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A meta-analysis of exposure to particulate matter and adverse birth outcomes
Lamichhane, Dirga Kumar,Leem, Jong-Han,Lee, Ji-Young,Kim, Hwan-Cheol The Korean Society of Environmental Toxicology 2015 환경독성보건학회지 Vol.30 No.-
Objectives The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. Methods We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to $2.5{\mu}m$ and $10.0{\mu}m$ in diameter, $PM_{2.5}$ and $PM_{10}$, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results In random effects meta-analyses, BW as a continuous outcome was negatively associated with $10{\mu}g/m^3$ increase in $PM_{10}$ (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p=0.947) and $PM_{2.5}$ (-22.17 g; 95% CI, -37.93 to -6.41 g; Isquared=92.3%, p<0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per $10{\mu}g/m^3$ increase in $PM_{10}$ (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p=0.977) and $PM_{2.5}$ (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p<0.001) exposure during entire pregnancy was observed. Effect size of change in BW per $10{\mu}g/m^3$ increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.
Sex differences in genetic susceptibility to maternal mercury and head circumference at birth
( Dirga Kumar Lamichhane ),( Jong-han Leem ),( Hwan-cheol Kim ),( Dai-young Jung ),( Ji-younglee ),( Jung Keun Ko ),( Yangho Kim ),( Yun-chulhong ),( Mina Ha ),( Eun-hee Ha ) 한국모자보건학회 2016 한국모자보건학회 학술대회 연제집 Vol.2016 No.2
Introduction Some studies have reported effects of prenatal mercury (Hg) on reduced head circmiiference at birth; however, modifying effects of maternal glutathione S-transferase Ml (GSTM1) or glutathione S-transferase T1 (GSTT1) genotype and infant sex remain unexplored. Our aim was to examine interactions among blood Hg, sex, and GSTM1/GSTT1 polymorphisms in reducing head circumference at birth. Methods This study used data from Mothers and Children’ s Environmental Health study (2006-2011) that included total Hg concentration in maternal and cord blood from 515 women and newborns. Information on head circumference (HC) was obtained from medical records and head circumference-to-length ratio (HCLR) was calculated. We defined the threshold level for Hg effects at the 90<sup>th</sup> percentile. Linearregressions were adjusted for pre pregnancy weight, age, education, parity, weight gain during pregnancy, gestationalage, and urinarycotinine levels, and effect modification was examined instratified analysis and by fitting interaction terms. Results Hg level in early pregnancy that exceeded the 90thpercentile(5.79/g/L)wassignificantlyassociatedwithsmallerHCinmalesofmothershavingnullalleleforGSTM1(β=-0.86;95%confidenceinterval:-1.63,-0.09)(HgxsexxGSTMlnullPinteraction=0.02).ResultsweresimilarforHCLRmodels(Pinteraction=0.04).However, theineteractionofHglevelduringpregnancyorincordblood,sex,andGSTTlnullwasnotsignificant.FurtheranalysesstratifiedbysexandGSTMlgenotyperevealedsignificantinteractionsbetweenHglevelinearlypregnancyandsexonlyininfantsborntomothershavingGSTMlnull(Hgxsex,Pinteraction=0.01)butnotinGSTMlpresentgenotype(Pinteraction=0.37). Conclusions Small HC at birth is related to behavioural symptoms later in life; therefore, the most evident effects of Hg on the reduced HC in males born to mothers with GSTM1 null genotype need further investigations to validate our findings.
A meta-analysis of exposure to particulate matter and adverse birth outcomes
Dirga Kumar Lamichhane,Jong-Han Leem,Ji-Young Lee,Hwan-Cheol Kim 환경독성보건학회 2015 환경독성보건학회지 Vol.30 No.-
Objectives: The objective of this study was to conduct a systematic review to provide summarized evidence on the association between maternal exposure to particulate air pollution and birth weight (BW) and preterm birth (PTB) after taking into consideration the potential confounding effect of maternal smoking. Methods: We systematically searched all published cohort and case-control studies examining BW and PTB association with particulate matter (PM, less than or equal to 2.5 μm and 10.0 μm in diameter, PM2.5 and PM10, respectively) from PubMed and Web of Science, from January 1980 to April 2015. We extracted coefficients for continuous BW and odds ratio (OR) for PTB from each individual study, and meta-analysis was used to combine the coefficient and OR of individual studies. The methodological quality of individual study was assessed using a standard protocol proposed by Downs and Black. Forty-four studies met the inclusion criteria. Results: In random effects meta-analyses, BW as a continuous outcome was negatively associated with 10 μg/m3 increase in PM10 (-10.31 g; 95% confidence interval [CI], -13.57 to -3.13 g; I-squared=0%, p =0.947) and PM2.5 (-22.17 g; 95% CI, -37.93 to -6.41 g; Isquared= 92.3%, p <0.001) exposure during entire pregnancy, adjusted for maternal smoking. A significantly increased risk of PTB per 10 μg/m3 increase in PM10 (OR, 1.23; 95% CI, 1.04 to 1.41; I-squared=0%, p =0.977) and PM2.5 (OR, 1.14; 95% CI, 1.06 to 1.22; I-squared=92.5%, p <0.001) exposure during entire pregnancy was observed. Effect size of change in BW per 10 μg/m3 increase in PM tended to report stronger associations after adjustment for maternal smoking. Conclusions: While this systematic review supports an adverse impact of maternal exposure to particulate air pollution on birth outcomes, variation in effects by exposure period and sources of heterogeneity between studies should be further explored.