Independent and Combined Effects of Heatwaves and PM2.5 on Preterm Birth in Guangzhou, China: A Survival Analysis

Wang, Qiong; Li, Bing; Benmarhnia, Tarik; Hajat, Shakoor; Ren, Meng; Liu, Tao; Knibbs, Luke D.; Zhang, Huanhuan; Bao, Junzhe; Zhang, Yawei; Zhao, Qingguo; Huang, Cunrui

doi:10.1289/ehp5117

Cited by 93 publications

(78 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Specifically, heatwave associations were larger in magnitude among Hispanic and non-Hispanic black mothers compared to non-Hispanic white mothers. In several previous studies, investigators reported positive associations between heatwaves and preterm birth, with larger magnitudes compared to our study [ 9 , 11 , 13 , 19 – 22 , 42 ]. In the current study, we observed only a slight overall increase in the risk of preterm birth for certain heatwave definitions, and most estimates were close to the null.…”

Section: Discussioncontrasting

confidence: 71%

“…However, no consistent epidemiological evidence suggests that extreme temperature should have a greater impact on births later in gestational age (e.g., late preterm (34–36 weeks) and early-term birth (37–38 weeks)) compared to those in early gestation (e.g., extremely preterm (< 28 weeks) and very preterm (28–32 weeks)). Some studies observed stronger associations of temperature among early preterm birth [ 11 , 14 , 19 ], while others found the opposite [ 22 , 43 ].…”

Section: Discussionmentioning

confidence: 99%

“…However, the magnitude of association varied considerably, and it is unclear what factors influence this relationship. A few studies also found that heatwaves, conceptually defined as consecutive days of high ambient temperature, were positively associated with preterm birth in the last week before delivery [ 19 – 22 ], and that these associations persisted even after adjusting for current day temperatures [ 23 ]. Unfortunately, synthesizing results from heatwave studies is challenging due to differences in location, study design, and heatwave definition.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Acute associations between heatwaves and preterm and early-term birth in 50 US metropolitan areas: a matched case-control study

et al. 2021

View full text Add to dashboard Cite

Background The effect of heatwaves on adverse birth outcomes is not well understood and may vary by how heatwaves are defined. The study aims to examine acute associations between various heatwave definitions and preterm and early-term birth. Methods Using national vital records from 50 metropolitan statistical areas (MSAs) between 1982 and 1988, singleton preterm (< 37 weeks) and early-term births (37–38 weeks) were matched (1:1) to controls who completed at least 37 weeks or 39 weeks of gestation, respectively. Matching variables were MSA, maternal race, and maternal education. Sixty heatwave definitions including binary indicators for exposure to sustained heat, number of high heat days, and measures of heat intensity (the average degrees over the threshold in the past 7 days) based on the 97.5th percentile of MSA-specific temperature metrics, or the 85th percentile of positive excessive heat factor (EHF) were created. Odds ratios (OR) for heatwave exposures in the week preceding birth (or corresponding gestational week for controls) were estimated using conditional logistic regression adjusting for maternal age, marital status, and seasonality. Effect modification by maternal education, age, race/ethnicity, child sex, and region was assessed. Results There were 615,329 preterm and 1,005,576 early-term case-control pairs in the analyses. For most definitions, exposure to heatwaves in the week before delivery was consistently associated with increased odds of early-term birth. Exposure to more high heat days and more degrees above the threshold yielded higher magnitude ORs. For exposure to 3 or more days over the 97.5th percentile of mean temperature in the past week compared to zero days, the OR was 1.027 for early-term birth (95%CI: 1.014, 1.039). Although we generally found null associations when assessing various heatwave definitions and preterm birth, ORs for both preterm and early-term birth were greater in magnitude among Hispanic and non-Hispanic black mothers. Conclusion Although associations varied across metrics and heatwave definitions, heatwaves were more consistently associated with early-term birth than with preterm birth. This study’s findings may have implications for prevention programs targeting vulnerable subgroups as climate change progresses.

show abstract

Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Acute associations between heatwaves and preterm and early-term birth in 50 US metropolitan areas: a matched case-control study

et al. 2021

View full text Add to dashboard Cite

show abstract

“…those of PM2.5, have been shown to have been in the 1980's twice as high, compared with the corresponding pollutant levels in the same region during the second decade of the 21st century (Kukkonen et al, 2018). Wang et al (2020) presented that PM2.5 exposure strengthened the effect of moderate heat waves (short or only moderate temperature rise) associated with preterm births during January 2015 -July 2017 in Guangdong province, China. However, during the intensive heat waves, the effects were not additive.…”

Section: (I) the Role Of Air Pollution In Pandemicsmentioning

confidence: 99%

Advances in Air Quality Research – Current and Emerging Challenges

Sokhi

Moussiopoulos

Baklanov

et al. 2021

Preprint

View full text Add to dashboard Cite

Abstract. This review provides a community’s perspective on air quality research focussing mainly on developments over the past decade. The article provides perspectives on current and future challenges as well as research needs for selected key topics. While this paper is not an exhaustive review of all research areas in the field of air quality, we have selected key topics that we feel are important from air quality research and policy perspectives. After providing a short historical overview, this review focuses on improvements in characterising sources and emissions of air pollution, new air quality observations and instrumentation, advances in air quality prediction and forecasting, understanding interactions of air quality with meteorology and climate, exposure and health assessment, and air quality management and policy. In conducting the review, specific objectives were (i) to address current developments that push the boundaries of air quality research forward, (ii) to highlight the emerging prominent gaps of knowledge in air quality research and (iii) and to make recommendations to guide the direction for future research within the wider community. This review also identifies areas of particular importance for air quality policy. The original concept of this review was borne at the International Conference on Air Quality 2020 (held online due to the COVID 19 restrictions during 18–26 May 2020), but the article incorporates a wider landscape of research literature within the field of air quality science. On air pollution emissions the review highlights, in particular, the need to reduce uncertainties in emissions from diffuse sources, particulate matter chemical components, shipping emissions and the importance of considering both indoor and outdoor sources. There is a growing need to have integrated air pollution and related observations from both ground based and remote sensing instruments, including especially those on satellites. The research should also capitalize on the growing area of lower cost sensors, while ensuring a quality of the measurements which are regulated by guidelines. Connecting various physical scales in air quality modelling is still a continual issue, with cities being affected by air pollution gradients at local scales and by long range transport. At the same time, one should allow for the impacts from climate change on a longer timescale. Earth system modelling offers considerable potential by providing a consistent framework for treating scales and processes, especially where there are significant feedbacks, such as those related to aerosols, chemistry and meteorology. Assessment of exposure to air pollution should consider both the impacts of indoor and outdoor emissions, as well as apply more sophisticated, dynamic modelling approaches. With particulate matter being one of the most important pollutants for health, research is indicating the urgent need to understand, in particular, the role of particle number and chemical components in terms of health impact, which in turn requires improved emission inventories and models for predicting high resolution distributions of these metrics over cities. The review also examines, how air pollution management needs to adapt to the above-mentioned new challenges and briefly considers the implications from the COVID-19 pandemic for air quality. Finally, we provide recommendations for air quality research and support for policy.

show abstract

“… 3 , 4 A retrospective cohort study published in Environmental Health Perspectives looked at the relationship between fine particulate matter (

) combined with heatwaves and the risk of preterm birth in Guangzhou, China. 5 …”

mentioning

confidence: 99%

Heatwaves and PM2.5: Sometimes-Surprising Associations with Preterm Birth

Nicole¹

2020

Environ Health Perspect

View full text Add to dashboard Cite

Extreme heat is linked to higher mortality from a variety of causes ranging from heart disease to heat stroke. 1,2 Climate change is not only raising the global temperatures-with local areas experiencing extreme heatwaves-it may also cause a deterioration in air quality by altering the behavior of primary pollutants and the formation of secondary pollutants. 3,4 A retrospective cohort study published in Environmental Health Perspectives looked at the relationship between fine particulate matter (PM 2:5) combined with heatwaves and the risk of preterm birth in Guangzhou, China. 5 Heat and air pollution have each been independently associated with increases in the risk of preterm birth (fewer than 37 weeks of gestation). 6,7,8 Although findings have not been conclusive, some past studies showed that extreme heat and air pollution may work synergistically to increase mortality, particularly from cardiovascular and respiratory conditions. 9,10 However, the combined effects of heat and pollution on premature birth are even less certain. Complications of preterm birth are a leading cause of mortality among children under 5 years of age, especially in developing countries, causing approximately 1 million deaths in 2015. 11 Using birth registry data, the authors of the new paper looked at 215,059 singleton live births in Guangzhou that occurred during the warm season (May through October) in 2015, 2016, and Environmental Health Perspectives 094002-2 128(9) September 2020

show abstract

Independent and Combined Effects of Heatwaves and PM2.5 on Preterm Birth in Guangzhou, China: A Survival Analysis

Cited by 93 publications

References 51 publications

Acute associations between heatwaves and preterm and early-term birth in 50 US metropolitan areas: a matched case-control study

Acute associations between heatwaves and preterm and early-term birth in 50 US metropolitan areas: a matched case-control study

Advances in Air Quality Research – Current and Emerging Challenges

Heatwaves and PM2.5: Sometimes-Surprising Associations with Preterm Birth

Contact Info

Product

Resources

About