Ambient Temperature and Stillbirth: A Multi-Center Retrospective Cohort Study.

MedStar author(s):
Citation: Environmental Health Perspectives. 125(6):067011, 2017 Jun 22PMID: 28650842Institution: MedStar Washington Hospital CenterDepartment: Obstetrics and Gynecology/Maternal-Fetal MedicineForm of publication: Journal ArticleMedline article type(s): Journal Article | Multicenter StudySubject headings: *Climate Change | *Environmental Exposure/sn [Statistics & Numerical Data] | *Stillbirth/ep [Epidemiology] | *Temperature | Stress, Physiological | United States/ep [Epidemiology]Year: 2017Local holdings: Available online from MWHC library: 1972 - presentISSN:
  • 0091-6765
Name of journal: Environmental health perspectivesAbstract: BACKGROUND: Climate change is expected to have adverse health effects, but the association between extreme ambient temperatures and stillbirth is unclear.CONCLUSIONS: Extremes of local ambient temperature may have chronic and acute effects on stillbirth risk, even in temperate zones. Temperature-related effects on pregnancy outcomes merit additional investigation. https://doi.org/10.1289/EHP945.METHODS: We linked 223,375 singleton births of gestation (2002-2008) from 12 U.S. sites to local temperature. Chronic exposure to hot (), cold (), or mild () temperatures was defined using window- and site-specific temperature distributions for three-months preconception, first and second trimester, and whole-pregnancy averages. For acute exposure, average temperature for the week preceding delivery was compared to two alternative control weeks in a case-crossover analysis.OBJECTIVES: We investigated acute and chronic associations between extreme ambient temperatures and stillbirth risk, and estimated the attributable risk associated with local temperature extremes in the United States.RESULTS: In comparison with mild, whole-pregnancy exposure to cold [adjusted odds ratio (aOR) = 4.75; 95% confidence interval (CI): 3.95, 5.71] and hot (aOR = 3.71; 95% CI: 3.07, 4.47) were associated with stillbirth risk, and preconception and first and second trimester exposures were not. Approximately 17-19% of stillbirth cases were potentially attributable to chronic whole-pregnancy exposures to local temperature extremes. This is equivalent to and excess cases in the United States annually. In the case-crossover analysis, a 1degreeC increase during the week preceding delivery was associated with a increase in stillbirth risk during the warm season (May-September). This incidence translates to additional stillbirths per 10,000 births for each 1degreeC increase.All authors: Grantz KL, Ha S, Liu D, Mendola P, Sherman S, Soo Kim S, Zhu YFiscal year: FY2017Digital Object Identifier: Date added to catalog: 2017-11-06
Holdings
Item type Current library Collection Call number Status Date due Barcode
Journal Article MedStar Authors Catalog Article 28650842 Available 28650842

Available online from MWHC library: 1972 - present

BACKGROUND: Climate change is expected to have adverse health effects, but the association between extreme ambient temperatures and stillbirth is unclear.

CONCLUSIONS: Extremes of local ambient temperature may have chronic and acute effects on stillbirth risk, even in temperate zones. Temperature-related effects on pregnancy outcomes merit additional investigation. https://doi.org/10.1289/EHP945.

METHODS: We linked 223,375 singleton births of gestation (2002-2008) from 12 U.S. sites to local temperature. Chronic exposure to hot (), cold (), or mild () temperatures was defined using window- and site-specific temperature distributions for three-months preconception, first and second trimester, and whole-pregnancy averages. For acute exposure, average temperature for the week preceding delivery was compared to two alternative control weeks in a case-crossover analysis.

OBJECTIVES: We investigated acute and chronic associations between extreme ambient temperatures and stillbirth risk, and estimated the attributable risk associated with local temperature extremes in the United States.

RESULTS: In comparison with mild, whole-pregnancy exposure to cold [adjusted odds ratio (aOR) = 4.75; 95% confidence interval (CI): 3.95, 5.71] and hot (aOR = 3.71; 95% CI: 3.07, 4.47) were associated with stillbirth risk, and preconception and first and second trimester exposures were not. Approximately 17-19% of stillbirth cases were potentially attributable to chronic whole-pregnancy exposures to local temperature extremes. This is equivalent to and excess cases in the United States annually. In the case-crossover analysis, a 1degreeC increase during the week preceding delivery was associated with a increase in stillbirth risk during the warm season (May-September). This incidence translates to additional stillbirths per 10,000 births for each 1degreeC increase.

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