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BioMed Research International
Volume 2018 (2018), Article ID 1948407, 15 pages
https://doi.org/10.1155/2018/1948407
Review Article

Exposure to Nitrogen Oxide in the First Trimester and Risk of Cardiovascular-Related Malformations: A Dose-Response Meta-Analysis of Observational Studies

1Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China
2Department of Obstetrics and Gynecology, Shengjing Hospital of China Medical University, Shenyang, China
3Department of Clinical Epidemiology, Shengjing Hospital of China Medical University, Shenyang, China
4Department of Neurosurgery, Shengjing Hospital of China Medical University, Shenyang, China
5Liaoning Women and Children’s Health Hospital, Shenyang, China
6Department of Science and Education, Shenyang Women and Children Health Care Centre, Shenyang, China

Correspondence should be addressed to Chun-Feng Liu; moc.liamtoh@852uilhz

Received 14 September 2017; Revised 23 February 2018; Accepted 5 March 2018; Published 10 April 2018

Academic Editor: Hai-Feng Pan

Copyright © 2018 Tie-Ning Zhang et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Nitrogen oxide () is produced during combustion at high temperature, which is a major constituent of air pollutants. Recent studies suggested inconsistent results on the association between 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 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 ppb increment in and NO2 concentration was 1.01 (95% CI: 0.98–1.04; = 38.6%, ) and 0.99 (95% CI: 0.95–1.04; = 37.8%, ), 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 and NO2 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 exposure in the first trimester and cardiovascular-related malformations in infants.