Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States

Autor: Scott C. Sheridan, Paul A. Romitti, Alison Woomert, Tanya L. Spero, Marilyn L. Browne, Yuantao Hao, Christopher G. Nolte, Marcia L. Feldkamp, Ziqiang Lin, Shao Lin, Gary M. Shaw, Sarah C. Fisher, Wangjian Zhang, Syni-An Hwang, Valerie Garcia
Rok vydání: 2019
Předmět:
Adult
Heart Defects
Congenital
Male
maternal heat exposure
medicine.medical_specialty
Hot Temperature
Epidemiology
projection
Early pregnancy factor
Heart defect
010501 environmental sciences
Risk Assessment
Pediatrics
01 natural sciences
03 medical and health sciences
0302 clinical medicine
Pregnancy
Risk Factors
Humans
Medicine
Women
030212 general & internal medicine
Projection (set theory)
Retrospective Studies
Original Research
0105 earth and related environmental sciences
2. Zero hunger
biology
business.industry
Obstetrics
Incidence
Infant
Newborn
medicine.disease
congenital heart defects
United States
Pregnancy Trimester
First
climate change
Maternal Exposure
13. Climate action
Prenatal Exposure Delayed Effects
biology.protein
Female
Seasons
Cardiology and Cardiovascular Medicine
business
Follow-Up Studies
Zdroj: Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
ISSN: 2047-9980
DOI: 10.1161/jaha.118.010995
Popis: BackgroundMore intense and longer‐lasting heat events are expected in the United States as a consequence of climate change. This study aimed to project the potential changes in maternal heat exposure during early pregnancy (3–8 weeks post conception) and the associated burden of congenital heart defects (CHDs) in the future.Methods and ResultsThis study expanded on a prior nationwide case‐control study that evaluated the association betweenCHDs and maternal heat exposure during early pregnancy in summer and spring. We defined multiple indicators of heat exposure, and applied published odds ratios obtained for the matching season of the baseline (1995–2005) into the projection period (2025–2035) to estimate potential changes inCHDburden throughout the United States. Increases in maternal heat exposure were projected across the United States and to be larger in the summer. The Midwest will potentially have the highest increase in summer maternal exposure to excessively hot days (3.42; 95% CI, 2.99–3.88 per pregnancy), heat event frequency (0.52; 95%CI,0.44–0.60) and heat event duration (1.73; 95%CI,1.49–1.97). We also found large increases in specificCHDsubtypes during spring, including a 34.0% (95%CI,4.9%–70.8%) increase in conotruncalCHDin the South and a 38.6% (95%CI, 9.9%–75.1%) increase in atrial septal defect in the Northeast.ConclusionsProjected increases in maternal heat exposure could result in an increasedCHDburden in certain seasons and regions of the United States.
Databáze: OpenAIRE
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