Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study

Abstract

Background The prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes. Methods We included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex. Results The bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings. Conclusions The 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.

Prophylactic antibiotic use during labor and delivery in China: a nationwide, multicenter, hospital-based, cross-sectional study

“…This study included 96 hospitals with at least a 70% completion rate in 24 provinces of China, and the preliminary sample size was 75,128 [ 17 ]. All participants in Heilongjiang province ( n = 1732) were excluded because the information on antibiotic use was invalid.…”

“…The CLDS data coordination center (DCC) was established to coordinate hospitals, train investigators, and manage the database. For data collection, the CLDS DCC randomly selected 6 weeks within 12 months for hospitals with at least 6000 annual births or 10 weeks within 12 months for hospitals with less than 6000 annual births [15][16][17]. The trained research nurses retrieved, reviewed, and extracted the data of new births and their mothers from the maternal delivery records under the supervision of the CLDS DCC.…”

Birth Outcomes, Health, and Health Care Needs of Childbearing Women following Wildfire Disasters: An Integrative, State-of-the-Science Review

“… 67 , 68 Natural disasters such as earthquakes have also affected birth weight and length of gestation, with some studies reporting sex-specific differences in results. 7 , 9 , 69 …”

Assessing Exposure to Unconventional Oil and Gas Development: Strengths, Challenges, and Implications for Epidemiologic Research

“…These have been used to assess short-term exposure windows for acute health outcomes, such as 1 month prior to health events [ 94 ], and longer-term windows such as summing cumulative peak ground acceleration from shakemap data over a 6-year period [ 95 ]. Prior work has connected earthquakes to adverse perinatal and child health [ 100 – 103 ], but no studies have evaluated the role of UOGD-induced earthquakes and adverse birth outcomes.…”