Association Between Periconceptional Exposure to Environmental factors and Particulate Matter and The Risk of Esophageal Atresia: A Case-Control Study

M Çelik¹, Aİ Anadolulu², SS Yalçın¹, Ö Boybeyi³, Ç Ulukaya Durakbaşa⁴, T Soyer³

¹Hacettepe University Faculty of Medicine, Department of Pediatrics, Division of Social Pediatrics
²Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Istanbul
³Hacettepe University, Faculty of Medicine, Department of Pediatric Surgery, Ankara
⁴Istanbul Medeniyet University Faculty of Medicine Department of Pediatric Surgery

Aim:

Aim is to investigate the relation between periconceptional exposure to environmental risk factors and ambient air Particulate Matter (PM) 2.5 and 10 concentrations (µg/m³) and the occurence of esophageal atresia (EA).

Methods:

A 43-item survey was used to collect data on the demographic characteristics and periconceptional environmental factors. Data on ambient air PM2.5 and PM10 concentrations (µg/m³) in mothers' residential areas during the periconceptional period were obtained from the National Meteorology database. Healthy and EA groups were compared.

Results:

Totally 70 EA patients and 118 healthy controls were included which were similar in terms of mean age (4.1±2.1 and 4.5±1.6 years), gender, and maternal age. Conception during spring was significantly more common among EA cases, while autumn was the least common (p=0.039). The percentages of paternal age ≥35 years at conception, maternal periconceptional hormone use, and first-trimester hyperemesis were significantly higher in cases than controls (p=0.001,p=0.006, and p=0.009). Periconceptional PM2.5 and PM10 concentrations were not significantly different between the groups. In logistic regression analyses, it was found that paternal age ≥35 years at conception increased the risk of EA development 7.15-fold, maternal periconceptional sex hormone use 6.41-fold, and first-trimester hyperemesis 2.84-fold. In multiple logistic regression analyses adjusting for confounding factors related to the general and environmental characteristics, no significant association was found between the increase in each interquartile range in PM levels and EA risk.

Conclusions:

In our two-center study, we found that EA development in children is significantly associated with the season of conception, paternal age, maternal periconceptional sex hormone use, and hyperemesis in the first trimester. However, periconceptional exposure to PM2.5 and PM10 does not seem to be associated with an increased risk of EA.

Keywords: esophageal atresia, environmental exposures, periconceptional exposure, particulate matter, air pollution

M Çelik¹, Aİ Anadolulu², SS Yalçın¹, Ö Boybeyi³, Ç Ulukaya Durakbaşa⁴, T Soyer³

¹Hacettepe Üniversitesi, Tıp Fakültesi, Çocuk Sağlığı ve Hastalıkları AD, Sosyal Pediatri BD
²Department of Pediatric Surgery, Istanbul Medeniyet University Faculty of Medicine, Istanbul
³Hacettepe Üniversitesi Tıp Fakültesi, Çocuk Cerrahisi AD, Ankara
⁴İstanbul Medeniyet Üniversitesi Tıp Fakültesi Çocuk Cerrahisi Anabilim Dalı

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