ORIGINAL RESEARCH article
Front. Public Health
Sec. Environmental Health and Exposome
Associations between weekly maternal ambient particulate matter exposure and congenital heart disease
Provisionally accepted
- Suzhou Women and Childrens Health Hospital, Suzhou, China
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Background: The association between maternal exposure to air pollution and congenital heart diseases ( CHDs )has garnered increasing attention. However, investigation into the critical weekly-specific exposure windows for CHDs remains limited. This study evaluated the relationship between maternal ambient particulate matter exposure throughout the entire-pregnancy periods with the risk of CHDs , as well as explored critical weekly-specific exposure windows. Method: Based on the Jiangsu Maternal and Child Health Monitoring Manual and the Environmental Health Department of Suzhou CDC, 19914 pregnant women with complete hospital delivery records between 2021 and 2023 were included and concentrations data for five air pollutants (PM10, PM2.5, NO2, CO, SO2) in Suzhou city from 2020 to 2023 were obtained in this study. Distributed lag models (DLMs) incorporated in Cox proportional-hazards models were applied to assess the exposure-lag-response relationship between the weekly average exposure levels during pregnancy and the risk of CHDs, identifying the refined exposure windows. Results: A 10μg /m3 increase in maternal exposure to PM10 was positively associated with CHDs during gestational weeks 5 to 12 and weeks 18 to 22 (P<0.05). The strongest association was observed in gestational week 5 and 6 (HR,1.010; 95% CI, 1.000-1.020; HR,1.010; 95% CI, 1.002-1.017) . The association between maternal exposure to PM2.5 with the risk of CHDs was not observed during all gestational weeks. Conclusions: Our research evidence demonstrates that exposure to high concentrations of PM10 increases the risk of CHDs, with susceptible exposure windows identified as gestational weeks 5-12 and weeks 18-22. Our study provides further evidence supporting the association between maternal exposure to ambient particulate matter and CHDs, while also identify critical windows. However, further researchs are required to confirm these findings.
Keywords: Ambient particulate matter, gestational exposure, congenital heart defects, susceptible exposure windows, Suzhou
Received: 12 May 2025; Accepted: 21 Nov 2025.
Copyright: © 2025 Sun, Shao, Gong, Peng, Zhou and Wu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Fanjie Zhou, jiefanzhou@126.com
Qianlan Wu, 274146133@qq.com
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