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Recent studies suggested inconsistent results on the association between N<\/mml:mi>O<\/mml:mi><\/mml:mrow>x<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math> exposure and cardiovascular-related malformations. We aimed to assess aforementioned association in pregnant women in the first trimester and cardiovascular-related malformations of infants. A systematic literature review identified studies for observational studies about N<\/mml:mi>O<\/mml:mi><\/mml:mrow>x<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math> exposure and cardiovascular-related malformation in PubMed. Random-effect models were used to estimate summary odds ratio (SOR) and 95% confidence intervals (CIs) for aforementioned association. Finally, nine studies met the inclusion criteria. Overall, the SOR of cardiovascular-related malformation per 10\u2009ppb increment in N<\/mml:mi>O<\/mml:mi><\/mml:mrow>x<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math> and NO2<\/jats:sub> concentration was 1.01 (95% CI: 0.98\u20131.04; I<\/mml:mi><\/mml:mrow>2<\/mml:mn><\/mml:mrow><\/mml:msup><\/mml:mrow><\/mml:math> = 38.6%, P<\/mml:mi>=<\/mml:mo>0.09<\/mml:mn><\/mml:math>) and 0.99 (95% CI: 0.95\u20131.04; I<\/mml:mi><\/mml:mrow>2<\/mml:mn><\/mml:mrow><\/mml:msup><\/mml:mrow><\/mml:math> = 37.8%, P<\/mml:mi>=<\/mml:mo>0.13<\/mml:mn><\/mml:math>), respectively. Stratifying by study design, geographic locations, and confounded adjustments, the majority of strata showed negative results, which were consistent with the main findings. However, we found that exposure to N<\/mml:mi>O<\/mml:mi><\/mml:mrow>x<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math> and NO2<\/jats:sub> in the first trimester increased the risk of coarctation of the aorta (COA) malformation by 13% and 19%, respectively. Our study provided limited evidence regarding the association between N<\/mml:mi>O<\/mml:mi><\/mml:mrow>x<\/mml:mi><\/mml:mrow><\/mml:msub><\/mml:math> exposure in the first trimester and cardiovascular-related malformations in infants.<\/jats:p>","DOI":"10.1155\/2018\/1948407","type":"journal-article","created":{"date-parts":[[2018,4,10]],"date-time":"2018-04-10T23:32:28Z","timestamp":1523403148000},"page":"1-15","source":"Crossref","is-referenced-by-count":4,"title":["Exposure to Nitrogen Oxide in the First Trimester and Risk of Cardiovascular-Related Malformations: A Dose-Response Meta-Analysis of Observational Studies"],"prefix":"10.1155","volume":"2018","author":[{"given":"Tie-Ning","family":"Zhang","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Da","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qi-Jun","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Xia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ri","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xing-Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, 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