Temperature, placental abruption and stillbirth
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 temper...
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Format: | Article |
Language: | English |
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Elsevier
2019-10-01
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Series: | Environment International |
Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412019313248 |
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Article |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Amal Rammah Kristina W. Whitworth Inkyu Han Wenyaw Chan Judy Wendt Hess Elaine Symanski |
spellingShingle |
Amal Rammah Kristina W. Whitworth Inkyu Han Wenyaw Chan Judy Wendt Hess Elaine Symanski Temperature, placental abruption and stillbirth Environment International |
author_facet |
Amal Rammah Kristina W. Whitworth Inkyu Han Wenyaw Chan Judy Wendt Hess Elaine Symanski |
author_sort |
Amal Rammah |
title |
Temperature, placental abruption and stillbirth |
title_short |
Temperature, placental abruption and stillbirth |
title_full |
Temperature, placental abruption and stillbirth |
title_fullStr |
Temperature, placental abruption and stillbirth |
title_full_unstemmed |
Temperature, placental abruption and stillbirth |
title_sort |
temperature, placental abruption and stillbirth |
publisher |
Elsevier |
series |
Environment International |
issn |
0160-4120 |
publishDate |
2019-10-01 |
description |
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. Keywords: Temperature, Stillbirth, Placental abruption |
url |
http://www.sciencedirect.com/science/article/pii/S0160412019313248 |
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doaj-d56030efbda4472bbcd83b50f1f470872020-11-25T01:21:25ZengElsevierEnvironment International0160-41202019-10-01131Temperature, placental abruption and stillbirthAmal Rammah0Kristina W. Whitworth1Inkyu Han2Wenyaw Chan3Judy Wendt Hess4Elaine Symanski5Epidemiology, 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, USASouthwest 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, USAEpidemiology, 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, USADepartment of Biostatistics and Data Science, UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USAEpidemiology, 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, USAEpidemiology, 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; Corresponding author at: Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Herman Pressler Street, Suite W-1030, Houston, TX 77030, USA.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. Keywords: Temperature, Stillbirth, Placental abruptionhttp://www.sciencedirect.com/science/article/pii/S0160412019313248 |