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"Relationship between Environmental Air Quality and Congenital Heart Defects".

紀錄類型:	書目-電子資源 : Monograph/item
正題名/作者:	"Relationship between Environmental Air Quality and Congenital Heart Defects"./
作者:	Hall, Katherine C.
出版者:	Ann Arbor : ProQuest Dissertations & Theses, : 2019,
面頁冊數:	164 p.
附註:	Source: Dissertations Abstracts International, Volume: 80-10, Section: B.
Contained By:	Dissertations Abstracts International80-10B.
標題:	Environmental Health. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=13808940
ISBN:	9781392048481

"Relationship between Environmental Air Quality and Congenital Heart Defects".
Hall, Katherine C.

"Relationship between Environmental Air Quality and Congenital Heart Defects". - Ann Arbor : ProQuest Dissertations & Theses, 2019 - 164 p.

Source: Dissertations Abstracts International, Volume: 80-10, Section: B.

Thesis (Ph.D.)--The University of Mississippi Medical Center, 2019.

This item must not be sold to any third party vendors.

Congenital heart defects (CHDs) impact nearly 40,000 infants annually in the United States. Of these infants, one-quarter are diagnosed with a critical CHD requiring invasive cardiac catheterization intervention or surgical treatment within the first year of life for survival. Despite the number of infants affected, over 80% of all CHDs diagnosed have an unknown etiology. Environmental risk factors have been recognized as an important determinant of health and may be a modifiable risk factor associated with a CHD diagnosis. Air pollution is one environmental factor that is associated with mortality and morbidity affecting vulnerable populations, including infants in utero. Two criteria air pollutants in particular that have documented impacts on one's health are particulate matter <2.5 (PM2.5) and ozone (O3). An improvement in modifiable environmental factors such as air pollution levels could potentially lower the risk of CHDs. The purpose of this research was to further explore the relationship between air quality and a critical CHD diagnosis. Specifically, the hypothesis was that increasing amounts of PM 2.5 and O3 during the critical exposure window of fetal development would be associated with increased rates of critical CHD diagnosis. A retrospective, case-control epidemiological study was conducted using 199 live-born infants with a diagnosis of critical CHD and a random sample of 550 live birth controls from January 1, 2014 to December 31, 2016 in Mississippi. The cases were obtained from the Society of Thoracic Surgeons - Congenital Heart Surgery (STS) database and hospital data from a local state hospital. The controls were randomly selected from 99,706 infants born during the same time frame from the Mississippi Department of Health Vital Statistics database. Case data included date of birth, diagnosis, sex, race, and maternal address. Control data included date of birth by week, sex, race, and maternal residence distance from the closest PM2.5 and O3 monitoring station. Air pollution data were obtained from the Environmental Protection Agency's air quality monitors for PM2.5 and O3 pollutants. ArcGIS geographical information systems (GIS) software was used to geocode monitoring stations in Mississippi and surrounding contiguous states, and maternal residence for all cases. Control infants' maternal residence was geocoded by the Mississippi Department of Health Vital Statistics and distance from the nearest monitoring stations was calculated and provided for data analysis. Using tension spline spatial interpolation, exposure to the air pollutants during weeks one through twelve of gestation was assessed for each infant in the study based on residential location. Data analysis included frequencies, chi-square, and independent t-test analysis to evaluate the relationship between covariates (race, sex, and maternal residential distance from air monitoring station) and air pollution exposure levels for both cases and controls. These results were used to determine statistical significance between the PM2.5 and O3 sample groups. Bivariate logistic regression models were used to calculate adjusted odds ratios (aORs) and 95% confidence intervals (CI) for the association between exposure to these environmental air pollutants during early pregnancy and the diagnosis of a critical CHD. Separate analytic models were conducted using the time frame of weeks one to twelve gestation, and weeks three to eight gestation. The majority of cases were male, White, and had a maternal residence within 10 to 50 km from an air monitoring station. The average distance from the maternal residence to the PM2.5 monitoring station was 24.17 km and 24.26 km to the closest O3 monitoring station. There was no association in the regression models. However, there was an observed positive trend for increased odds as pollutant levels of PM2.5 increased. It was also identified that the odds varied among models for O 3 as one model identified lower pollutant levels to have the highest odds (aOR 1.45; 95% CI= 0.45, 4.69) while another model identified higher odds associated with the highest pollutant levels (aOR 1.48; 0.44, 4.51). Additional analysis by week also revealed statistically significant increased odds of a critical CHD diagnosis during specific weeks in early pregnancy. Odds were higher in weeks five (p=.013) and eight ( p=.011) with increasing exposure to PM2.5. With week 5 the aOR increased from 0.98 to 2.27 (95% CI=0.40, 2.38 in 2nd quartile; 95% CI=0.57, 3.02 in 3rd quartile; 95% CI=1.00, 5.12 in 4th quartile). (Abstract shortened by ProQuest.).

ISBN: 9781392048481Subjects--Topical Terms:

578282
Environmental Health.

"Relationship between Environmental Air Quality and Congenital Heart Defects".
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