Table 8.
Persistent organic pollutants and other contaminant and congenital heart disease: Main findings from the literature.
| Author Ref. | Article Type | All CHDs or Any CHD Subtypes | Study Limitations |
|---|---|---|---|
| Wang et al. [71] | Case control study | All CHDs: Phthalates: OR 1.6 (95% CI: 1.0, 2.6); Alkylphenolic compounds OR 1.8 (95% CI: 1.1, 3.0) |
Exposure assessed by maternal questionnaire, so potential recall bias. Did not assess strength or duration of exposure. Only recent exposure considered. Small size. |
| Wang et al. [72] | Hospital based case control study | Maternal occupational phthalate exposure: VSD OR 3.7 (95% CI: 1.7, 8.0); PDA OR 3.8 (95% CI: 1.6, 8.9), ASD OR 3.5 (95% CI: 1.4, 8.7); PVS OR 4.2 (95% CI: 1.1, 16.0). Maternal alkylphenolic compound exposure: VSD OR 2.2 (95% CI: 1.3, 3.6); PDA OR 2.0 (95% CI: 1.1, 3.5); PVS OR 3.8 (95% CI: 1.5, 9.4). Maternal heavy metal exposure: VSD OR 7.3 (95% CI: 2.0, 27.6); ASD OR 6.5 (95% CI: 1.1, 36.7). Paternal occupational phthalate exposure: VSD OR 1.6 (95% CI: 1.0, 2.4); PVS OR 2.4 (95% CI: 1.1, 5.2); Paternal alkylphenolic compound exposure: VSD OR 1.5 (95% CI: 1.0, 2.2). |
Hospital study not representative of general population, although selection bias minimized. The reference for occupational exposure was developed for Western Europe, which may not be applicable in China. Participants may have recall bias. Non-occupational exposure not assessed. |
| Liu et al. [73] | Hospital based case control study | All CHDs: Maternal exposure to any housing renovations: OR 1.89 (95% CI: 1.29, 2.77); moved into a new house within one month after decoration at either 3 months before pregnancy (OR 2.38, 95% CI: 1.03, 5.48) or during first trimester (OR 4.00, 95% CI: 1.62, 9.86). | Hospital study not representative of general population. Participants may have recall bias. Not possible to investigate individual CHDs. |
| Snijder et al. [74] | Case control study | No association of maternal occupational exposure to chemicals with risk of CHDs. Paternal occupational exposure to: Phthalates: All CHDs: OR 2.08 (95% CI: 1.27, 3.40); VSDs: OR 2.84 (95% CI: 1.37, 5.92). PCBs: ASD OR 4.22 (95% CI: 1.23, 14.42); Alkylphenolic compounds: COA OR 3.85 (95% CI: 1.17, 12.67). |
Non-occupational exposure not considered. Participants may have recall bias. |
| Wijnands et al. [75] | Case control study | No association of maternal exposure to chemicals with risk of CHDs. Paternal phthalate exposure: VSD OR 1.93 (95% CI: 1.05, 3.54). No association with paternal exposure to other chemicals. |
Did not consider all potentially confounding factors. Possible recall and other bias. |
Abbreviations: VSD: Ventricular septal defect; ASD: Atrial septal defect; PDA: Patent ductus arteriosus; PVS: Pulmonary valve stenosis.