Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review

Marjan Mosalman Haghighi¹, Caradee Yael Wright^{2

3}, Julian Ayer^{4

5}, Michael F Urban⁶, Minh Duc Pham^{7

8}, Melanie Boeckmann⁹, Ashtyn Areal¹⁰, Bianca Wernecke^{11

12}, Callum P Swift¹³, Matthew Robinson¹⁴, Robyn S Hetem¹⁵, Matthew F Chersich¹⁶, Climate Change And Heat-Health Study Group

Affiliations

¹ The Heart Centre for Children, The Children's Hospital at Westmead, The University of Sydney, Sydney 2041, Australia.
² Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa.
³ Department of Geoinformatics, Geography and Meteorology, University of Pretoria, Pretoria 0001, South Africa.
⁴ The Heart Centre for Children, The Children's Hospital at Westmead, Westmead 2041, Australia.
⁵ Clinical School, The Children's Hospital at Westmead, The University of Sydney, Sydney 2041, Australia.
⁶ Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, University of Stellenbosch, Parow, Cape Town 7505, South Africa.
⁷ Burnet Institute, Melbourne 3004, Australia.
⁸ Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne 3004, Australia.
⁹ Department of Environment and Health, School of Public Health, Bielefeld University, 33699 Bielefeld, Germany.
¹⁰ IUF-Leibniz Research Institute for Environmental Medicine in Düsseldorf, 40225 Düsseldorf, Germany.
¹¹ Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa.
¹² Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa.
¹³ Emergency Department, Tallaght University Hospital, D24 NR04 Dublin, Ireland.
¹⁴ Department of Public Health, Health Service Executive, R95 A002 Kilkenny, Ireland.
¹⁵ School of Animal, Plant and Environmental Sciences, Faculty of Science, University of the Witwatersrand, Johannesburg 2000, South Africa.
¹⁶ Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.

PMID: 34063033
PMCID: PMC8124753
DOI: 10.3390/ijerph18094910

Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review

Marjan Mosalman Haghighi et al. Int J Environ Res Public Health. 2021.

. 2021 May 5;18(9):4910.

doi: 10.3390/ijerph18094910.

Authors

Affiliations

¹ The Heart Centre for Children, The Children's Hospital at Westmead, The University of Sydney, Sydney 2041, Australia.
² Environment and Health Research Unit, South African Medical Research Council, Pretoria 0001, South Africa.
³ Department of Geoinformatics, Geography and Meteorology, University of Pretoria, Pretoria 0001, South Africa.
⁴ The Heart Centre for Children, The Children's Hospital at Westmead, Westmead 2041, Australia.
⁵ Clinical School, The Children's Hospital at Westmead, The University of Sydney, Sydney 2041, Australia.
⁶ Division of Molecular Biology and Human Genetics, Faculty of Medicine and Health Sciences, University of Stellenbosch, Parow, Cape Town 7505, South Africa.
⁷ Burnet Institute, Melbourne 3004, Australia.
⁸ Department of Epidemiology and Preventive Medicine, Faculty of Medicine Nursing and Health Science, Monash University, Melbourne 3004, Australia.
⁹ Department of Environment and Health, School of Public Health, Bielefeld University, 33699 Bielefeld, Germany.
¹⁰ IUF-Leibniz Research Institute for Environmental Medicine in Düsseldorf, 40225 Düsseldorf, Germany.
¹¹ Environment and Health Research Unit, South African Medical Research Council, Johannesburg 2094, South Africa.
¹² Environmental Health Department, Faculty of Health Sciences, University of Johannesburg, Johannesburg 2094, South Africa.
¹³ Emergency Department, Tallaght University Hospital, D24 NR04 Dublin, Ireland.
¹⁴ Department of Public Health, Health Service Executive, R95 A002 Kilkenny, Ireland.
¹⁵ School of Animal, Plant and Environmental Sciences, Faculty of Science, University of the Witwatersrand, Johannesburg 2000, South Africa.
¹⁶ Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg 2000, South Africa.

PMID: 34063033
PMCID: PMC8124753
DOI: 10.3390/ijerph18094910

Abstract

Links between heat exposure and congenital anomalies have not been explored in detail despite animal data and other strands of evidence that indicate such links are likely. We reviewed articles on heat and congenital anomalies from PubMed and Web of Science, screening 14,880 titles and abstracts in duplicate for articles on environmental heat exposure during pregnancy and congenital anomalies. Thirteen studies were included. Most studies were in North America (8) or the Middle East (3). Methodological diversity was considerable, including in temperature measurement, gestational windows of exposure, and range of defects studied. Associations were detected between heat exposure and congenital cardiac anomalies in three of six studies, with point estimates highest for atrial septal defects. Two studies with null findings used self-reported temperature exposures. Hypospadias, congenital cataracts, renal agenesis/hypoplasia, spina bifida, and craniofacial defects were also linked with heat exposure. Effects generally increased with duration and intensity of heat exposure. However, some neural tube defects, gastroschisis, anopthalmia/microphthalmia and congenital hypothyroidism were less frequent at higher temperatures. While findings are heterogenous, the evidence raises important concerns about heat exposure and birth defects. Some heterogeneity may be explained by biases in reproductive epidemiology. Pooled analyses of heat impacts using registers of congenital anomalies are a high priority.

Keywords: birth defects; climate change; congenital; environmental health; heat; maternal health; neonates.

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Conflict of interest statement

M.F.C. holds investments in the fossil fuel industry through his pension fund as per the policies of the Wits Health Consortium. The University of the Witwatersrand holds investments in the fossil fuel industry through their endowments and other financial reserves. A.M. is a member of the Global Change Institute, University of the Witwatersrand, where part of the administrative support is funded by Exxaro, which has interests in coal mining and renewable energy. The other authors declare they have no actual or potential competing financial interests.

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References

1. WHO Fact Sheet: Congenital Anomalies. [(accessed on 1 December 2020)];2020 Available online: https://www.who.int/en/news-room/fact-sheets/detail/congenital-anomalies.
1. Flores A.L., Vellozzi C., Valencia D., Sniezek J. Global Burden of Neural Tube Defects, Risk Factors, and Prevention. Indian J. Community Health. 2014;26(Suppl. S1):3–5. - PMC - PubMed
1. Hennekam R.C., Biesecker L.G., Allanson J.E., Hall J.G., Opitz J.M., Temple I.K., Carey J.C. Elements of Morphology Consortium Elements of morphology: General terms for congenital anomalies. Am. J. Med. Genet. Part A. 2013;161:2726–2733. doi: 10.1002/ajmg.a.36249. - DOI - PubMed
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1. Chersich M.F., Pham M.D., Areal A., Haghighi M.M., Manyuchi A., Swift C.P., Wernecke B., Robinson M., Hetem R., Boeckmann M., et al. Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: Systematic review and meta-analysis. BMJ. 2020;371:m3811. doi: 10.1136/bmj.m3811. - DOI - PMC - PubMed

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Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review

Affiliations

Impacts of High Environmental Temperatures on Congenital Anomalies: A Systematic Review

Authors

Affiliations

Abstract

Conflict of interest statement

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