Prenatal acute thermophysiological stress and spontaneous preterm birth in Western Australia, 2000–2015: A space-time-stratified case-crossover analysis

Nyadanu, Sylvester Dodzi; Tessema, Gizachew Assefa; Mullins, Ben; Pereira, Gavin

doi:10.1016/j.ijheh.2022.114029

Cited by 12 publications

(9 citation statements)

References 67 publications

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“…Exposure to a temperature extreme > 95th percentile also resulted in large range of increased risk of preterm birth (1.028 to 3.171) [44][45][46][47][48][49][50] . Exposure to a temperature extreme > 97.5th percentile increased the odds ratio of preterm birth 51 to 1.014-1.039, and to 1.290-1.586 after exposure to a temperature extreme > 99th percentile [52][53][54] .…”

Section: Resultsmentioning

confidence: 94%

“…One cohort study reported a 1.187-2.493 odds ratio of preterm birth when exposed to a temperature extreme < 1st percentile of mean daily temperature 55 , and another reported a maximum preterm birth odds ratio of 1.192-1.744 following the 2008 cold spell in two sub-tropical cities in Guangdong Province, China 56 . Nineteen studies concluded that exposure to temperature extremes (with assorted de nitions) was associated with an increased risk of preterm birth [43][44][45][46][47][48][49][51][52][53][54][55][56][57][58][59][60][61][62][63] . In terms of absolute increases in temperature, the odds ratio of preterm births was 1.043-1.246 following an increase of 5.5 o C in weekly mean temperature [64][65][66] , similar to other studies 67-71 identifying a positive relationship between increases in mean ambient temperature and preterm birth.…”

Section: Resultsmentioning

confidence: 99%

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First systematic review and meta-analysis of the risk magnitude of climate-change effects on child health

Weeda,

Bradshaw,

Judge

et al. 2023

Preprint

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Children are significantly more vulnerable than adults to climate-related health threats, but studies examining how climate change affects human health have been mainly descriptive and lack an assessment of the magnitude of health effects children face. In this systematic review and meta-analysis, we searched online databases PubMed, Medline, Embase, and Web of Science for observational studies published up to 5 January 2023 following PRISMA guidelines. We included studies if they explored climate variables/events and measured a quantifiable child-health outcome. We extracted data from published reports for a meta-analysis where we standardised effect sizes and compared them among different groupings of climate variables and health outcomes. We evaluated each study individually and aggregated and analysed relevant qualitative and quantitative data. We identified 1301 articles from the four large databases in our systematic literature review, of which 163 studies were eligible for analysis. We identified many relationships between climate change and child health, the strongest of which were increasing risk (60% on average) of preterm birth from exposure to temperature extremes. Respiratory disease, mortality, and morbidity were also influenced by climate changes, but to a lesser extent than preterm birth. The effects of different pollutants on health outcomes were considerably smaller compared to temperature effects, but with most (16/20 = 80%) pollutant studies indicating at least a weak effect. Most studies occurred in high-income regions, but we found no geographical clustering according to health outcome, climate variable, or magnitude of risk. We identified the following protective factors for climate-related child-health threats: (i) economic stability and strength, (ii) access to quality healthcare, (iii) adequate infrastructure, and (iv) food security. Threats to these services vary by local geographical, climate, and socio-economic conditions. Children will have increased prevalence and severity of disease due to anthropogenic climate change, and our quantification of the magnitude of expected increases is essential to plan for mitigation that will improve the health of current and future generations.

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Section: Resultsmentioning

confidence: 94%

Section: Resultsmentioning

confidence: 99%

First systematic review and meta-analysis of the risk magnitude of climate-change effects on child health

Weeda,

Bradshaw,

Judge

et al. 2023

Preprint

View full text Add to dashboard Cite

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“… 20 Such discrepancies may be due to geographical differences in thermal or temperature distributions even within the same setting, acclimatization, adaptation or mitigation strategies, differences in study design, characteristics of study population, exposure assessment method, and exposure thresholds. 10 , 19 , 21 , 42 Trimester-specific results from all the previous studies were based on separate models for each trimester. 10 , 19 – 21 Our sensitivity results for the separate trimester-specific models were consistent with that of the main results that included all trimesters concurrently in a single model.…”

Section: Discussionmentioning

confidence: 99%

“…Appropriate public health interventions, such as actively raising the awareness of the risk of exposure to extreme climate events to minimize outdoor activities, use of air conditioning, the shift to sustainable non–fossil-based energy and greening the environment, thermal–health warning systems, and other climate governance policies, are required. 42 , 43 , 86 , 88 These measures are critically important for achieving the United Nations’ Sustainable Development Goals 3 and 13 89 to ensure that the health outcomes at birth are not affected by the changing climate with serious health implications. 13 , 88 , 90 …”

Section: Discussionmentioning

confidence: 99%

“…The space–time-varying exposure assessment reduces exposure misclassification as compared with the conventional use of simple models or proximity to sparse monitoring stations 18 that tend to be distant from where people reside, as well as excluding rural residents because monitoring stations are often sited in cities and urban areas. 20 , 42 Application of DLNM nested in Cox PH regression is a further strength because it allowed us to investigate the hazards of fetal growth at finer temporal scales (i.e., gestational weeks and months) that are less biased and may be biologically more relevant as compared with trimester-based periods of exposure to detect critical susceptible windows. 28 , 30 Given the limited related research on SGA, 11 no known previous evidence on LGA, and that no previous study used a biothermal stress exposure metric, our findings have added to and provided new epidemiological evidence to the literature.…”

Section: Discussionmentioning

confidence: 99%

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Critical Windows of Maternal Exposure to Biothermal Stress and Birth Weight for Gestational Age in Western Australia

Nyadanu,

Tessema,

Mullins

et al. 2023

Environ Health Perspect

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Background: There is limited and inconsistent evidence on the risk of ambient temperature on small for gestational age (SGA) and there are no known related studies for large for gestational age (LGA). In addition, previous studies used temperature rather than a biothermal metric. Objectives: Our aim was to examine the associations and critical susceptible windows of maternal exposure to a biothermal metric [Universal Thermal Climate Index (UTCI)] and the hazards of SGA and LGA. Methods: We linked 385,337 singleton term births between 1 January 2000 and 31 December 2015 in Western Australia to daily spatiotemporal UTCI. Distributed lag nonlinear models with Cox regression and multiple models were used to investigate maternal exposure to UTCI from 12 weeks preconception to birth and the adjusted hazard ratios (HRs) of SGA and LGA. Results: Relative to the median exposure, weekly and monthly specific exposures showed potential critical windows of susceptibility for SGA and LGA at extreme exposures, especially during late gestational periods. Monthly exposure showed strong positive associations from the 6th to the 10th gestational months with the highest hazard of 13% for SGA ( ; 95% CI: 1.10, 1.14) and 7% for LGA ( ; 95% CI: 1.03, 1.11) at the 10th month for the 1st UTCI centile. Entire pregnancy exposures showed the strongest hazards of 11% for SGA ( ; 95% CI: 1.04, 1.18) and 3% for LGA ( ; 95% CI: 0.95, 1.11) at the 99th UTCI centile. By trimesters, the highest hazards were found during the second and first trimesters for SGA and LGA, respectively, at the 99th UTCI centile. Based on estimated interaction effects, male births, mothers who were non-Caucasian, smokers, years of age, and rural residents were most vulnerable. Conclusions: Both weekly and monthly specific extreme biothermal stress exposures showed potential critical susceptible windows of SGA and LGA during late gestational periods with disproportionate sociodemographic vulnerabilities. https://doi.org/10.1289/EHP12660

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High-temperature exposure and risk of spontaneous abortion during early pregnancy: a case–control study in Nanjing, China

Zhao

et al. 2022

Environ Sci Pollut Res

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Prenatal acute thermophysiological stress and spontaneous preterm birth in Western Australia, 2000–2015: A space-time-stratified case-crossover analysis

Cited by 12 publications

References 67 publications

First systematic review and meta-analysis of the risk magnitude of climate-change effects on child health

First systematic review and meta-analysis of the risk magnitude of climate-change effects on child health

Critical Windows of Maternal Exposure to Biothermal Stress and Birth Weight for Gestational Age in Western Australia

High-temperature exposure and risk of spontaneous abortion during early pregnancy: a case–control study in Nanjing, China

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