Correlation between Exposure to Fine Particulate Matter (PM(2.5)) during Pregnancy and Congenital Anomalies: Its Surgical Perspectives

BACKGROUND: Fine particulate matter (PM(2.5)) can easily penetrate blood vessels and tissues through the human respiratory tract and cause various health problems. Some studies reported that particular matter (PM) exposure during pregnancy is associated with low birth weight or congenital cardiovascular anomalies. This study aimed to investigate the correlation between the degree of exposure to PM ≤ 2.5 μm (PM(2.5)) during pregnancy and congenital anomalies relevant to the field of pediatric surgery. METHODS: Mother-infant dyads with registered addresses in the Metropolitan City were selected during 3 years. The electronic medical records of mothers and neonates were retrospectively analyzed, with a focus on maternal age at delivery, date of delivery, gestation week, presence of diabetes mellitus (DM) or hypertension, parity, the residence of the mother and infant, infant sex, birth weight, Apgar score, and presence of congenital anomaly. The monthly PM(2.5) concentration from the first month of pregnancy to the delivery was computed based on the mothers' residences. RESULTS: PM(2.5) exposure concentration in the second trimester was higher in the congenital anomaly group than in the non-congenital anomaly group (24.82 ± 4.78 µg/m(3), P = 0.023). PM(2.5) exposure concentration did not affect the incidence of nervous, cardiovascular, and gastrointestinal anomalies. While statistically insignificant, the groups with nervous, cardiovascular, gastrointestinal, musculoskeletal, and other congenital anomalies were exposed to higher PM(2.5) concentrations in the first trimester compared with their respective counterparts. The effect of PM(2.5) concentration on the incidence of congenital anomalies was significant even after adjusting for the mother's age, presence of DM, hypertension, and parity. The incidence of congenital anomalies increased by 26.0% (95% confidence interval of 4.3% and 49.2%) per 7.23 µg/m(3) elevation of PM(2.5) interquartile range in the second trimester. CONCLUSIONS: The congenital anomaly group was exposed to a higher PM(2.5) concentration in the second trimester than the non-congenital anomaly group. The PM(2.5) exposure concentration level in the first trimester tended to be higher in groups with anomalies than those without anomalies. This suggests that continuous exposure to a high PM(2.5) concentration during pregnancy influences the incidence of neonatal anomalies in surgical respects.