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A population-based case-control study of the association between weather-related extreme heat events and orofacial clefts.

ABSTRACT: BACKGROUND:Limited epidemiologic research exists on the association between weather-related extreme heat events (EHEs) and orofacial clefts (OFCs). We estimated the associations between maternal exposure to EHEs in the summer season and OFCs in offspring and investigated the potential modifying effect of body mass index on these associations. METHODS:We conducted a population-based case-control study among mothers who participated in the National Birth Defects Prevention Study for whom at least 1 day of their first two post-conception months occurred during summer. Cases were live-born infants, stillbirths, and induced terminations with OFCs; controls were live-born infants without major birth defects. We defined EHEs using the 95th and the 90th percentiles of the daily maximum universal apparent temperature distribution. We used unconditional logistic regression with Firth's penalized likelihood method to estimate adjusted odds ratios and 95% confidence intervals, controlling for maternal sociodemographic and anthropometric variables. RESULTS:We observed no association between maternal exposure to EHEs and OFCs overall, although prolonged duration of EHEs may increase the risk of OFCs in some study sites located in the Southeast climate region. Analyses by subtypes of OFCs revealed no associations with EHEs. Modifying effect by BMI was not observed. CONCLUSIONS:We did not find a significantly increased risk of OFCs associated with maternal exposure to EHEs during the relevant window of embryogenesis. Future studies should account for maternal indoor and outdoor activities and for characteristics such as hydration and use of air conditioning that could modify the effect of EHEs on pregnant women.

SUBMITTER: Soim A

PROVIDER: S-EPMC7551893 | biostudies-literature | 2018 Nov

REPOSITORIES: biostudies-literature

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A population-based case-control study of the association between weather-related extreme heat events and orofacial clefts.

Soim Aida A Sheridan Scott C SC Hwang Syni-An SA Hsu Wan-Hsiang WH Fisher Sarah C SC Shaw Gary M GM Feldkamp Marcia L ML Romitti Paul A PA Reefhuis Jennita J Langlois Peter H PH Browne Marilyn L ML Lin Shao S

Birth defects research 20181019 19

<h4>Background</h4>Limited epidemiologic research exists on the association between weather-related extreme heat events (EHEs) and orofacial clefts (OFCs). We estimated the associations between maternal exposure to EHEs in the summer season and OFCs in offspring and investigated the potential modifying effect of body mass index on these associations.<h4>Methods</h4>We conducted a population-based case-control study among mothers who participated in the National Birth Defects Prevention Study for ...[more]

PMID: 30338937

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Project description:BackgroundThe environmental etiology of non-syndromic orofacial clefts (NSOFCs) is still under research. The aim of this case-control study is to assess COVID-19 associated factors that may be related to the risk of NSOFC in five Arab countries. These factors include COVID-19 infection, COVID-19 symptoms, family member or friends infected with COVID-19, stress, smoking, socioeconomic status and fear of COVID-19.MethodsThe study took place in governmental hospitals in five Arab countries from November 2020 to November 2021. Controls are matched in the month of delivery and site of recruitment. A clinical examination was carried out using LASHAL classification. Maternal exposure to medication, illnesses, supplementation, COVID-19 infection during their pregestation and 1st trimester periods were evaluated using a validated questionnaire. Maternal exposure to stress was assessed using the Life Events scale, fear of covid-19 scale, family member or friend affected with covid-19 infection, pregnancy planning and threatened abortion.ResultsThe study recruited 1135 infants (386 NSOFC and 749 controls). Living in urban areas, maternal exposure to medications 3-months pregestation, maternal exposure to any of the prenatal life events and maternal fear of COVID-19 significantly increased the risk of having a child with NSOFC. On the other hand, mothers exposed to supplementation 3-months pregestation, mothers suspected of having COVID-19 infection, family members or friends testing positive with COVID-19 significantly decreased the risk of having a child with NSOFC.ConclusionsThis study suggests that NSOFC may be associated with maternal exposure to lifetime stress and COVID-19 fear in particular, with no direct effect of the COVID-19 infection itself. This highlights the importance of providing psychological support for expecting mothers during stressful events that affect populations such as the COVID-19 pandemic, in addition to the usual antenatal care.

Project description:At a global level, climate change is expected to result in more frequent and higher-intensity weather events, with impacts ranging from inconvenient to catastrophic. The potential for disasters to act as "focusing events" for policy change, including adaptation to climate change risk, is well known. Moreover, local action is an important element of climate change adaptation and related risk management efforts. As such, there is a good reason to expect local communities to mobilize in response to disaster events, both with immediate response and recovery-focused activities, as well as longer-term preparedness and adaptation-focused public policy changes. However, scholars also note that the experience of disaster does not always yield policy change; indeed, disasters can also result in policy inertia and failure, perhaps as often or more often than major policy change. This study poses two key research questions. First, we ask to what degree policy change occurs in communities impacted by an extreme weather event. Second, we seek to understand the conditions that lead to adaptation-oriented policy adoption in response to an extreme weather event. Our results suggest two main recipes for future-oriented policy adoption in the wake of an extreme weather event. For both recipes, a high-impact event is a necessary condition for future-oriented policy adoption. In the first recipe for change, policy adoption occurs in Democratic communities with highly focused media attention. The second, less expected recipe for change involves Republican communities that have experienced other uncommon weather events in the recent past. We use a comparative case approach with 15 cases and fuzzy set qualitative comparative analysis methods. Our approach adds to the existing literature on policy change and local adaptation by selecting a mid-N range of cases where extreme weather events have the potential to act as focusing events, thereby sidestepping selection on the dependent variable. Our approach also takes advantage of a novel method for measuring attention, the latent Dirichlet allocation approach.

Dataset Information

A population-based case-control study of the association between weather-related extreme heat events and orofacial clefts.

Publications

A population-based case-control study of the association between weather-related extreme heat events and orofacial clefts.

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