Environmental Exposures, Genetic Susceptibility and Preterm Birth

Preterm births cause a large public-health burden because of its high prevalence, leading cause of neonatal morbidity and mortality, and environmental hazards is considered to be a potential risk factors (Adams et al., 2000; Bloom et al., 2001; Tucker & McGuire, 2004; Colvin et al. 2004; Fraser et al. 2004; Murphy et al. 2004). The frequency of preterm births is about 12–13% in the USA and 5–9% in many other developed countries; however, the rate of preterm birth has increased in many locations (Goldenberg et al., 2008). Thus, to elicit of risk factors that could predict high risk of preterm birth represents a challenge to practitioners and researchers. The increasing rate of preterm birth in recent decades, despite improvements in health care, creates an impetus to better understand and prevent this disorder. The identification of women at increased risk of preterm delivery is an important challenge. Preterm birth likely depends on a number of interacting factors, including genetic, epigenetic, and environmental risk factors (Windham et al., 2000; Plunkett & Muglia, 2008). The epidemiological data suggested that both genetic factors and socioenvironmental factors may influence preterm birth (Wang et al., 2000; Nukui et al., 2004; Lewis et al., 2006; Suh et al., 2008)Aplinkotyros katedraVytauto Didžiojo universiteta

Clinical Study The Effect of Park and Urban Environments on Coronary Artery Disease Patients: A Randomized Trial

Aim. To test the hypothesis that walking in a park has a greater positive effect on coronary artery disease (CAD) patients' hemodynamic parameters than walking in an urban environment. Methods. Twenty stable CAD patients were randomized into two groups: 30-minute walk on 7 consecutive days in either a city park or busy urban street. Wilcoxon signed-rank test was employed to study short-term (30 min) and cumulative changes (following 7 consecutive days of exposure) in resting hemodynamic parameters in different environments. Results. There were no statistically significant differences in the baseline and peak exercise systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rate (HR), exercise duration, or HR recovery in urban versus park exposure groups. Seven days of walking slightly improved all hemodynamic parameters in both groups. Compared to baseline, the city park group exhibited statistically significantly greater reductions in HR and DBP and increases in exercise duration and HR recovery. The SBP and DBP changes in the urban exposed group were lower than in the park exposed group. Conclusions. Walking in a park had a greater positive effect on CAD patients' cardiac function than walking in an urban environment, suggesting that rehabilitation through walking in green environments after coronary events should be encouraged

Maternal Smoking, GSTM1 and GSTT1 Polymorphism and Susceptibility to Adverse Pregnancy Outcomes

The objective of the study was to investigate the association between maternal smoking, GSTM1, GSTT1 polymorphism, low birth weight (LBW, < 2,500 g) and intra-uterine growth restriction (IUGR, < 2,500 g and gestation ≥ 37 weeks) risk. Within a prospective cohort study in Kaunas (Lithuania), a nested case-control study on LBW and IUGR occurrence among 646 women with genotyping of GSTT1 and GSTM1 polymorphisms who delivered live singletons was conducted. Multivariate logistic regression analysis was used to study the association of maternal smoking and polymorphism in two genes metabolizing xenobiotics. Without consideration of genotype, light-smoking (mean 4.8 cigarettes/day) during pregnancy was associated with a small increase in LBW risk, adjusted OR 1.21; 95% CI 0.44 – 3.31. The corresponding odds for IUGR risk was 1.57; 95% CI 0.45 – 5.55. The findings suggested the greater LBW risk among light-smoking mothers with the GSTM1-null genotype (OR 1.91; 95% CI 0.43 – 8.47) compared to those with GSTM1-present genotype (OR 1.11; 95% CI 0.26 – 4.47). When both GSTM1 and GSTT1 genotypes were considered, the synergistic effect was found among smoking mothers: GSTT1-present and GSTM1-null genotype OR for LBW was 3.31; 95% CI 0.60–18.4 and that for IUGR was 2.47; 95% CI 0.31 – 13.1. However there was no statistically significant interaction between maternal smoking, GSTT1- present and GSTM1-null genotypes for LBW (OR 1.45; 95% CI 0.22 – 10.1, p = 0.66) and for IUGR (OR 1.10; 95% CI 0.10 – 12.6, p = 0.93). The results of this study suggested that smoking, even at a low-level, ought to be considered a potential risk factor for adverse birth outcomes and that genetic polymorphism may contribute to individual variation in tobacco smoke response

Individual exposures to drinking water trihalomethanes, low birth weight and small for gestational age risk: a prospective Kaunas cohort study

<p>Abstract</p> <p>Background</p> <p>Evidence for an association between exposure during pregnancy to trihalomethanes (THMs) in drinking water and impaired fetal growth is still inconsistent and inconclusive, in particular, for various exposure routes. We examined the relationship of individual exposures to THMs in drinking water on low birth weight (LBW), small for gestational age (SGA), and birth weight (BW) in singleton births.</p> <p>Methods</p> <p>We conducted a cohort study of 4,161 pregnant women in Kaunas (Lithuania), using individual information on drinking water, ingestion, showering and bathing, and uptake factors of THMs in blood, to estimate an internal dose of THM. We used regression analysis to evaluate the relationship between internal THM dose and birth outcomes, adjusting for family status, education, smoking, alcohol consumption, body mass index, blood pressure, ethnic group, previous preterm, infant gender, and birth year.</p> <p>Results</p> <p>The estimated internal dose of THMs ranged from 0.0025 to 2.40 mg/d. We found dose-response relationships for the entire pregnancy and trimester-specific THM and chloroform internal dose and risk for LBW and a reduction in BW. The adjusted odds ratio for third tertile vs. first tertile chloroform internal dose of entire pregnancy was 2.17, 95% CI 1.19-3.98 for LBW; the OR per every 0.1 μg/d increase in chloroform internal dose was 1.10, 95% CI 1.01-1.19. Chloroform internal dose was associated with a slightly increased risk of SGA (OR 1.19, 95% CI 0.87-1.63 and OR 1.22, 95% CI 0.89-1.68, respectively, for second and third tertile of third trimester); the risk increased by 4% per every 0.1 μg/d increase in chloroform internal dose (OR 1.04, 95% CI 1.00-1.09).</p> <p>Conclusions</p> <p>THM internal dose in pregnancy varies substantially across individuals, and depends on both water THM levels and water use habits. Increased internal dose may affect fetal growth.</p

The Influence of the North Atlantic Oscillation Index on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

The North Atlantic Oscillation (NAO) is the most prominent pattern of atmospheric variability over the middle and high latitudes of the Northern Hemisphere, especially during the cold season. It is found that &ldquo;weather types&rdquo; are associated with human health. It is possible that variations in NAO indices (NAOI) had additional impact on human health. We investigated the association between daily emergency ambulance calls (EACs) for exacerbation of essential hypertension and the NAOI by using Poisson regression, adjusting for season, weather variables and exposure to CO, particulate matter and ozone. An increased risk of EACs was associated with NAOI &lt; &minus;0.5 (Rate Ratio (RR) = 1.07, p = 0.013) and NAOI &gt; 0.5 (RR = 1.06, p = 0.004) with a lag of 2 days as compared to &minus;0.5 &le; NAOI &le; 0.5. The impact of NAOI &gt; 0.5 was stronger during November-March (RR = 1.10, lag = 0, p = 0.026). No significant associations were found between the NAOI and EACs during 8:00&ndash;13:59. An elevated risk was associated during 14:00&ndash;21:59 with NAOI &lt; &minus;0.5 (RR = 1.09, p = 0.003) and NAOI &gt; 0.5 (RR = 1.09, p = 0.019) and during 22:00&ndash;7:59 with NAOI &lt; &minus;0.5 (RR = 1.12, lag = 1, p = 0.001). The non-linear associations were found between the NAO and EACs. The different impact of the NAO was found during the periods November&ndash;March and April&ndash;October. The impact of the NAOI was not identical for different times of the day

Effects of Weather and Heliophysical Conditions on Emergency Ambulance Calls for Elevated Arterial Blood Pressure

We hypothesized that weather and space weather conditions were associated with the exacerbation of essential hypertension. The study was conducted during 2009–2010 in the city of Kaunas, Lithuania. We analyzed 13,475 cards from emergency ambulance calls (EACs), in which the conditions for the emergency calls were made coded I.10–I.15. The Kaunas Weather Station provided daily records of air temperature (T), wind speed (WS), relative humidity, and barometric pressure (BP). We evaluated the associations between daily weather variables and daily number of EACs by applying a multivariate Poisson regression. Unfavorable heliophysical conditions (two days after the active-stormy geomagnetic field or the days with solar WS &gt; 600 km/s) increased the daily number of elevated arterial blood pressure (EABP) by 12% (RR = 1.12; 95% confidence interval (CI) 1.04–1.21); and WS ≥ 3.5 knots during days of T &lt; 1.5 °C and T ≥ 12.5 °C by 8% (RR = 1.08; CI 1.04–1.12). An increase of T by 10 °C and an elevation of BP two days after by 10 hPa were associated with a decrease in RR by 3%. An additional effect of T was detected during days of T ≥ 17.5 °C only in females. Women and patients with grade III arterial hypertension at the time of the ambulance call were more sensitive to weather conditions. These results may help in the understanding of the population’s sensitivity to different weather conditions

Risk of congenital anomalies in relation to the uptake of trihalomethane from drinking water during pregnancy

Objectives: Congenital anomalies have been inconsistently associated with maternal crude estimated exposure to drinking water trihalomethane (THM). We investigated the relationship between individual THM uptake during the first trimester of pregnancy and congenital anomalies. Methods: We estimated maternal THM uptake for 3074 live births using residential tap water concentrations, drinking water ingestion, showering and bathing, and uptake factors of THM in the blood. Multiple logistic regression was used to investigate the association of THM exposure with congenital anomalies. Results: We observed no statistically significant relationships between congenital anomalies and the total THM internal dose. We found little indication of a dose-response relationship for brominated THM and congenital heart anomalies. The relationship was statistically significant for bromodichloromethane (BDCM) (OR=2.16, 95% CI 1.05 to 4.46, highest vs lowest tertile) during the first month of pregnancy. During the first trimester of pregnancy, the probability of developing heart anomalies increased for every 0.1 μg/d increase in the BDCM and for every 0.01 μg/d increase in the internal dibromochloromethane (DBCM) dose (OR 1.70, 95% CI 1.09 to 2.66, and OR 1.25, 95% CI 1.01 to 1.54, respectively). A dose-response relationship was evident for musculoskeletal anomalies and DBCM exposure during the first and second months of pregnancy, while BDCM exposure tended to increase the risk of urogenital anomalies. Conclusions: This study shows some evidence for an association between the internal dose of THM and the risk of congenital anomalies. In particular, increased prenatal exposure to brominated THM might increase the risk of congenital heart and musculoskeletal anomalies

Statistical Associations between Geomagnetic Activity, Solar Wind, Cosmic Ray Intensity, and Heart Rate Variability in Patients after Open-Heart Surgery

The aim of this study was to identify associations of the parameters of heart rate variability (HRV) with the variations in geomagnetic activity (GMA), solar wind, and cosmic ray intensity (CRI) in patients after coronary artery bypass grafting or valve surgery in Kaunas, Lithuania, during 2008&ndash;2012. The data from 5-minute electrocardiograms (ECGs) in 220 patients were used. ECGs were carried out at 1.5 months, 1 year, and 2 years after the surgery (N = 495). A lower (higher) very-low-frequency-band (VLF) and a higher (lower) high-frequency band (HF) in normalised units (n.u.) were associated with a low maximal daily 3-hourly ap (the DST index &gt; 1). A lower mean standard deviation of beat-to-beat intervals (SDNN) and VLF, LF, and HF powers were lower in patients when Ap &lt; 8 occurred two days after the surgery, and a low solar wind speed (SWS) occurred two days before the ECG. The effect of CRI was non-significant if the linear trend was included in the model. Low GMA and a low SWS may effect some HRV variables in patients after open-heart surgery. The GMA during the surgery may affect the SDNN in short-term ECG during the longer period