de sobrepeso y obesidad en el infante. Se concluye que la exposición al humo del cigarrillo durante la gestación se relaciona con alteraciones en el crecimiento del niño y en el desarrollo de enfermedades prevalentes asociadas a la obesidad.

Most smokers use tobacco regularly because they are addicted to various active and toxic compounds such as nicotine. Cigarette smoking during pregnancy can cause abruption, placenta previa, ectopic pregnancy and spontaneous abortion, as well as induce alterations in the fetus. In this review, information was collected in databases such as PubMed, Embase and Google Scholar, concerning the possible effects of maternal smoking during pregnancy on the development of childhood obesity. Thirty-eigth articles written in English and Spanish published from year 1988 to 2015, which included meta-analysis, original articles and reviews were selected topic. It was found that exposure to cigarette smoke during pregnancy has been widely described as a risk factor for alterations in fetal development such as intrauterine growth retardation and low birth weight. In addition, it has been widely associated with disorders of child development in advanced stages, preschool and school age: increased body mass index regarding the appropriate percentile for age, and increase in childhood overweight and obesity. It is concluded that exposure to cigarette smoke during pregnancy is associated with changes in child growth and development of prevalent diseases associated with obesity.

Association between maternal smoking, gender, and cleft lip and palate / Associação entre tabagismo materno, gênero e fendas labiopalatinas

ABSTRACT INTRODUCTION: Cleft lip and/or palate (CL/P) represent the most common congenital anomalies of the face. OBJECTIVE: To assess the relationship between maternal smoking, gender and CL/P. METHODS: This is an epidemiological cross-sectional study. We interviewed 1519 mothers divided into two groups: Cases: mothers of children with CL/P (n = 843) and Controls: mothers of children without CL/P (n = 676). All mothers were classified as smoker or non-smoker subjects during the first trimester of pregnancy. To determine an association among maternal smoking, gender, and CL/P, odds ratios were calculated and the adjustment was made by a logistic regression model. RESULTS: An association between maternal smoking and the presence of cleft was observed. There was also a strong association between male gender and the presence of cleft (OR = 3.51; 95% CI 2.83-4.37). By binary logistic regression analysis, it was demonstrated that both variables were independently associated with clefts. In a multivariate analysis, male gender and maternal smoking had a 2.5- and a 1.5-time greater chance of having a cleft, respectively. CONCLUSION: Our findings are consistent with a positive association between maternal smoking during pregnancy and CL/P in male gender. The results support the importance of smoking prevention and introduction of cessation programs among women with childbearing potential.

RESUMO Introdução: Fendas labiais e/ou palatinas (FL/P) representam as anomalias congênitas mais comuns da face. Objetivo: Avaliar a relação entre tabagismo materno, gênero e FL/P. Método: Realizou-se um estudo epidemiológico, de corte transversal. Foram entrevistadas 1.519 mães, divididas em dois grupos: Casos: mães de crianças com FL/P (n = 843); e Controles: mães de crianças sem FL/P (n = 676). Todas as mães foram classificadas como fumantes ou não fumantes durante o primeiro trimestre de gravidez. Para determinar a associação entre tabagismo materno, gênero e FL/P, odds ratios foram calculadas e o ajuste realizado pelo modelo de regressão logística. Resultados: Observou-se associação entre tabagismo materno, e fendas. Houve também forte associação entre sexo masculino e presença de fendas (OR = 3,51; 95% IC 2,83-4,37). Regressão logística binária demonstrou que ambas as variáveis foram independentemente associadas coma ocorrência de fendas. Na análise multivariada, o sexo masculino teve 2,5 vezes mais chance de apresentar fendas e tabagismo materno teve 1,5 vez mais chance dessa ocorrência. Conclusão: Os resultados são consistentes com a associação positiva entre tabagismo materno durante a gravidez e a ocorrência de FL/P no gênero masculino. Os resultados suportam a importância da prevenção do tabagismo e a aplicação de programas entre mulheres com potencial de gravidez.

The relationship between low birth weight and exposure to inhalable particulate matter / Relação entre baixo peso ao nascer e exposição ao material particulado inalável / Relación entre el bajo peso al nacer y la exposición a partículas inhalables

Atmospheric pollution is a global public health problem. The adverse effects of air pollution are strongly associated with respiratory and cardiovascular diseases and, to a lesser extent, with adverse pregnancy outcomes. This study analyzes the relationship between exposure to PM10 and low birth weight in the city of Santo André, São Paulo State, Brazil. We included babies born to mothers resident in Santo André between 2000 and 2006. Data on daily PM10 levels was obtained from the São Paulo State Environmental Agency. We performed descriptive analysis and logistic regressions. The prevalence rate of low birth weight was 5.9%. There was a dose-response relationship between PM10 concentrations and low birth weight. Exposure to the highest quartile of PM10 (37,50µg/m³) in the third trimester of pregnancy increased the risk of low birth weight by 26% (OR: 1.26; 95%CI: 1.14-1.40) when compared to the first quartile. The same effect was observed in the remaining trimesters. This effect was observed for ambient particle concentrations that met the current air quality standards.

Em todo o mundo a poluição atmosférica é um problema de saúde pública. Os efeitos adversos relacionados aos poluentes atmosféricos estão fortemente associados com doenças respiratórias e cardiovasculares e, em menor grau, com os resultados adversos da gravidez. O objetivo do trabalho foi avaliar a relação entre PM10 e baixo peso ao nascer no Município de Santo André, São Paulo, Brasil. Foram incluídos no estudo recém-nascidos de mães residentes em Santo André (2000-2006). A Agência Ambiental do Estado de São Paulo forneceu dados diários de PM10. Realizou-se análise descritiva e de regressão logística. A prevalência de baixo peso ao nascer foi de 5,9%. Observou-se uma relação dose-resposta entre as concentrações de PM10 e baixo peso ao nascer. As concentrações de PM10 no quartil mais alto (37,50µg/m³) no terceiro trimestre gestacional aumentaram o risco de baixo peso ao nascer em 26% (OR = 1,26; IC95%: 1,14-1,40) quando comparadas com o primeiro quartil. O mesmo efeito foi observado nos demais trimestres. Esse efeito foi verificado mesmo com as concentrações de partículas dentro dos padrões de qualidade do ar.

La contaminación del aire en todo el mundo es un problema de salud pública. Los efectos adversos relacionados con los contaminantes del aire están fuertemente asociados con enfermedades respiratorias y cardiovasculares, pero en menor medida con los resultados adversos del embarazo. En este estudió se evaluó la relación entre PM10 y bajo peso al nacer en el municipio de Santo André, São Paulo, Brasil. Se incluyeron en el estudio los recién nacidos de madres residentes en Santo André (2000-2006). La Agencia ambiental del Estado de São Paulo informó de los índices diarios de PM10. Además, se realizó un análisis descriptivo y por regresión logística. La prevalencia de bajo peso al nacer fue de un 5,9%. Hubo una relación dosis-respuesta entre las concentraciones de PM10 y bajo peso al nacer. Las concentraciones de PM10 en el cuartil más alto (37,50µg/m³) en el tercer trimestre aumentaban el riesgo gestacional de bajo peso al nacer en un 26% (OR = 1,26; IC95%: 1,14-1,40), en comparación con el primer cuartil. El mismo efecto se observó en los trimestres restantes. Este efecto fue observado incluso en partículas con concentraciones que están dentro de los estándares del aire.

Effect of prenatal organophosphate exposure on birth outcomes in rural areas in El Minia governorate

Chlorpyrifos [CPF] is a form of organophosphate [OP] insecticide that is widely used in both agricultural and home settings. This study was conducted in Minia University Hospital in collaboration with the Department of Forensic Medicine and Toxicology, Faculty of Medicine, El-Minia University to evaluate the effects of the prenatal exposure to OP on birth outcomes and the levels of maternal blood OP and umbilical cord blood OP in OP exposed areas in comparison with non exposed areas. Seventy pregnant women were recruited for the study during the period from June 2009 to June 2010. The pregnant women were divided into two groups, group I [study group] were selected from areas where exposure is to organophosphates compounds in the villages of Saft Al labn and AlByrjaiah and group 11 [control group] were selected from areas non exposed to organophosphates compounds, each included 35 pregnant women. They were subjected to history taking, general and obstetric examination, ultrasound evaluation, fetal biophysical profile [BPP] scoring, and doppler flow velocity waveform analysis. Chlorpyrifos [CPF] was determined in maternal and umbilical cord blood collected at parturition, in cases with exposed and non exposed babies to evaluate the fetal growth and different perinatal outcome variables.The difference between the two groups in clinical characteristics was statistically insignificant. There were statistical significant differences between the two groups as regards maternal blood CPF, and umbilical cord blood CPF levels [p<0.00l] suggesting a higher risk of CPF exposure in the study group. There were statistically significant differences in all perinatal outcome variables between the two groups [p<0.00l]. In the study group, There was positive correlation [r = 0.53, p0.0l] between maternal and umbilical cord blood CPF levels confirmed the transfer of CPF from mother to the fetus. There was a week but significant correlation between UC blood CPF levels and neonatal birth weight, head circumference and fetal length [r = - 0.22, p < 0.01], [r = - 0.25, p < 0.01], [r = - 0.14, p < 0.01] respectively. Maternal CPF exposure is associated with increased adverse perinatal outcome. For those interested in environmental health to take all the ways that reduce exposure to Chlorpyrifos and also the need to apply continuous bio-monitoring program to assess the impact of environmental pollutants on the health of women and children

Oral clefts, consanguinity, parental tobacco and alcohol use: a case-control study in Rio de Janeiro, Brazil

This hospital-based, case-control study investigated the possible associations between family history of malformations, parental consanguinity,smoking and alcohol drinking and nonsyndromic orofacial cleft (OC, subdivided in 2 main groups: CL/P - cleft lip with or without cleft palate and CP - cleft palate alone). 274 cases were matched (age, sex and place of residence) to 548 controls. Odds ratios (OR) and 95% confi dence intervals (95% CI) – adjusted for maternal age, schooling and smoking / alcohol use – were calculated by conditional logistic regression. The results demonstrated that the history of oral clefts either in thefather’s (CL/P: OR = 16.00, 5.64- 9.23; CP: OR = 6.64, 1.48-33.75) or in the mother’s family (CL/P: OR = 5.00, 2.31-10.99, CP: OR = 12.44, 1.33-294.87) was strongly associated with both types of clefts, but parental consanguinity was associated only with CL/P (OR = 3.8, 1.27-12.18). Prevalence of maternal smoking during the fi rst trimester of pregnancy was higher among cases but the OR (1.13, 0.81-1.57) was not statistically signifi cant. Maternal passive smoking (nonsmoking mothers) during pregnancy was associated with CL/P (1.39, 1.01-1.98) but not with CP.Maternal alcohol use during the 1st trimester increased odds for CL/P (OR = 2.08, 1.27-3.41) and CP (OR = 2.89, 1.25-8.30), and odds for OC tended to increase with dose. Neither smoking nor alcohol use by fathers increased risks for OC. This study provides further evidence of a possible role of maternal exposure to tobacco smoke and alcohol in the etiology of nonsyndromic oral clefts.

Single versus multiple courses of antenatal betamethasone and neonatal outcome: a randomized controlled trial.

OBJECTIVES: This study compared the beneficial and adverse neonatal effects of a single versus repeated courses of antenatal betamethasone. SETTING: Tertiary care hospital DESIGN: Open labeled, randomized controlled trial. PARTICIPANTS: Pregnant women (26-33 weeks) at risk of preterm delivery, who received one course of antenatal betamethasone and remained undelivered for 7 days.Those with uncertain gestation, major malformations and frank chorioamnionitis were excluded. INTERVENTIONS: Subjects were randomized to receive weekly antenatal betamethasone until 34 weeks or no further betamethasone. OUTCOME MEASURES: Primary: incidence of severe respiratory distress syndrome (RDS). Secondary: incidence of non-severe RDS and other neonatal morbidity; birth weight, length and occipito-frontal circumference (OFC); and, development and growth at 6 mo corrected age. RESULTS: 38 subjects were allocated to each group. Severe RDS was similar in multiple and single course groups (7% vs. 3% respectively, P=0.34), as was incidence of other morbidity. Composite outcome of RDS and or death within 28 days tended to be less in multiple course group (P=0.07). Birth anthropometry was similar in the 2 groups. At 6 mo corrected age (n=44), weight and length were significantly lower in multiple course group (p=0.003 and P=0.007, respectively), whereas OFC was not different (P=0.1). There were no differences vis a vis neurodevelopmental outcomes. CONCLUSIONS: A single course of antenatal betamethasone was as efficacious as multiple courses, with respect to prevention of neonatal morbidity. Multiple antenatal betamethasone courses have long-term adverse effects on infant weight and length growth, but not on OFC and neurodevelopment.

Are birth weight and maternal smoking during pregnancy associated with malnutrition and excess weight among school age children?

In the late 1980's child malnutrition was still prevalent in Brazil, and child obesity was beginning to rise in the richest regions of the country. To assess the extent of the nutritional transition during the period and the influence of birth weight and maternal smoking on the nutritional condition of schoolchildren, we estimated the prevalence of excess weight and malnutrition in a cohort of Brazilian schoolchildren from 1987 to 1989. We calculated the body mass index (BMI) of 8- to 10-year-old schoolchildren born in Ribeirão Preto in 1978/79. We considered children with a BMI <5th percentile (P5) to be malnourished, children with P5³BMI

Prevalencia de enfermedades respiratorias en el primer año de vida en hijos de madres que fumaron durante el embarazo / Prevalence of respiratory illnesses in infants whose mothers smoked tobacco during pregnancy

This study assessed the effect of maternal tobacco smoking during pregnancy on their infants' respiratory health during the first year of life in a random sample of 184 mother-infant binomials. Data were analyzed using chi square test for proportions and multivariate logistic regression adjusting for covariates. Infants exposed to maternal smoking during pregnancy had a significantly higher risk of suffering from wheezing (p < 0.01), acute respiratory illnesses (p < 0.01) and admissions due to pneumonia (p < 0.05) during their first year of life than non-exposed infants. Accordingly to what has been described in developed countries, in this sample from a low socioeconomic status population, active maternal tobacco smoking during pregnancy significantly increased infants' susceptibility for suffering from wheezing, acute respiratory illnesses and hospital admissions due to pneumonia during the first year of life.

Este estudio evaluó el efecto del tabaquismo materno durante el embarazo sobre la salud respiratoria de sus lactantes durante el primer año de vida, en 184 binomios madre-hijo. El análisis se realizó mediante chi cuadrado para proporciones y regresión logística multivariada ajustando para covariables. Los hijos de madres que fumaron durante el embarazo tuvieron un riesgo significativamente mayor de sufrir de bronquitis obstructiva (p < 0,01), de enfermedades respiratorias agudas en general (p < 0,01) y de hospitalización por neumonía (p < 0,05), en comparación con los hijos de madres que no fumaron durante el embarazo. Concordantemente con lo descrito en países desarrollados, en esta muestra proveniente de una población de bajos recursos socioeconómicos, el tabaquismo materno durante el embarazo aumentó significativamente la susceptibilidad de los lactantes para sufrir de bronquitis obstructivas, enfermedades respiratorias agudas y de hospitalizaciones por neumonía en su primer año de vida.

Poluição do ar e baixo peso ao nascer no Município do Rio de Janeiro, Brasil, 2002 / Air pollution and low birth weight in the city of Rio de Janeiro, Brazil, 2002

O objetivo deste trabalho é avaliar o efeito da poluição do ar sobre o peso ao nascer de recém-nascidos a termo e de gestação única no Município do Rio de Janeiro, Brasil. O desenho deste estudo foi o de corte transversal tendo como base o ano de 2002. Os dados sobre os nascimentos foram obtidos do Sistema de Informações de Nascidos Vivos (SINASC) do Ministério da Saúde. Baixo peso foi definido como menos de 2.500g. A exposição das mães foi estimada como a média do poluente para cada trimestre de gestação. Razões de odds (RO) ajustadas foram estimadas para cada fator de risco em potencial. Para PM10, CO e NO2 foram encontrados aumentos não significativos. Para SO2, a RO do quarto intervalo interquartil de exposição no terceiro trimestre de gestação foi 1,149 (IC95 por cento: 1,016;1,301). Para o O3, a RO estimada foi 0,830 (IC95 por cento: 0,750;0,987). Quando a variável de exposição foi introduzida no modelo como uma medida contínua, as RO para PM10, CO e SO2 no terceiro trimestre foram não significativas e iguais a 1,089, 2,223 e 1,259, respectivamente.

The objective of this study was to evaluate the effect of air pollution on low birth weight in full term singleton newborns in the city of Rio de Janeiro, Brazil. The study adopted a cross-sectional design based on the year 2002. Data on live births were obtained from the Live Birth Information System of the Brazilian Ministry of Health. Low birth weight was defined as less than 2,500g. Maternal exposure to air pollution was defined as the mean for a given pollutant over each trimester of pregnancy and was assessed taking birth date into account. Adjusted odds ratios (OR) were estimated for each potential risk factor. For PM10, CO, and NO2, no significant increases were detected. For SO2, the OR of the fourth interquartile range of exposure in the third trimester of pregnancy was 1.149 (95 percentCI: 1.016-1.301). For O3, the estimated OR was 0.830 (95 percentCI: 0.750-0.987). When exposure variable was regarded as a continuous measure, the OR for PM10, CO, and SO2 in the third trimester were not statistically significant and were 1.089, 2.223, and 1.259, respectively.

Correlation between blood mercury levels in mothers and newborns in Itaituba, Pará State, Brazil

This study evaluated transplacental mercury transfer by measuring Hg in blood samples of mothers and newborns (umbilical cord) in hospitals in the municipality (county) of Itaituba, Pará State, Brazil. Epidemiological and mercury exposure data were collected, besides clinical birth data. Mercury tests were performed by cold-vapor atomic absorption spectrophotometry. A total of 1,510 women and an equal number of their newborns participated in the study. Mean blood mercury was 11.53µg/L in mothers and 16.68µg/L in newborns (umbilical cord). The highest Hg levels were in the 31-40-year maternal age group and their newborns, with 14.37µg/L and 21.87µg/L, respectively. However, in all age groups the mean mercury level was higher in newborns than in mothers. There was a strong positive correlation between Hg levels in newborns and mothers (r = 0.8019; p = 0.000), with a significant linear regression model (r = 0.5283; p = 0.000). The results highlight the importance of monitoring pregnant women exposed to mercury as part of public health surveillance.

Este estudo avaliou a transferência transplacentária de mercúrio (Hg) utilizando amostras de sangue das mães e recém-nascidos (cordão umbilical) de hospitais do Município de Itaituba, Pará, Brazil. Foram coletados dados epidemiológicos e de exposição ao Hg, além de dados clínicos ao nascimento. As análises de mercúrio foram realizadas por espectrofotometria de absorção atômica com sistema de vapor frio. Um total de 1.510 mulheres e seus recém-nascidos participaram do estudo. A média de Hg em sangue das mães foi de 11,52µg/L e no cordão umbilical foi 16,68µg/L. Os níveis mais elevados de Hg foram verificados nas idades entre 31 a 40 anos, com médias de 14,37µg/L nas mães e 21,87µg/L nos recém-nascidos. Entretanto, em todas as faixas de idade materna as médias de Hg estavam mais elevadas nos recém-nascidos em relação às mães. Verificou-se correlação positiva e forte entre os níveis de Hg nas mães e recém-nascidos (r = 0,8019; p = 0,000) com modelo de regressão linear significante (r = 0,5283; p = 0,000). Estes resultados indicam a importância do monitoramento de mulheres grávidas expostas ao Hg como parte da vigilância em saúde.