Preterm birth seasonality in Greece: an epidemiological study

Baroutis, Georgios; Mousiolis, Athanasios; Hoffman, Derek; Antsaklis, Aris

doi:10.3109/14767058.2011.636103

Cited by 9 publications

(8 citation statements)

References 21 publications

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“…peaks and has shown models that include meteorological conditions to optimize preterm birth descriptions. 25 Further analysis on the seasonality of preterm births in Portugal is required, particularly with models to factor in heatwaves and low temperatures.…”

Section: Discussionmentioning

confidence: 99%

“…Several countries have reported seasonality preterm rates with preterm peaks during Summer and or Winter months 23,24 . Greece, with a similar Mediterranean climate as Portugal, has reported these two peaks and has shown models that include meteorological conditions to optimize preterm birth descriptions 25 . Further analysis on the seasonality of preterm births in Portugal is required, particularly with models to factor in heatwaves and low temperatures.…”

Section: Discussionmentioning

confidence: 99%

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Preterm birth characteristics and outcomes in Portugal, between 2010 and 2018—A cross‐sectional sequential study

Elias

Nogueira

Sousa

2023

Health Science Reports

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Introduction According to the World Health Organization, 11% of all children are born prematurely, representing 15 million births annually. An extensive analysis on preterm birth, from extreme to late prematurity and associated deaths, has not been published. The authors characterize premature births in Portugal, between 2010 and 2018, according to gestational age, geographic distribution, month, multiple gestations, comorbidities, and outcomes. Methods A sequential, cross‐sectional, observational epidemiologic study was conducted, and data were collected from the Hospital Morbidity Database, an anonymous administrative database containing information on all hospitalizations in National Health Service hospitals in Portugal, and coded according to the ICD‐9‐CM (International Classification of Diseases), until 2016, and ICD‐10 subsequently. Data from the National Institute of Statistics was utilized to compare the Portuguese population. Data were analyzed using R software. Results In this 9‐year study, 51.316 births were preterm, representing an overall prematurity rate of 7.7%. Under 29 weeks, birth rates varied between 5.5% and 7.6%, while births between 33 and 36 weeks varied between 76.9% and 81.0%. Urban districts presented the highest preterm rates. Multiple births were 8× more likely preterm and accounted for 37%–42% of all preterm births. Preterm birth rates slightly increased in February, July, August, and October. Overall, respiratory distress syndrome (RDS), sepsis, and intraventricular hemorrhage were the most common morbidities. Preterm mortality rates varied significantly with gestational age. Conclusion In Portugal, 1 in 13 babies was born prematurely. Prematurity was more common in predominantly urban districts, a surprise finding that warrants further studies. Seasonal preterm variation rates also require further analysis and modelling to factor in heat waves and low temperatures. A decrease in the case rate of RDS and sepsis was observed. Compared with previously published results, preterm mortality per gestational age decreased; however, further improvements are attainable in comparison with other countries.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Preterm birth characteristics and outcomes in Portugal, between 2010 and 2018—A cross‐sectional sequential study

Elias

Nogueira

Sousa

2023

Health Science Reports

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“…Preterm birth was identified as a major outcome variable in 44 articles (Table 3 [17,19,20,24,25,28,31,33,35,37,[42][43][44][45]48,52,54,55,57,58,63,64,66,67,[71][72][73]76,[79][80][81][83][84][85][86][87][88][90][91][92][93][96][97][98]). Most studies implemented a cohort (17), time-series, registry (11) or population registry (10) design, and described positive associations (40) between environmental heat exposures and preterm birth.…”

Section: Preterm Birthmentioning

confidence: 99%

“…See reference list for 44 studies included in analysis[17,19,20,24,25,28,31,33,35,37,[42][43][44][45]48,52,54,55,57,58,63,64,66,67,[71][72][73]76,[79][80][81][83][84][85][86][87][88][90][91][92][93][96][97][98].1 Several studies included temperature exposures up to month prior to delivery in analysis; included in 2nd/3rd trimester 2. Ha et al, 2017, included multiple exposure periods from 1st/2nd trimesters in analysis[44]-included in any part of pregnancy.…”

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confidence: 99%

Extreme Heat and Pregnancy Outcomes: A Scoping Review of the Epidemiological Evidence

Syed

O’Sullivan

Phillips

2022

IJERPH

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Background: Extreme heat caused by climate change is a major public health concern, disproportionately affecting poor and racialized communities. Gestational heat exposure is a well-established teratogen in animal studies, with a growing body of literature suggesting human pregnancies are similarly at risk. Characterization of extreme heat as a pregnancy risk is problematic due to nonstandard definitions of heat waves, and variable study designs. To better focus future research in this area, we conducted a scoping review to assess the effects of extreme heat on pregnancy outcomes. Methods: A scoping review of epidemiological studies investigating gestational heat-exposure and published 2010 and 2020, was conducted with an emphasis on study design, gestational windows of sensitivity, adverse pregnancy outcomes and characterization of environmental temperatures. Results: A sample of 84 studies was identified, predominantly set in high-income countries. Preterm birth, birthweight, congenital anomalies and stillbirth were the most common pregnancy outcome variables. Studies reported race/ethnicity and/or socioeconomic variables, however these were not always emphasized in the analysis. Conclusion: Use of precise temperature data by most studies avoided pitfalls of imprecise, regional definitions of heat waves, however inconsistent study design, and exposure windows are a significant challenge to systematic evaluation of this literature. Despite the high risk of extreme heat events and limited mitigation strategies in the global south, there is a significant gap in the epidemiological literature from these regions. Greater consistency in study design and exposure windows would enhance the rigor of this field.

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“…Spontaneous preterm birth has been reported to occur more often during summer months 5 , but no seasonality has been observed among induced preterm births. Some studies report a second peak of preterm births during winter 6 , while gestational diabetes and gestational hypertension are more common during the warm months of spring and summer 2,7,8 . Although current data are contradictory, women giving birth in the last three months of the year have been reported to be more likely to develop postpartum depressive symptoms 9,10 .…”

Section: Introductionmentioning

confidence: 99%

Spring peaks and autumn troughs identified in peripheral inflammatory markers during the peripartum period

Henriksson

White

Iliadis

et al. 2019

Sci Rep

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Seasonal variations have recently been described in biomarkers, cell types, and gene expression associated with the immune system, but so far no studies have been conducted among women in the peripartum period. It is of note that pregnancy complications and outcomes, as well as autoimmune diseases, have also been reported to exhibit seasonal fluctuations. We report here a clear-cut seasonal pattern of 23 inflammatory markers, analysed using proximity-extension assay technology, in pregnant women. The inflammatory markers generally peaked in the spring and had a trough in the autumn. During the postpartum period we found seasonality in one inflammatory marker, namely monocyte chemotactic protein 4 (MCP-4). Our findings suggest that seasonal variations in peripheral inflammatory markers are only observed during pregnancy. The results of this study could be valuable to professionals working within the field of immunology-related areas, and provide insight for the understanding of obstetric complications.

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Preterm birth seasonality in Greece: an epidemiological study

Abstract: Evidence for seasonality of preterm birth was shown and extreme weather was associated with a higher incidence of it.

Cited by 9 publications

References 21 publications

Preterm birth characteristics and outcomes in Portugal, between 2010 and 2018—A cross‐sectional sequential study

Preterm birth characteristics and outcomes in Portugal, between 2010 and 2018—A cross‐sectional sequential study

Extreme Heat and Pregnancy Outcomes: A Scoping Review of the Epidemiological Evidence

Spring peaks and autumn troughs identified in peripheral inflammatory markers during the peripartum period

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