Air pollution and limb defects: A matched-pairs case-control study in Taiwan

Abstract

BackgroundAir pollution influences the development of limb defects in animals. There is little epidemiologic evidence on the effect of prenatal air pollution exposure on the risk of limb defects. ObjectiveTo assess the relations between exposure to ambient air pollutants and the risk of limb defects. MethodsWe conducted a matched-pairs case-control study in Taiwan from 2001 through 2007. The case group consisted of 1687 limb defects and the control group was density-sampling matched one to ten based on the month and year of conception from 1510,064 live singleton newborns in 2001–2007. Adjusted conditional logistic regression models were used to estimate odds ratios per 10ppb change for O3, NO2, 1ppb change for SO2, 10µg/m3 change for PM10, and 100ppb change for CO during the first trimester and first three gestational months. ResultsOf the specific limb defects, reduction deformities of limbs (adjusted OR=1.024, 95% CI: 1.000, 1.048) was associated with a 1ppb increase in SO2 during weeks of 9–12 of gestation as well as the first trimester. Reduction deformities of limbs was also associated with a 10ppb increase in O3 during weeks of 1–4 of gestation (adjusted OR=1.391, 95% CI: 1.064, 1.818) among preterm births. ConclusionThe present study provides evidence that exposure to outdoor air SO2 during the first trimester of pregnancy may increase the risk of limb defects. Exposure to O3 was associated with reduction deformities of limbs among preterm births. Similar levels of SO2 and O3 are encountered globally by large numbers of pregnant women.