Maternal environmental noise exposure during the periconceptional period and risk of congenital heart disease in offspring: a case-control study in Northwest China.
Yan M, Zhao Y, et al. • Frontiers in public health • 2026
Maternal periconceptional exposure to environmental noise was associated with increased congenital heart disease risk in offspring (OR, 1.81; 95% CI, 1.36–2.40), particularly with prolonged exposure and specific sources such as traffic and construction.
Key Findings
Results
Maternal periconceptional noise exposure was associated with a significantly increased risk of congenital heart disease in offspring.
OR of 1.81 (95% CI, 1.36–2.40) for any maternal periconceptional noise exposure compared to no exposure.
Study design: multicenter hospital-based case-control study in Xi'an, Northwest China.
589 mothers of infants with CHD and 1,193 frequency-matched controls were included.
Multivariable logistic regression was used, adjusting for potential confounders.
Results
Noise exposure duration showed a dose-dependent and nonlinear positive association with CHD risk, with mid-range daily exposure carrying the highest odds.
Exposure for 4 to ≤8 hours per day was associated with an OR of 3.24 (95% CI, 2.02–5.20) compared to no noise exposure.
Exposure for more than 8 hours per day was associated with an OR of 2.07 (95% CI, 1.19–3.58).
Restricted cubic spline analysis indicated a positive nonlinear association between noise exposure duration and CHD risk.
The highest risk was observed in the 4–8 hours/day category rather than the >8 hours/day category, suggesting a nonlinear rather than strictly monotonic relationship.
Results
Traffic noise was independently associated with increased CHD risk in offspring.
OR of 1.75 (95% CI, 1.20–2.56) for maternal periconceptional exposure to traffic noise.
Noise source was assessed using standardized questionnaires capturing dominant noise sources including traffic, construction, and industrial noise.
Traffic noise was analyzed as an independent exposure category.
Results
Construction and industrial noise was independently associated with increased CHD risk in offspring.
OR of 2.13 (95% CI, 1.29–3.50) for maternal periconceptional exposure to construction and industrial noise.
This category showed a higher point estimate than traffic noise (OR 2.13 vs. 1.75).
Construction and industrial noise was assessed separately from traffic noise using standardized questionnaires.
Methods
Maternal noise exposure was assessed during the periconceptional period using standardized questionnaires capturing multiple dimensions of exposure.
Questionnaires captured exposure duration, perceived interference, and dominant noise sources (traffic, construction, and industrial).
The study population was drawn from a low- and middle-income setting in Northwest China, a context described as underrepresented in prior evidence.
The case-control design included frequency matching of controls to cases.
What This Means
This research suggests that mothers who are exposed to environmental noise—such as from traffic, construction, or industrial sources—around the time of conception may have a higher risk of having a baby born with a congenital heart defect (CHD). The study, conducted in Xi'an, China, compared nearly 600 mothers of babies with CHD to over 1,100 mothers of babies without CHD. Mothers who reported any noise exposure during the periconceptional period were about 81% more likely to have a child with CHD than those who reported no such exposure.
The relationship between noise exposure duration and CHD risk was not straightforwardly linear. Mothers exposed to noise for 4 to 8 hours per day had more than three times the odds of having a child with CHD compared to unexposed mothers, while those exposed for more than 8 hours per day had about twice the odds. Both traffic noise and construction or industrial noise were independently linked to increased risk. These findings add to a growing body of evidence that environmental noise may have biological effects beyond hearing—potentially influencing fetal development through stress-related or other physiological pathways.
This research suggests that reducing environmental noise exposure during the period around conception could be a meaningful consideration for birth defect prevention, particularly in rapidly urbanizing areas of low- and middle-income countries where noise pollution is prevalent and understudied. Because the study relied on self-reported noise exposure and was conducted in one region of China, further research in diverse settings would help confirm and extend these findings.
Yan M, Zhao Y, Zhang Y, Zhao D, Wang B, Si J, et al.. (2026). Maternal environmental noise exposure during the periconceptional period and risk of congenital heart disease in offspring: a case-control study in Northwest China.. Frontiers in public health. https://doi.org/10.3389/fpubh.2026.1923108