Amal Rammah1, Kristina W Whitworth2, Inkyu Han1, Wenyaw Chan3, Judy Wendt Hess4, Elaine Symanski5. 1. Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health (SWCOEH), UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA. 2. Southwest Center for Occupational and Environmental Health (SWCOEH), UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Epidemiology, Human Genetics and Environmental Sciences, UTHealth School of Public Health in San Antonio, 7411 John Smith Drive, Suite 1100, San Antonio, TX 78229, USA. 3. Department of Biostatistics and Data Science, UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA. 4. Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health (SWCOEH), UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Shell Health Risk Science Team, Shell Oil Company, 150 N. Dairy Ashford, Houston, TX 77079, USA. 5. Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health (SWCOEH), UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA. Electronic address: elaine.symanski@uth.tmc.edu.
Abstract
BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth. OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013. METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling to select six control periods one to three weeks before and after each event and applied conditional logistic regression to examine associations between increases of apparent temperature and stillbirths during the warm season (May-September). We adjusted for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) and used stratified analysis to examine differences in risk by maternal race/ethnicity. We also examined the association among stillbirths with and without placental abruptions. RESULTS: Independent of air pollutant exposures, a 10 °F increase in apparent temperature in the week preceding delivery (lag days 1 to 6) was positively associated with a 45% (adjusted OR = 1.45, 95% confidence interval (CI): 1.18, 1.77) increase in risk for stillbirth. Risks were elevated for stillbirths occurring in June through August, for Hispanic and non-Hispanic Black women, but not for non-Hispanic Whites. We also observed elevated risks associated with temperature increases in the few days preceding delivery among stillbirths caused by placental abruption, with the risk being highest on lag day 1 (OR = 1.93, 95% CI: 1.15, 3.23). CONCLUSIONS: Independent of maternal ambient air pollutant exposure, we found evidence of an association between apparent temperature increases in the week preceding an event and risk of stillbirth. Risks for stillbirth varied by race/ethnicity. Further, in the first study to evaluate the impact of temperature on a specific complication during pregnancy, the risks were higher among mothers with placental abruption.
BACKGROUND: Pregnant women may be vulnerable to changes in ambient temperature and warming climates. Recent evidence suggests that temperature increases are associated with placental abruption, a risk factor for stillbirth. OBJECTIVES: We investigated the effect of acute exposures to apparent temperature on stillbirths in Harris County, Texas, 2008-2013. METHODS: We conducted a case-crossover study to investigate the association between temperature and stillbirth among 708 women. We used data from the National Climatic Data Center to estimate maternal exposure to daily average apparent temperature over the days (lag days 1 through 6) preceding the stillbirth event. We employed symmetric bidirectional sampling to select six control periods one to three weeks before and after each event and applied conditional logistic regression to examine associations between increases of apparent temperature and stillbirths during the warm season (May-September). We adjusted for fine particulate matter (PM2.5), nitrogen dioxide (NO2) and ozone (O3) and used stratified analysis to examine differences in risk by maternal race/ethnicity. We also examined the association among stillbirths with and without placental abruptions. RESULTS: Independent of air pollutant exposures, a 10 °F increase in apparent temperature in the week preceding delivery (lag days 1 to 6) was positively associated with a 45% (adjusted OR = 1.45, 95% confidence interval (CI): 1.18, 1.77) increase in risk for stillbirth. Risks were elevated for stillbirths occurring in June through August, for Hispanic and non-Hispanic Black women, but not for non-Hispanic Whites. We also observed elevated risks associated with temperature increases in the few days preceding delivery among stillbirths caused by placental abruption, with the risk being highest on lag day 1 (OR = 1.93, 95% CI: 1.15, 3.23). CONCLUSIONS: Independent of maternal ambient air pollutant exposure, we found evidence of an association between apparent temperature increases in the week preceding an event and risk of stillbirth. Risks for stillbirth varied by race/ethnicity. Further, in the first study to evaluate the impact of temperature on a specific complication during pregnancy, the risks were higher among mothers with placental abruption.
Authors: Yohani Dalugoda; Jyothi Kuppa; Hai Phung; Shannon Rutherford; Dung Phung Journal: Int J Environ Res Public Health Date: 2022-02-04 Impact factor: 3.390
Authors: Agalyaa Puhenthirar; James W Smallcombe; William Casasola; Daniela S Inoue; Georgia K Chaseling; Nicholas Ravanelli; Kate M Edwards; Ollie Jay Journal: Sports Med Date: 2021-06-24 Impact factor: 11.136