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Geographic patterns in critical CHDs: a spatial analysis of selected air pollutants

Ghazal Zargari1, Payam Amini2, Asim Thapa1

  • 1School of Public Health, University of Albertahttps://ror.org/0160cpw27, Edmonton, AB, Canada.

Cardiology in the Young
|January 26, 2026
PubMed

Insights

Environmental pollutants like ozone and fine particulate matter show negative associations with critical congenital heart disease (CHD) categories. Accounting for spatial factors is crucial for understanding these complex environmental health links.

Area of Science:

  • Environmental Health
  • Pediatric Cardiology
  • Spatial Epidemiology

Background:

  • Critical congenital heart disease (CHD) is a major cause of infant mortality and requires surgical intervention.
  • Understanding environmental risk factors for critical CHD is essential for public health initiatives.

Purpose of the Study:

  • To determine the association between critical CHD categories and exposure to specific environmental pollutants during early pregnancy.
  • To investigate the impact of spatial heterogeneity on these associations.

Main Methods:

  • Retrospective analysis of 1484 infants undergoing complex cardiac surgery (1996-2021).
  • Assessed exposure to nitrogen dioxide, ozone, fine particulate matter (PM2.5), and air quality from smoke.
  • Employed geographically weighted multinomial logistic regression to account for spatial heterogeneity.

Main Results:

  • Statistically significant negative associations between fine particulate matter exposure and critical CHD categories were found in small clusters in Saskatchewan and Manitoba.
  • Significant negative associations with ozone exposure were observed in 15.1% of locations, primarily in Alberta and Saskatchewan.
  • Nitrogen dioxide and air quality from smoke showed no significant associations with critical CHD categories.

Conclusions:

  • Accounting for spatial heterogeneity is vital for uncovering patterns between environmental pollutants and critical CHD.
  • Negative associations suggest pollutants may act as a 'second hit,' increasing critical CHD risk in genetically predisposed infants.
Abstract

Keywords:
CHDgeographically weighted multinomial logistic regressionpollutionspatial clustering

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