{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,12]],"date-time":"2025-10-12T02:10:26Z","timestamp":1760235026078,"version":"build-2065373602"},"reference-count":56,"publisher":"MDPI AG","issue":"15","license":[{"start":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T00:00:00Z","timestamp":1626825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Hypoplastic left heart syndrome (HLHS) and single ventricle (SV) remain a significant cause of cardiac deaths occurring in the first week of life. Their pathogenesis and seasonal frequency are still unknown. Therefore, we attempt to look at the genesis of the HLHS and SV in the context of territorial distribution as well as seasonality. A total of 193 fetuses diagnosed with HLHS and 92 with SV were selected. The frequency was analyzed depending on the year, calendar month, quarter and season (fall-winter vs. spring-summer). The spatial distribution of HLHS and SV in Poland was analyzed. We observed a statistically significant overrepresentation of HLHS formation frequency in March: 27 (14.00%) in comparison to a monthly median of 15 (IQR: 13.75\u201316.25; p = 0.039), as well as a significantly higher frequency of HLHS in 2007\u22122009: 65 cases (33.68%) in comparison to the annual mean of 13.79 \u00b1 6.36 (p &lt; 0.001). We noted a higher frequency of SV among parous with the last menstrual period reported in the fall\/winter season of 58 vs. 34 in the spring\/summer season (p = 0.014). The performed analysis also revealed significant SV overrepresentation in 2008: 11 cases (12.00%) in comparison to the annual mean of 6.57 \u00b1 2.71 (p = 0.016). Every single case of HLHS was observed when the concentration of benzo(a)pyrene and\/or PM10 exceeded the acceptable\/target level. Our research indicates that both the season and the level of pollution are significant factors affecting the health of parous women and their offspring. The reason why HLHS and SV develop more frequently at certain times of the year remains unclear, therefore research on this topic should be continued, as well as on the effects of PM10 and benzo(a)pyrene exposure.<\/jats:p>","DOI":"10.3390\/jcm10153207","type":"journal-article","created":{"date-parts":[[2021,7,21]],"date-time":"2021-07-21T11:53:23Z","timestamp":1626868403000},"page":"3207","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Seasonality of Hypoplastic Left Heart Syndrome and Single Ventricle Heart in Poland in the Context of Air Pollution"],"prefix":"10.3390","volume":"10","author":[{"given":"Iwona","family":"Strzelecka","sequence":"first","affiliation":[{"name":"Department for Diagnoses and Prevention, Medical University of Lodz, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ma\u0142gorzata","family":"Biedrzycka","sequence":"additional","affiliation":[{"name":"Student\u2019s Scientific Association Prenatal Cardiology, Medical University of Lodz, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6551-6804","authenticated-orcid":false,"given":"Filip Franciszek","family":"Karuga","sequence":"additional","affiliation":[{"name":"Student\u2019s Scientific Association Prenatal Cardiology, Medical University of Lodz, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4051-0887","authenticated-orcid":false,"given":"Bartosz","family":"Szmyd","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Oncology, and Hematology, Medical University of Lodz, 91-738 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Katarzyna","family":"Batarowicz","sequence":"additional","affiliation":[{"name":"Department for Diagnoses and Prevention, Medical University of Lodz, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Respondek-Liberska","sequence":"additional","affiliation":[{"name":"Department for Diagnoses and Prevention, Medical University of Lodz, 93-338 \u0141\u00f3d\u017a, Poland"},{"name":"Department of Prenatal Cardiology, Polish Mother\u2019s Memorial Hospital, 93-338 \u0141\u00f3d\u017a, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2021,7,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"640","DOI":"10.1002\/bdr2.1501","article-title":"Risk factors associated with the development of double-inlet ventricle congenital heart disease","volume":"111","author":"Paige","year":"2019","journal-title":"Birth Defects Res."},{"key":"ref_2","unstructured":"Allen, H.D., Driscoll, D.J., Shaddy, R.E., and Feltes, T.F. (2013). Moss & Adams\u2019 Heart Disease in Infants, Children, and Adolescents: Including the Fetus and Young Adult, Wolters Kluwer Health."},{"key":"ref_3","unstructured":"Nichols, D.G., Ungerleider, R.M., Spevak, P.J., Greeley, W.J., Cameron, D.E., Lappe, D.G., and Wetzel, R.C. (2006). Chapter 40-Hypoplastic Left Heart Syndrome. Critical Heart Disease in Infants and Children, Mosby. [2nd ed.]."},{"key":"ref_4","unstructured":"Malec, E., Januszewska, K., and Paw\u0142owska, M. (2014). Moje dziecko ma wad\u0119 serca. Warszawa: Wyd. Fundacja Mam Serce. Fundacja Na rzecz Dzieci z Wadami Serca Cor Infantis, Fundacja Mam serce, Fundacja na rzecz Dzieci z Wadami Serca Cor Infantis."},{"key":"ref_5","unstructured":"Artman, M., Teitel, D.F., and Mahoney, L. (2017). Neonatal Cardiology, McGraw Hill Education. [3rd ed.]."},{"key":"ref_6","first-page":"9","article-title":"Does evolving fetal heart defects pose a separate clinical program?","volume":"3","author":"Strzelecka","year":"2013","journal-title":"Prenat. Cardiol."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1515\/pcard-2017-0005","article-title":"Follow-Up on 107 Fetuses with Normal Us + Echo After 37TH Week of Gestation","volume":"7","author":"Strzelecka","year":"2017","journal-title":"Prenat. Cardiol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Rao, P. (2021). Single Ventricle\u2014A Comprehensive Review. Children, 8.","DOI":"10.3390\/children8060441"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1016\/j.pcl.2020.06.008","article-title":"Outcomes in Hypoplastic Left Heart Syndrome","volume":"67","author":"Metcalf","year":"2020","journal-title":"Pediatr. Clin. N. Am."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"H947","DOI":"10.1152\/ajpheart.00518.2019","article-title":"Heart failure in single right ventricle congenital heart disease: Physiological and molecular considerations","volume":"318","author":"Garcia","year":"2020","journal-title":"Am. J. Physiol. Hear. Circ. Physiol."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Rebizant, B., Kole\u015bnik, A., Grzyb, A., Chaberek, K., S\u0119kowska, A., Witwicki, J., Szymkiewicz-Dangel, J., and D\u0119bska, M. (2021). Fetal Cardiac Interventions\u2014Are They Safe for the Mothers?. J. Clin. Med., 10.","DOI":"10.3390\/jcm10040851"},{"key":"ref_12","unstructured":"Bartel, H. (2010). Embriologia: Podr\u0119cznik Dla Student\u00f3w, Wydawnictwo Lekarskie PZWL."},{"key":"ref_13","doi-asserted-by":"crossref","unstructured":"Feinstein, J.A., Benson, D.W., Dubin, A.M., Cohen, M.S., Maxey, D.M., Mahle, W.T., Pahl, E., Villafae, J., Bhatt, A.B., and Peng, L.F. (2012). Hypoplastic left heart syndrome: Current considerations and expectations. J. Am. Coll. Cardiol., 59.","DOI":"10.1016\/j.jacc.2011.09.022"},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Debska, M., Kolesnik, A., Rebizant, B., Sekowska, A., Grzyb, A., Chaberek, K., Witwicki, J., Debski, R., and Dangel, J. (2020). Fetal Cardiac Interventions\u2014Polish Experience from \u201cZero\u201d to the Third World Largest Program. J. Clin. Med., 9.","DOI":"10.3390\/jcm9092888"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"841","DOI":"10.1161\/CIRCULATIONAHA.110.958405","article-title":"A European Surveillance of Congenital Anomalies (EUROCAT) Working Group Congenital Heart Defects in Europe","volume":"123","author":"Dolk","year":"2011","journal-title":"Circulation"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"142","DOI":"10.1038\/pr.2016.194","article-title":"Hypoplastic left heart syndrome: From comfort care to long-term survival","volume":"81","author":"Yabrodi","year":"2017","journal-title":"Pediatr. Res."},{"key":"ref_17","unstructured":"Respondek-Liberska, M. (2006). Kardiologia Prenatalna Dla Po\u0142o\u017cnik\u00f3w I Kardiolog\u00f3w Dzieci\u0119cych, Czelej."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Alboliras, E., Hijazi, Z.M., and Lopez, L.H.D. (2018). Visual Guide to Neonatal Cardiology, John Wiley Sons.","DOI":"10.1002\/9781118635520"},{"key":"ref_19","unstructured":"Hogge, W.A., Wilkins, I., and Hill, L.C.B. (2017). Sanders\u2019 Structural Fetal Abnormalities, Mc Graw Hill Education. [3rd ed.]."},{"key":"ref_20","first-page":"950","article-title":"Morfologiczne i molekularne podstawy rozwoju serca","volume":"67","author":"Kiszka","year":"2013","journal-title":"Adv. Hyg. Exp. Med. Postepy Hig. i Med. Dosw."},{"key":"ref_21","unstructured":"Chief, I. (2021, April 08). For E.P. Air Quality Assessment\u2014Annual Air Quality Assessments, Available online: http:\/\/powietrze.gios.gov.pl\/pjp\/maps\/air\/quality\/type\/R?lang=en."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"698","DOI":"10.1002\/pd.5677","article-title":"Detection screening and seasonality evaluation of hypoplastic left heart syndrome in the polish national registry for fetal cardiac anomalies from the years 2004 to 2016","volume":"40","author":"Fendler","year":"2020","journal-title":"Prenat. Diagn."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"636","DOI":"10.1002\/bdra.20301","article-title":"Analysis of seasonal variation of birth defects in Atlanta","volume":"76","author":"Siebert","year":"2006","journal-title":"Birth Defects Res. Part A: Clin. Mol. Teratol."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"29","DOI":"10.1016\/j.jpeds.2018.12.024","article-title":"Analysis of the Seasonal Trend of Congenital Heart Defects","volume":"207","author":"Dong","year":"2019","journal-title":"J. Pediatr."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1016\/j.jtcvs.2010.06.060","article-title":"Seasonality of hypoplastic left heart syndrome in the United States: A 10-year time-series analysis","volume":"141","author":"Eghtesady","year":"2011","journal-title":"J. Thorac. Cardiovasc. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1007\/s12519-011-0326-0","article-title":"Birth defects surveillance in China","volume":"7","author":"Dai","year":"2011","journal-title":"World. J. Pediatr."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1016\/j.jacc.2007.07.021","article-title":"Hypoplastic Left Heart Syndrome Is Heritable","volume":"50","author":"Hinton","year":"2007","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1069","DOI":"10.1007\/s00246-018-1861-4","article-title":"The Genetic Landscape of Hypoplastic Left Heart Syndrome","volume":"39","author":"Yagi","year":"2018","journal-title":"Pediatr. Cardiol."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1093\/hmg\/ddp532","article-title":"Deletion of ETS-1, a gene in the Jacobsen syndrome critical region, causes ventricular septal defects and abnormal ventricular morphology in mice","volume":"19","author":"Ye","year":"2009","journal-title":"Hum. Mol. Genet."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1038\/ng.3870","article-title":"The complex genetics of hypoplastic left heart syndrome","volume":"49","author":"Liu","year":"2017","journal-title":"Nat Genet"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"912","DOI":"10.1152\/physiolgenomics.00091.2016","article-title":"Impact of MYH6 variants in hypoplastic left heart syndrome","volume":"48","author":"Stamm","year":"2016","journal-title":"Physiol. Genomics"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"863","DOI":"10.1289\/ehp.1307289","article-title":"Maternal exposure to criteria air pollutants and congenital heart defects in offspring: Results from the National Birth Defects Prevention Study","volume":"122","author":"Stingone","year":"2014","journal-title":"Environ. Health Perspect."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"554","DOI":"10.1016\/j.mehy.2005.09.013","article-title":"Hypoplastic left heart syndrome: Rheumatic heart disease of the fetus?","volume":"66","author":"Eghtesady","year":"2006","journal-title":"Med. Hypotheses"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1007\/s00246-005-0859-x","article-title":"A cluster of hypoplastic left heart malformation in Baltimore, Maryland","volume":"27","author":"Kuehl","year":"2006","journal-title":"Pediatr. Cardiol."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1078","DOI":"10.1016\/j.placenta.2015.08.003","article-title":"Hypoplastic left heart syndrome is associated with structural and vascular placental abnormalities and leptin dysregulation","volume":"36","author":"Jones","year":"2015","journal-title":"Placenta"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"45","DOI":"10.1016\/j.ijcard.2018.04.003","article-title":"Non-inheritable risk factors during pregnancy for congenital heart defects in offspring: A matched case-control study","volume":"264","author":"Feng","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"e010995","DOI":"10.1161\/JAHA.118.010995","article-title":"Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States","volume":"8","author":"Zhang","year":"2019","journal-title":"J. Am. Heart Assoc."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1016\/j.earlhumdev.2017.12.011","article-title":"A compromised maternal vitamin D status is associated with congenital heart defects in offspring","volume":"117","author":"Koster","year":"2018","journal-title":"Early Hum. Dev."},{"key":"ref_39","doi-asserted-by":"crossref","unstructured":"Strzelecka, I., Karuga, F.F., Szmyd, B., Walter, A., Daszkiewicz, G., and Respondek-Liberska, M. (2021). Placental thickness in the 2D prenatal ultrasonographic examination. Arch. Med. Sci.","DOI":"10.5114\/aoms\/132778"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1002\/bdra.20007","article-title":"Excess Birth Prevalence of Hypoplastic Left Heart Syndrome in Eastern Wisconsin for Birth Cohorts 1997\u20131999","volume":"70","author":"Cronk","year":"2004","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1002\/bdra.20828","article-title":"Modeling geographic risk of complex congenital heart defects in Eastern Wisconsin","volume":"91","author":"Cronk","year":"2011","journal-title":"Birth Defects Res. Part A Clin. Mol. Teratol."},{"key":"ref_42","doi-asserted-by":"crossref","unstructured":"Chen, E.K.C., Zmirou-Navier, D., Padilla, C., and Deguen, S. (2014). Effects of air pollution on the risk of congenital anomalies: A systematic review and meta-analysis. Int. J. Environ. Res. Public Health, 11.","DOI":"10.3390\/ijerph110807642"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1004","DOI":"10.1093\/aje\/kwp011","article-title":"Ambient air pollution and cardiovascular malformations in Atlanta, Georgia, 1986\u20132003","volume":"169","author":"Strickland","year":"2009","journal-title":"Am. J. Epidemiol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"598","DOI":"10.1289\/ehp.1002946","article-title":"Ambient air pollution and risk of congenital anomalies: A systematic review and meta-analysis","volume":"119","author":"Vrijheid","year":"2011","journal-title":"Environ. Health Perspect."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1038\/jes.2016.1","article-title":"Maternal exposure to air pollutant PM2.5 and PM10 during pregnancy and risk of congenital heart defects","volume":"26","author":"Zhang","year":"2016","journal-title":"J. Exp. Sci. Environ. Epidemiol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.envres.2013.03.005","article-title":"Air pollution and congenital heart defects","volume":"124","author":"Friger","year":"2013","journal-title":"Environ. Res."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"223","DOI":"10.1136\/oem.2009.045997","article-title":"Ambient air pollution and risk of congenital anomalies in England, 1991-1999","volume":"67","author":"Dolk","year":"2010","journal-title":"Occup. Environ. Med."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1093\/aje\/kwi189","article-title":"Relation between ambient air quality and selected birth defects, seven county study, Texas, 1997-2000","volume":"162","author":"Gilboa","year":"2005","journal-title":"Am. J. Epidemiol."},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1007\/978-981-33-4187-6_7","article-title":"Toxicological Effects of BPDE on Dysfunctions of Female Trophoblast Cells","volume":"1300","author":"Wang","year":"2021","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Ye, Y., Jiang, S., Zhang, C., Cheng, Y., Zhong, H., Du, T., Xu, W., Azziz, R., Zhang, H., and Zhao, X. (2020). Environmental Pollutant Benzo [a] pyrene Induces Recurrent Pregnancy Loss through Promoting Apoptosis and Suppressing Migration of Extravillous Trophoblast. BioMed Res. Int., 2020.","DOI":"10.1155\/2020\/8983494"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"22","DOI":"10.1515\/pcard-2016-0003","article-title":"Heart Tumors in 33 Fetuses\u2014Review of Twenty-Two Years of the Single-Centre Experience","volume":"6","year":"2016","journal-title":"Prenat. Cardiol."},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Szmyd, B., Biedrzycka, M., Karuga, F.F., Rogut, M., Strzelecka, I., and Respondek-liberska, M. (2021). Interventricular Septal Thickness as a Diagnostic Marker of Fetal Macrosomia. J. Clin. Med., 10.","DOI":"10.3390\/jcm10050949"},{"key":"ref_53","doi-asserted-by":"crossref","unstructured":"Szmyd, B., Karuga, F., Gach, A., Moszura, T., Kopala, M., and Respondek-Liberska, M. (2021). Complex cardiovascular defects in a male infant with Williams syndrome juxtaposed with results of a preliminary survey illustrating other patients\u2019 experiences. Kardiol. Pol.","DOI":"10.33963\/KP.15740"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"137","DOI":"10.1002\/ijgo.12373","article-title":"Systematic review and meta-analysis of the performance of second-trimester screening for prenatal detection of congenital heart defects","volume":"140","author":"Ket","year":"2018","journal-title":"Int. J. Gynecol. Obstet."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"31","DOI":"10.5603\/GP.2019.0005","article-title":"Prenatally diagnosed foramen ovale restriction in fetuses with hypoplastic left heart syndrome may be a predictor of longer hospitalization, but not of a need for an urgent Rashkind procedure","volume":"90","author":"Sokolowski","year":"2019","journal-title":"Ginekol. Pol."},{"key":"ref_56","first-page":"18","article-title":"Routine third trimester fetal cardiac evaluation: Time for consideration","volume":"5","author":"Strzelecka","year":"2015","journal-title":"Prenat. Cardiol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/15\/3207\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T06:32:48Z","timestamp":1760164368000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/10\/15\/3207"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,7,21]]},"references-count":56,"journal-issue":{"issue":"15","published-online":{"date-parts":[[2021,8]]}},"alternative-id":["jcm10153207"],"URL":"https:\/\/doi.org\/10.3390\/jcm10153207","relation":{},"ISSN":["2077-0383"],"issn-type":[{"type":"electronic","value":"2077-0383"}],"subject":[],"published":{"date-parts":[[2021,7,21]]}}}