Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Environmental Exposure Assessment
2.3. Potential Confounders
2.4. Statistical Analysis
2.5. Reporting Guidelines
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Conflicts of Interest
References
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Demographic Characteristic | Controls | Cases | Odds Ratio (95% CI) | p |
---|---|---|---|---|
Plurality | ||||
1 | 87,408 | 8553 | 1.00 (Ref) | |
2 | 2304 | 409 | 1.81 (1.63–2.02) | <0.001 * |
3+ | 94 | 19 | 2.07 (1.26–3.38) | 0.004 * |
Maternal Age (years) | ||||
≤25 | 43,057 | 3861 | 1.00 (Ref) | |
26–30 | 23,523 | 2456 | 1.16 (1.10–1.23) | <0.001 * |
31–35 | 15,979 | 1791 | 1.25 (1.18–1.33) | <0.001 * |
>35 | 7244 | 872 | 1.34 (1.24–1.45) | <0.001 * |
Previous Live Births | ||||
0 | 34,291 | 4099 | 1.00 (Ref) | |
1 | 27,431 | 2580 | 0.79 (0.75–0.83) | <0.001 * |
2–3 | 22,177 | 1856 | 0.70 (0.66–0.74) | <0.001 * |
4+ | 3788 | 227 | 0.50 (0.44–0.57) | <0.001 * |
Race/ethnicity | ||||
Non-Hispanic white | 32,624 | 4815 | 1.00 (Ref) | |
Non-Hispanic black | 10,076 | 1200 | 0.81 (0.75–0.86) | <0.001 * |
Hispanic | 43,403 | 2624 | 0.41 (0.39–0.43) | <0.001 * |
Other | 3565 | 328 | 0.62 (0.55–0.70) | <0.001 * |
Gestational Age (weeks) | ||||
Full term (38–42) | 68,893 | 6391 | 1.00 (Ref) | |
Early term (≤37) | 16,880 | 2255 | 1.44 (1.37–1.52) | <0.001 * |
Post-term (>42) | 3734 | 301 | 0.87 (0.77–0.98) | 0.022 * |
Birth Weight (g) | ||||
Normal (2501–3999) | 75,403 | 6911 | 1.00 (Ref) | |
Low (≤2500) | 6222 | 1422 | 2.49 (2.34–2.65) | <0.001 * |
High (>3999) | 8138 | 645 | 0.86 (0.80–0.94) | 0.001 * |
Education | ||||
Less than 12 years | 27,701 | 1812 | 1.00 (Ref) | |
12 years | 26,116 | 2611 | 1.53 (1.44–1.63) | <0.001 * |
Greater than 12 years | 35,070 | 4476 | 1.95 (1.84–2.07) | <0.001 * |
Poverty density | ||||
Low | 21,731 | 2827 | 1.00 (Ref) | |
Medium-low | 20,484 | 2092 | 0.79 (0.74–0.83) | <0.001 * |
Medium-high | 24,842 | 2350 | 0.73 (0.69–0.77) | <0.001 * |
High | 22,753 | 1712 | 0.58 (0.54–0.62) | <0.001 * |
Maternal diabetes | ||||
No | 86,765 | 8636 | 1.00 (Ref) | |
Yes | 3045 | 345 | 1.14 (1.02–1.28) | 0.025 * |
Maternal smoking | ||||
No | 84,135 | 8359 | 1.00 (Ref) | |
Yes | 5280 | 576 | 1.10 (1.00–1.20) | 0.039 * |
HMHAP Exposure | Pollutant Level (μg/m3) | Cases/Controls | Unadjusted OR (95% CI) | Adjusted OR (95% CI) a | p-Trend b |
---|---|---|---|---|---|
Arsenic | |||||
Low | 0.00013–0.00036 | 1708/16,778 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.00036–0.00042 | 1631/16,749 | 0.96 (0.89–1.03) | 1.00 (0.93–1.07) | <0.001 * |
Medium | >0.00042–0.00052 | 1747/16,798 | 1.02 (0.95–1.10) | 1.08 (1.01–1.16) | |
Medium-high | >0.00052–0.00068 | 1585/16,698 | 0.93 (0.87–1.00) | 1.01 (0.94–1.09) | |
High | >0.00068–0.0054 | 1787/16,810 | 1.04 (0.97–1.12) | 1.18 (1.10–1.27) | |
Cadmium | |||||
Low | 0.000037–0.000044 | 1506/16,761 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.000044–0.000054 | 1759/16,694 | 1.17 (1.09–1.26) | 1.04 (0.96–1.11) | 0.343 |
Medium | >0.000054–0.000067 | 1890/16,735 | 1.26 (1.17–1.35) | 1.13 (1.05–1.21) | |
Medium-high | >0.000067–0.000089 | 1821/16,887 | 1.20 (1.12–1.29) | 1.11 (1.03–1.19) | |
High | >0.000089–0.0049 | 1482/16,756 | 0.98 (0.91–1.06) | 1.00 (0.93–1.08) | |
Chromium | |||||
Low | 0.000041–0.00031 | 1632/16,734 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.00031–0.00044 | 1834/16,816 | 1.12 (1.04–1.20) | 1.08 (1.00–1.16) | 0.006 * |
Medium | >0.00044–0.00061 | 1671/16,773 | 1.02 (0.95–1.10) | 1.05 (0.97–1.12) | |
Medium-high | >0.00061–0.00080 | 1722/16,730 | 1.06 (0.98–1.13) | 1.12 (1.04–1.20) | |
High | >0.00080–0.014 | 1599/16,780 | 0.98 (0.91–1.05) | 1.10 (1.02–1.19) | |
Lead | |||||
Low | 0.00049–0.0012 | 1599/16,725 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.0012–0.0015 | 1577/16,804 | 0.98 (0.91–1.06) | 0.99 (0.92–1.07) | <0.001 * |
Medium | >0.0015–0.0019 | 1684/16,748 | 1.05 (0.98–1.13) | 1.04 (0.97–1.12) | |
Medium-high | >0.0019–0.0025 | 1753/16,794 | 1.09 (1.02–1.17) | 1.13 (1.05–1.21) | |
High | >0.0025–0.034 | 1845/16,762 | 1.15 (1.07–1.24) | 1.20 (1.11–1.28) | |
Manganese | |||||
Low | 0.00058–0.00061 | 1491/16,783 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.00061–0.00075 | 1703/16,743 | 1.14 (1.06–1.23) | 1.06 (0.98–1.14) | <0.001 * |
Medium | >0.00075–0.00094 | 1796/16,759 | 1.21 (1.12–1.30) | 1.12 (1.04–1.20) | |
Medium-high | >0.00094–0.0012 | 1813/16,782 | 1.22 (1.13–1.31) | 1.18 (1.10–1.27) | |
High | >0.0012–0.022 | 1655/16,766 | 1.11 (1.03–1.20) | 1.11 (1.03–1.20) | |
Mercury | |||||
Low | 1.69 × 10−9–6.03 × 10−6 | 1585/16,787 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >6.03 × 10−6–0.000020 | 1693/16,775 | 1.07 (0.99–1.15) | 1.06 (0.99–1.14) | 0.006 * |
Medium | >0.000020–0.000038 | 1895/16,745 | 1.20 (1.12–1.29) | 1.16 (1.08–1.24) | |
Medium-high | >0.000038–0.000073 | 1764/16,814 | 1.11 (1.03–1.19) | 1.14 (1.06–1.23) | |
High | >0.000073–0.0016 | 1521/16,712 | 0.96 (0.90–1.04) | 1.08 (1.00–1.16) | |
Nickel | |||||
Low | 0.000065–0.00022 | 1648/16,737 | 1.00 (Ref) | 1.00 (Ref) | |
Medium-low | >0.00022–0.00046 | 1650/16,791 | 1.00 (0.93–1.07) | 1.03 (0.95–1.10) | 0.071 |
Medium | >0.00046–0.00072 | 1838/16,759 | 1.11 (1.04–1.19) | 1.14 (1.06–1.22) | |
Medium-high | >0.00072–0.0011 | 1767/16,774 | 1.07 (1.00–1.15) | 1.09 (1.02–1.17) | |
High | >0.0011–0.029 | 1555/16,772 | 0.94 (0.88–1.01) | 1.04 (0.97–1.12) |
HMHAP-Weighted Risk | OR (95% CI) a | p-Trend b |
---|---|---|
Low | 1.00 (Ref) | |
Medium-Low | 1.05 (0.98–1.13) | <0.001 * |
Medium | 1.11 (1.03–1.19) | |
Medium-High | 1.14 (1.06–1.22) | |
High | 1.11 (1.03–1.20) |
© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
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White, J.T.; Kovar, E.; Chambers, T.M.; Sheth, K.R.; Peckham-Gregory, E.C.; O’Neill, M.; Langlois, P.H.; Jorgez, C.J.; Lupo, P.J.; Seth, A. Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants. Int. J. Environ. Res. Public Health 2019, 16, 930. https://doi.org/10.3390/ijerph16060930
White JT, Kovar E, Chambers TM, Sheth KR, Peckham-Gregory EC, O’Neill M, Langlois PH, Jorgez CJ, Lupo PJ, Seth A. Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants. International Journal of Environmental Research and Public Health. 2019; 16(6):930. https://doi.org/10.3390/ijerph16060930
Chicago/Turabian StyleWhite, Jeffrey T., Erin Kovar, Tiffany M. Chambers, Kunj R. Sheth, Erin C. Peckham-Gregory, Marisol O’Neill, Peter H. Langlois, Carolina J. Jorgez, Philip J. Lupo, and Abhishek Seth. 2019. "Hypospadias Risk from Maternal Residential Exposure to Heavy Metal Hazardous Air Pollutants" International Journal of Environmental Research and Public Health 16, no. 6: 930. https://doi.org/10.3390/ijerph16060930