{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T02:35:19Z","timestamp":1787366119570,"version":"build-2736575974"},"reference-count":31,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2021,4,13]],"date-time":"2021-04-13T00:00:00Z","timestamp":1618272000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,11,2]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>From 1948 to 1954, the Atomic Bomb Casualty Commission conducted a study of pregnancy outcomes among births to atomic bomb survivors (Hiroshima and Nagasaki, Japan) who had received radiation doses ranging from 0 Gy to near-lethal levels. Past reports (1956, 1981, and 1990) on the cohort did not identify significant associations of radiation exposure with untoward pregnancy outcomes, such as major congenital malformations, stillbirths, or neonatal deaths, individually or in aggregate. We reexamined the risk of major congenital malformations and perinatal deaths in the children of atomic bomb survivors (n\u00a0=\u00a071,603) using fully reconstructed data to minimize the potential for bias, using refined estimates of the gonadal dose from Dosimetry System 2002 and refined analytical methods for characterizing dose-response relationships. The analyses showed that parental exposure to radiation was associated with increased risk of major congenital malformations and perinatal death, but the estimates were imprecise for direct radiation effects, and most were not statistically significant. Nonetheless, the uniformly positive estimates for untoward pregnancy outcomes among children of both maternal and paternal survivors are useful for risk assessment purposes, although extending them to populations other than the atomic bomb survivors comes with uncertainty as to generalizability.<\/jats:p>","DOI":"10.1093\/aje\/kwab099","type":"journal-article","created":{"date-parts":[[2021,4,9]],"date-time":"2021-04-09T11:46:02Z","timestamp":1617968762000},"page":"2323-2333","source":"Crossref","is-referenced-by-count":38,"title":["Congenital Malformations and Perinatal Deaths Among the Children of Atomic Bomb Survivors: A Reappraisal"],"prefix":"10.1093","volume":"190","author":[{"given":"Michiko","family":"Yamada","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoji","family":"Furukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshimi","family":"Tatsukawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiko","family":"Marumo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachiyo","family":"Funamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ritsu","family":"Sakata","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kotaro","family":"Ozasa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry M","family":"Cullings","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dale L","family":"Preston","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paivi","family":"Kurttio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,4,13]]},"reference":[{"issue":"2","key":"2021110206560714600_ref1","first-page":"183","article-title":"Studies on the potential genetic effects of the atomic bombs","volume":"6","author":"Neel","year":"1956\u20131957","journal-title":"Acta Genet Stat Med"},{"issue":"4513","key":"2021110206560714600_ref2","doi-asserted-by":"crossref","first-page":"1220","DOI":"10.1126\/science.7268429","article-title":"Genetic effects of the atomic bombs: a reappraisal","volume":"213","author":"Schull","year":"1981","journal-title":"Science"},{"issue":"1","key":"2021110206560714600_ref3","doi-asserted-by":"crossref","first-page":"1","DOI":"10.2307\/3577576","article-title":"Congenital malformations, stillbirths, and early mortality among the children of atomic bomb survivors: a reanalysis","volume":"122","author":"Otake","year":"1990","journal-title":"Radiat Res"},{"issue":"6","key":"2021110206560714600_ref4","first-page":"1053","article-title":"The children of parents exposed to atomic bombs: estimates of the genetic doubling dose of radiation for humans","volume":"46","author":"Neel","year":"1990","journal-title":"Am J Hum Genet"},{"issue":"suppl B","key":"2021110206560714600_ref5","doi-asserted-by":"crossref","first-page":"B67","DOI":"10.1269\/jrr.47.B67","article-title":"Genetic effects of radiation in atomic-bomb survivors and their children: past, present and future","volume":"47","author":"Nakamura","year":"2006","journal-title":"J Radiat Res"},{"issue":"13","key":"2021110206560714600_ref6","doi-asserted-by":"crossref","first-page":"1316","DOI":"10.1016\/S1470-2045(15)00209-0","article-title":"Risk of death among children of atomic bomb survivors after 62 years of follow-up: a cohort study","volume":"16","author":"Grant","year":"2015","journal-title":"Lancet Oncol"},{"issue":"2","key":"2021110206560714600_ref7","doi-asserted-by":"crossref","first-page":"281","DOI":"10.1088\/0952-4746\/33\/2\/281","article-title":"Radiation risk of individual multifactorial diseases in offspring of the atomic-bomb survivors: a clinical health study","volume":"33","author":"Tatsukawa","year":"2013","journal-title":"J Radiol Prot"},{"key":"2021110206560714600_ref8","volume-title":"The Children of Atomic Bomb Survivors: A Genetic Study","author":"Neel","year":"1991"},{"issue":"1","key":"2021110206560714600_ref9","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1667\/RR3546.1","article-title":"Dose estimation for atomic bomb survivor studies: its evolution and present status","volume":"166","author":"Cullings","year":"2006","journal-title":"Radiat Res"},{"issue":"6","key":"2021110206560714600_ref10","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph15061219","article-title":"Changes in risk perception of the health effects of radiation and mental health status: the Fukushima Health Management Survey","volume":"15","author":"Suzuki","year":"2018","journal-title":"Int J Environ Res Public Health"},{"issue":"8","key":"2021110206560714600_ref11","doi-asserted-by":"crossref","first-page":"3523","DOI":"10.1073\/pnas.74.8.3523","article-title":"Mutation frequencies in female mice and the estimation of genetic hazards of radiation in women","volume":"74","author":"Russell","year":"1977","journal-title":"Proc Natl Acad Sci U S A"},{"key":"2021110206560714600_ref12","volume-title":"The Effects on Populations of Exposure to Low Levels of Ionizing Radiation","author":"Committee on the Biological Effects of Ionizing Radiation, National Academy of Sciences\u2013National Research Council","year":"1980"},{"issue":"1-2","key":"2021110206560714600_ref13","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1016\/j.mrfmmm.2012.01.003","article-title":"The effects of maternal irradiation during adulthood on mutation induction and transgenerational instability in mice","volume":"732","author":"Abouzeid Ali","year":"2012","journal-title":"Mutat Res"},{"issue":"suppl 4","key":"2021110206560714600_ref14","doi-asserted-by":"crossref","first-page":"141","DOI":"10.1111\/1471-0528.12995","article-title":"Causes of and factors associated with stillbirth in low- and middle-income countries: a systematic literature review","volume":"121","author":"Aminu","year":"2014","journal-title":"BJOG"},{"issue":"4 suppl","key":"2021110206560714600_ref15","doi-asserted-by":"crossref","first-page":"957","DOI":"10.1542\/peds.113.S3.957","article-title":"Environmental causes of human congenital malformations: the pediatrician\u2019s role in dealing with these complex clinical problems caused by a multiplicity of environmental and genetic factors","volume":"113","author":"Brent","year":"2004","journal-title":"Pediatrics"},{"key":"2021110206560714600_ref16","volume-title":"R: A Language and Environment for Statistical Computing","author":"R Core Team","year":"2014"},{"issue":"4","key":"2021110206560714600_ref17","first-page":"339","article-title":"A cohort-type study of survival in the children of parents exposed to atomic bombings","volume":"18","author":"Kato","year":"1966","journal-title":"Am J Hum Genet"},{"key":"2021110206560714600_ref18","volume-title":"Hiroshima and Nagasaki: The Physical, Medical, and Social Effects of the Atomic Bombings","author":"Lebow","year":"1981"},{"issue":"1","key":"2021110206560714600_ref19","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1097\/00004032-200307000-00013","article-title":"Genetic effects of radiotherapy for childhood cancer","volume":"85","author":"Boice","year":"2003","journal-title":"Health Phys"},{"issue":"1","key":"2021110206560714600_ref20","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.mrrev.2013.04.001","article-title":"Evidence relevant to untargeted and transgenerational effects in the offspring of irradiated parents","volume":"753","author":"Little","year":"2013","journal-title":"Mutat Res"},{"issue":"2","key":"2021110206560714600_ref21","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1080\/10428194.2017.1352097","article-title":"Pregnancy and child health outcomes in pediatric and young adult leukemia and lymphoma survivors: a systematic review","volume":"59","author":"Shliakhtsitsava","year":"2018","journal-title":"Leuk Lymphoma"},{"issue":"3","key":"2021110206560714600_ref22","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1200\/JCO.2011.37.2938","article-title":"Congenital anomalies in the children of cancer survivors: a report from the Childhood Cancer Survivor Study","volume":"30","author":"Signorello","year":"2012","journal-title":"J Clin Oncol"},{"issue":"1","key":"2021110206560714600_ref23","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1111\/j.1399-0004.2008.01109.x","article-title":"Radiotherapy for childhood cancer and risk for congenital malformations in offspring: a population-based cohort study","volume":"75","author":"Winther","year":"2009","journal-title":"Clin Genet"},{"issue":"2","key":"2021110206560714600_ref24","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1093\/oxfordjournals.aje.a114799","article-title":"A case-control study of congenital malformations and occupational exposure to low-level ionizing radiation","volume":"127","author":"Sever","year":"1988","journal-title":"Am J Epidemiol"},{"issue":"4","key":"2021110206560714600_ref25","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/bdra.23340","article-title":"Maternal occupational exposure to ionizing radiation and major structural birth defects","volume":"103","author":"Lim","year":"2015","journal-title":"Birth Defects Res A Clin Mol Teratol"},{"issue":"2","key":"2021110206560714600_ref26","doi-asserted-by":"crossref","first-page":"73","DOI":"10.1136\/oem.53.2.73","article-title":"Health of children born to medical radiographers","volume":"53","author":"Roman","year":"1996","journal-title":"Occup Environ Med"},{"issue":"9238","key":"2021110206560714600_ref27","doi-asserted-by":"crossref","first-page":"1293","DOI":"10.1016\/S0140-6736(00)02812-9","article-title":"Fetal death and congenital malformation in babies born to nuclear industry employees: report from the Nuclear Industry Family Study","volume":"356","author":"Doyle","year":"2000","journal-title":"Lancet"},{"issue":"9741","key":"2021110206560714600_ref28","doi-asserted-by":"crossref","first-page":"624","DOI":"10.1016\/S0140-6736(10)60752-0","article-title":"Stillbirth and neonatal death in relation to radiation exposure before conception: a retrospective cohort study","volume":"376","author":"Signorello","year":"2010","journal-title":"Lancet"},{"issue":"9188","key":"2021110206560714600_ref29","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1016\/S0140-6736(99)04138-0","article-title":"Stillbirths among offspring of male radiation workers at Sellafield nuclear reprocessing plant","volume":"354","author":"Parker","year":"1999","journal-title":"Lancet"},{"issue":"2","key":"2021110206560714600_ref30","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1088\/0952-4746\/21\/2\/303","article-title":"Risk of stillbirth in offspring of men exposed to ionising radiation","volume":"21","author":"Abrahamson","year":"2001","journal-title":"J Radiol Prot"},{"issue":"1","key":"2021110206560714600_ref31","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1200\/JCO.2011.35.0504","article-title":"Genetic disease in the children of Danish survivors of childhood and adolescent cancer","volume":"30","author":"Winther","year":"2012","journal-title":"J Clin Oncol"}],"container-title":["American Journal of Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/aje\/advance-article-pdf\/doi\/10.1093\/aje\/kwab099\/39586680\/kwab099.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/190\/11\/2323\/41025373\/kwab099.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"http:\/\/academic.oup.com\/aje\/article-pdf\/190\/11\/2323\/41025373\/kwab099.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T22:09:45Z","timestamp":1671833385000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/aje\/article\/190\/11\/2323\/6224945"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,4,13]]},"references-count":31,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2021,4,13]]},"published-print":{"date-parts":[[2021,11,2]]}},"URL":"https:\/\/doi.org\/10.1093\/aje\/kwab099","relation":{},"ISSN":["0002-9262","1476-6256"],"issn-type":[{"value":"0002-9262","type":"print"},{"value":"1476-6256","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2021,11]]},"published":{"date-parts":[[2021,4,13]]}}}