Abstract
The potential association between maternal exposure to PM10 ranging from 3 months prior to conception to the end of the early trimester and the risk of anorectal atresia/stenosis in offspring has not been established. Thus, we determined the association between maternal exposure to PM10 and risk of anorectal atresia/stenosis in offspring in this study. We recruited 713 patients including 480 male and 233 female with anorectal atresia/stenosis and 7950 randomly selected healthy offspring from the Maternal and Child Health Certificate Registry of Liaoning Province and delivered between 1 January 2010 and 31 December 2015. Monthly PM10 concentrations were retrieved from the Environment Protection Bureau of each city in Liaoning Province. We established a multivariable logistic regression model to calculate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs). Maternal exposure to PM10 was associated with an increased risk for anorectal atresia/stenosis in offspring during the 3 months prior to conception (per 10 μg/m3 increment: OR = 1.15, 95% CI = 1.03-1.20; per SD [27 μg/m3] increment: OR = 1.33, 95% CI = 1.09-1.63) and the first trimester (per 10 μg/m3 increment: OR = 1.08, 95% CI = 1.00-1.17; per SD [28 μg/m3] increment: OR = 1.26, 95% CI = 1.01-1.57). Evaluation of the association with a shorter exposure window (1 month) revealed a positive association between anorectal atresia/stenosis and PM10 from the 3rd month prior to pregnancy to each month of the 1st trimester. Maternal exposure to PM10 3 months prior to conception and during the 1st trimester was associated with an increased risk of anorectal atresia/stenosis in the offspring. Future perspective cohort studies are needed to confirm our findings.
Highlights
Anorectal atresia/stenosis refers to a congenital malformation that is characterized by absence of continuity of the anorectal canal, communication between the rectum and anus, or narrowing of the anal canal with or without a fistula to neighboring organs (Liu et al, 2019)
We analyzed the single months from the 3rd month before pregnancy to the 1st month before pregnancy; the results showed that maternal particulate matter (PM) with aerodynamic diameters ≤ 10 μm (PM10) exposure was positively associated with anorectal atresia/stenosis risk
The high anorectal deformity rate where the PM10 concentration was rather high as well, enabled us to concluded that maternal exposure to PM10 3 months prior to conception and in the 1st trimester was associated with an increased risk of anorectal atresia/stenosis in offspring
Summary
Anorectal atresia/stenosis refers to a congenital malformation that is characterized by absence of continuity of the anorectal canal, communication between the rectum and anus, or narrowing of the anal canal with or without a fistula to neighboring organs (Liu et al, 2019). The incidence of anorectal atresia/stenosis is high among gastrointestinal tract malformations in offspring. Previous studies have shown that the prevalence of anorectal atresia was approximately 1 per 5000 to 1 per 1500 live births (Boocock and Donnai, 1987; Cho et al, 2001). Anorectal atresia/stenosis has been associated with genetic factors; in most cases the etiology is complex and has not been established. Anorectal atresia/stenosis could be related to environmental factors. Little information is available about the association between air pollutants and anorectal atresia/stenosis. The potential association between maternal exposure to PM10 ranging from 3 months prior to conception to the end of the early trimester and the risk of anorectal atresia/stenosis in offspring have not been established.
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