A time-stratified, case-crossover study of heat exposure and perinatal mortality from 16 hospitals in sub-Saharan Africa.

Autor: Hanson C; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden. claudia.hanson@ki.se.; London School of Hygiene and Tropical Medicine, London, UK. claudia.hanson@ki.se.; Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya. claudia.hanson@ki.se., de Bont J; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden., Annerstedt KS; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden., Alsina MDR; Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden., Nobile F; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy., Roos N; Clinical Epidemiology Division, Department of Medicine, Karolinska Institutet, Stockholm, Sweden., Waiswa P; Makerere University, Kampala, Uganda., Pembe A; Department of Obstetrics and Gynaecology, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, Tanzania., Dossou JP; Centre de Recherche en Reproduction Humaine et en Démographie (CERRHUD), Cotonou, Benin., Chipeta E; Centre for Reproductive Health, Kamuzu University of Health Science, Blantyre, Malawi., Benova L; Department of Public Health, Institute of Tropical Medicine, Antwerp, Belgium., Kidanto H; Centre of Excellence for Women and Child Health, Aga Khan University, Nairobi, Kenya., Part C; London School of Hygiene and Tropical Medicine, London, UK., Stafoggia M; Department of Epidemiology, Lazio Region Health Service/ASL Roma 1, Rome, Italy., Filippi V; London School of Hygiene and Tropical Medicine, London, UK., Ljungman P; Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.; Department of Cardiology, Danderyd Hospital, Danderyd, Sweden.
Jazyk: angličtina
Zdroj: Nature medicine [Nat Med] 2024 Sep 03. Date of Electronic Publication: 2024 Sep 03.
DOI: 10.1038/s41591-024-03245-7
Abstrakt: Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case-crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0-6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval (CI) 1.01-1.78)). The estimates for stillbirths were similarly positive, but CIs included unity: OR = 1.29 (95% CI 0.95-1.77) for all stillbirths, OR = 1.18 (95% CI 0.71-1.95) for antepartum stillbirths and OR = 1.64 (95% CI 0.74-3.63) for intrapartum stillbirths. The cumulative exposure-response curve suggested that the steepest slopes for heat for intrapartum stillbirths and associations were stronger during the hottest seasons. We conclude that short-term heat exposure may increase mortality risks, particularly for intrapartum stillbirths, raising the importance of improved intrapartum care.
(© 2024. The Author(s).)
Databáze: MEDLINE
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