{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,5]],"date-time":"2026-09-05T08:35:18Z","timestamp":1788597318497,"version":"build-2803163510"},"reference-count":33,"publisher":"American Chemical Society (ACS)","issue":"8","license":[{"start":{"date-parts":[[2017,12,29]],"date-time":"2017-12-29T00:00:00Z","timestamp":1514505600000},"content-version":"vor","delay-in-days":1358,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2014,8,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Background: Epidemiologic literature suggests that exposure to air pollutants is associated with fetal development.<\/jats:p>\n                  <jats:p>Objectives: We investigated maternal exposures to air pollutants during weeks 2\u20138 of pregnancy and their associations with congenital heart defects.<\/jats:p>\n                  <jats:p>Methods: Mothers from the National Birth Defects Prevention Study, a nine-state case\u2013control study, were assigned 1-week and 7-week averages of daily maximum concentrations of carbon monoxide, nitrogen dioxide, ozone, and sulfur dioxide and 24-hr measurements of fine and coarse particulate matter using the closest air monitor within 50 km to their residence during early pregnancy. Depending on the pollutant, a maximum of 4,632 live-birth controls and 3,328 live-birth, fetal-death, or electively terminated cases had exposure data. Hierarchical regression models, adjusted for maternal demographics and tobacco and alcohol use, were constructed. Principal component analysis was used to assess these relationships in a multipollutant context.<\/jats:p>\n                  <jats:p>Results: Positive associations were observed between exposure to nitrogen dioxide and coarctation of the aorta and pulmonary valve stenosis. Exposure to fine particulate matter was positively associated with hypoplastic left heart syndrome but inversely associated with atrial septal defects. Examining individual exposure-weeks suggested associations between pollutants and defects that were not observed using the 7-week average. Associations between left ventricular outflow tract obstructions and nitrogen dioxide and between hypoplastic left heart syndrome and particulate matter were supported by findings from the multipollutant analyses, although estimates were attenuated at the highest exposure levels.<\/jats:p>\n                  <jats:p>Conclusions: Using daily maximum pollutant levels and exploring individual exposure-weeks revealed some positive associations between certain pollutants and defects and suggested potential windows of susceptibility during pregnancy.<\/jats:p>\n                  <jats:p>Citation: Stingone JA, Luben TJ, Daniels JL, Fuentes M, Richardson DB, Aylsworth AS, Herring AH, Anderka M, Botto L, Correa A, Gilboa SM, Langlois PH, Mosley B, Shaw GM, Siffel C, Olshan AF, National Birth Defects Prevention Study. 2014. Maternal exposure to criteria air pollutants and congenital heart defects in offspring: results from the National Birth Defects Prevention Study. Environ Health Perspect 122:863\u2013872;\u2002http:\/\/dx.doi.org\/10.1289\/ehp.1307289<\/jats:p>","DOI":"10.1289\/ehp.1307289","type":"journal-article","created":{"date-parts":[[2014,4,11]],"date-time":"2014-04-11T12:07:52Z","timestamp":1397218072000},"page":"863-872","source":"Crossref","is-referenced-by-count":98,"title":["Maternal Exposure to Criteria Air Pollutants and Congenital Heart Defects in Offspring: Results from the National Birth Defects Prevention Study"],"prefix":"10.1021","volume":"122","author":[{"given":"Jeanette A.","family":"Stingone","sequence":"first","affiliation":[{"name":"Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J.","family":"Luben","sequence":"additional","affiliation":[{"name":"National Center for Environmental Assessment, Office of Research and Development, U.S. Environmental Protection Agency, Research Triangle Park, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie L.","family":"Daniels","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Montserrat","family":"Fuentes","sequence":"additional","affiliation":[{"name":"Department of Statistics, North Carolina State University, Raleigh, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David B.","family":"Richardson","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, UNC Gillings School of Global Public Health, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arthur S.","family":"Aylsworth","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, and"},{"name":"Department of Pediatrics Genetics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy H.","family":"Herring","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marlene","family":"Anderka","sequence":"additional","affiliation":[{"name":"Massachusetts Center for Birth Defects Research and Prevention, Massachusetts Department of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenzo","family":"Botto","sequence":"additional","affiliation":[{"name":"Department of Genetics and Pediatrics, University of Utah, Salt Lake City, Utah, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adolfo","family":"Correa","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzanne M.","family":"Gilboa","sequence":"additional","affiliation":[{"name":"National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, Georgia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter H.","family":"Langlois","sequence":"additional","affiliation":[{"name":"Texas Center for Birth Defects Research and Prevention, Texas Department of State Health Services, Austin, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bridget","family":"Mosley","sequence":"additional","affiliation":[{"name":"Arkansas Center for Birth Defects Research and Prevention, University of Arkansas for Medical Sciences, Little Rock, Arkansas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gary 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