206 - Maternal exposure to air pollutant PM2.5 and heavy metals during pregnancy and risk of congenital heart defects using national health insurance claims data of south Korea

Poster Number: 206
Publication Number: 206.203

YOONJI CHOI, korea university ansan hospital, Ansan, Kyonggi-do, Republic of Korea

Background: Maternal exposure to ambient air pollution (PM2.5) and heavy metals has increasingly been linked to congenital heart diseases (CHDs). Human embryonic development of cardiovascular system occurs early during pregnancy.

Objective: The objective of this study was to evaluate whether high levels of maternal exposure to PM2.5 and heavy metals are related to increased risk of CHDs using national health insurance claims data of south Korea.

Design/Methods: Data on mothers and their newborns from 2016 to 2020 provided by the National Health Insurance Service were used (n = 1,261,648). Data of exposure to ambient air pollutants (PM2.5, CO, SO2, NO2, and O3) and heavy metals (Pb, Cd, Cr, Cu, Mn, Fe, Ni, and As) during weeks 3–8 of pregnancy were retrieved from Korea Environment Corporation and atmospheric condition data based on the mother's registration area were matched. We matched two groups of patients according to age, gender, and income. Logistic regression model adjusted for maternal age, infant sex, season of conception, Household income was performed.

Results: A total of 60,527 CHDs data were extracted. Areas with high SO2 showed more occurrences of total CHDs (P < 0.0001) and VSD (P < 0.0001) than areas with low SO2. Areas with high Cd showed more occurrences of VSD (P < 0.0001) and PS (P < 0.0001) than areas with low Cd. The PM2.5 during early pregnancy was not associated with CHDs, but a positive correlation between increased SO2 [6.843 (5.746-8.149)] and Cd [1.513 (1.187-1.93)] exposure during early pregnancy has been shown to be associated with the occurrence of VSD.

Conclusion(s): Increased SO2 and Cd exposure during early pregnancy is associated with the occurrence of VSD.