摘要：AbstractBackgroundPreliminary studies suggest that offspring to mothers living near oil and natural gas (O&G) well sites are at higher risk of congenital heart defects (CHDs).ObjectivesOur objective was to address the limitations of previous studies in a new and more robust evaluation of the relationship between maternal proximity to O&G well site activities and births with CHDs.MethodsWe employed a nested case-control study of 3324 infants born in Colorado between 2005 and 2011. 187, 179, 132, and 38 singleton births with an aortic artery and valve (AAVD), pulmonary artery and valve (PAVD), conotruncal (CTD), or tricuspid valve (TVD) defect, respectively, were frequency matched 1:5 to controls on sex, maternal smoking, and race and ethnicity yielding 2860 controls. We estimated monthly intensities of O&G activity at maternal residences from three months prior to conception through the second gestational month with our intensity adjusted inverse distance weighted model. We used logistic regression models adjusted for O&G facilities other than wells, intensity of air pollution sources not associated with O&G activities, maternal age and socioeconomic status index, and infant sex and parity, to evaluate associations between CHDs and O&G activity intensity groups (low, medium, and high).ResultsOverall, CHDs were 1.4 (1.0, 2.0) and 1.7 (1.1, 2.6) times more likely than controls in the medium and high intensity groups, respectively, compared to the low intensity group. PAVDs were 1.7 (0.93, 3.0) and 2.5 (1.1, 5.3) times more likely in the medium and high intensity groups for mothers with an address found in the second gestational month. In rural areas, AAVDs, CTDs, and TVDs were 1.8 (0.97, 3.3) and 2.6 (1.1, 6.1); 2.1 (0.96, 4.5) and 4.0 (1.4, 12); and 3.4 (0.95, 12) and 4.6 (0.81, 26) times more likely than controls in the medium and high intensity groups.ConclusionsThis study provides further evidence of a positive association between maternal proximity to O&G well site activities and several types of CHDs, particularly in rural areas.Highlights•Higher pulmonary artery and valve defect prevalence in oil and gas activity area•Congenital heart defect prevalence highest in rural areas with oil and gas activity•Higher aortic artery and valve defect prevalence in rural oil and gas activity area•Higher conotruncal defect prevalence in rural oil and gas activity area•Higher tricuspid valve defect prevalence in rural oil and gas activity area
关键词：AbbreviationsAAVDaortic artery and valve defect;CDPHEColorado Department of Public Health and Environment;CHDscongenital heart defect;CRCSNColorado Responds to Children with Special Needs;CTDconotruncal defect;IA-IDWintensity adjusted inverse distance weighted;IDWinverse distance weighted;NO2nitrogen dioxide;O&Goil and natural gas;ORodds ratio;PAVDpulmonary artery and valve defect;PM2.5particulate matter ≤2.5 μm;ppbvparts per billion by volume;SESsocioeconomic status;TVDtricuspid valve defect;Congenital heart defects;Birth outcomes;Oil and natural gas development;Case control study;Environmental exposure;Hydraulic fracturing
