Seasonality of fetal trisomy 21 – have ambient air pollutants played a role?

OBJECTIVE: To examine the seasonality of fetal trisomy 21 and its relationship with ambient air pollutants. METHODS: The averaged incidence by month-of-conception of the 113 cases (2002-2009) in our registry was correlated with month of conception and monthly ambient levels of nitrogen oxides (NOx, NO and NO2), sulfur dioxide, carbon monoxide, and ozone as reported by the Hong Kong Environmental Protection Department at the month of, and four-week after, conception. RESULTS: The incidence was highest in February (3.45/1000 births) and lowest in October (1.28/1000 births), and showed a significant difference (p = 0.003) and positive correlation (p = 0.003) from winter to autumn. It was also correlated with NO (p = 0.017) and inversely with ozone (p = 0.014) at conception. CONCLUSIONS: Seasonal variation in incidence of fetal trisomy 21 was correlated with ambient levels of nitric oxides and ozone. The role of environmental pollutants on fetal aneuploidy warrants further investigation.