Ambient temperature and stillbirth risks in northern Sweden, 1880-1950.
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ABSTRACT:
SUBMITTER: Karlsson L
PROVIDER: S-EPMC8663868 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:BackgroundElevated temperature is well-recognized as a health hazard, and may be particularly harmful to pregnant women, including increasing risk of stillbirth. We conducted a study in Northern and Central Florida, an area prone to periodic extreme heat but with significant seasonal variation, focusing on the most socioeconomically vulnerable populations least able to mitigate the impact of heat.MethodsWe obtained electronic health records data from the OneFlorida Data Trust for the period 2012-2017, with 1876 stillbirths included in the analysis. We used a case-crossover design to examine the risk of stillbirth associated with acute exposures to elevated heat prior to the outcome, contrasting the case period (the week preceding the stillbirth) with a control period (the week prior to the case period and the week after the stillbirth). Average heat index and maximum warning level during the case and control periods of each woman were assigned by ZIP code. Conditional logistic regression models were used to assess the association between stillbirth and heat exposure, controlling for PM2.5 and O3.ResultsThe adjusted odds ratio showed no overall association with stillbirth except for a weak association for exposure above the 90th percentile which was larger among the most socioeconomically deprived and non-Hispanic Black women. In the hot months, there was a clear association for all indices of heat exposure, but largest again for the most socioeconomically deprived population (aOR = 2.4, 95% CI: 1.2-5.2 in the 4th vs. 1st quartile) and among non-Hispanic Black women (aOR = 1.8, 95% CI: 1.0-3.2 in the 4th vs. 1st quartile).ConclusionsOur results provide further evidence that elevated ambient heat is related to stillbirth and encourage a focus on the most susceptible individuals and possible clinical pathways.
| S-EPMC8638076 | biostudies-literature
Project description:BackgroundClimate change is expected to have adverse health effects, but the association between extreme ambient temperatures and stillbirth is unclear.ObjectivesWe investigated acute and chronic associations between extreme ambient temperatures and stillbirth risk, and estimated the attributable risk associated with local temperature extremes in the United States.MethodsWe linked 223,375 singleton births ?23?weeks of gestation (2002–2008) from 12 U.S. sites to local temperature. Chronic exposure to hot (>90th?percentile), cold (<10th?percentile), or mild (10th–90th?percentile) temperatures was defined using window- and site-specific temperature distributions for three-months preconception, first and second trimester, and whole-pregnancy averages. For acute exposure, average temperature for the week preceding delivery was compared to two alternative control weeks in a case-crossover analysis.ResultsIn comparison with mild, whole-pregnancy exposure to cold [adjusted odds ratio (aOR) = 4.75; 95% confidence interval (CI): 3.95, 5.71] and hot (aOR = 3.71; 95% CI: 3.07, 4.47) were associated with stillbirth risk, and preconception and first and second trimester exposures were not. Approximately 17–19% of stillbirth cases were potentially attributable to chronic whole-pregnancy exposures to local temperature extremes. This is equivalent to ?1,116?cold-related and ?1,019?hot-related excess cases in the United States annually. In the case-crossover analysis, a 1°C increase during the week preceding delivery was associated with a 6%?(3–9%) increase in stillbirth risk during the warm season (May–September). This incidence translates to ?4?(2–6) additional stillbirths per 10,000 births for each 1°C increase.ConclusionsExtremes of local ambient temperature may have chronic and acute effects on stillbirth risk, even in temperate zones. Temperature-related effects on pregnancy outcomes merit additional investigation. https://doi.org/10.1289/EHP945.
| S-EPMC5743476 | biostudies-literature
Project description:It is well-established that exposure to non-optimum temperatures adversely affects public health, with the negative impact varying with latitude, as well as various climatic and population characteristics. This work aims to assess the relationship between ambient temperature and mortality from cardiorespiratory diseases in Eastern Macedonia and Thrace, in Northern Greece. For this, a standard time-series over-dispersed Poisson regression was fit, along with a distributed lag nonlinear model (DLNM), using a maximum lag of 21 days, to capture the non-linear and delayed temperature-related effects. A U-shaped relationship was found between temperature and cardiorespiratory mortality for the overall population and various subgroups and the minimum mortality temperature was observed around the 65th percentile of the temperature distribution. Exposure to extremely high temperatures was found to put the highest risk of cardiorespiratory mortality in all cases, except for females which were found to be more sensitive to extreme cold. It is remarkable that the highest burden of temperature-related mortality was attributed to moderate temperatures and primarily to moderate cold. The elderly were found to be particularly susceptible to both cold and hot thermal stress. These results provide new evidence on the health response of the population to low and high temperatures and could be useful to local authorities and policy-makers for developing interventions and prevention strategies for reducing the adverse impact of ambient temperature.
| S-EPMC9819162 | biostudies-literature
Project description:BackgroundWe examined the association of maternal obesity with risk of stillbirth, focusing on whether the pattern of results varied by gestational age or maternal race-ethnicity or parity.MethodsAnalyses included 4,012 stillbirths and 1,121,234 liveborn infants delivered in California from 2007-2010. We excluded stillbirths due to congenital anomalies, women with hypertensive disorders or diabetes, and plural births, to focus on fetuses and women without these known contributing conditions. We used Poisson regression to estimate relative risks (RR) and 95% confidence intervals (CI). Separate models were run for stillbirths delivered at 20-23, 24-27, 28-31, 32-36, 37-41 weeks, relative to liveborn deliveries at 37-41 weeks.ResultsFor stillbirth at 20-23 weeks, RRs were elevated for all race-ethnicity and parity groups. The RR for a 20-unit change in BMI (which reflects the approximate BMI difference between a normal weight and an Obese III woman) was 3.5 (95% CI 2.2, 5.6) for nulliparous white women and ranged from 1.8 to 5.0 for other sub-groups. At 24-27 weeks, the association was significant (p<0.05) only for multiparous non-Hispanic whites; at 28-31 weeks, for multiparous whites and nulliparous whites and blacks; at 32-36 weeks, for multiparous whites and nulliparous blacks; and at 37-41 weeks, for all groups except nulliparous blacks. The pattern of results was similar when restricted to stillbirths due to unknown causes and somewhat stronger when restricted to stillbirths attributable to obstetric causes.ConclusionIncreased risks were observed across all gestational ages, and some evidence of heterogeneity of the associations was observed by race-ethnicity and parity.
| S-EPMC4605840 | biostudies-literature
Project description:Cardiovascular disease (CVD) is the number one cause of death globally and evidence is steadily increasing on the role of non-traditional risk factors such as meteorology and air pollution. Nevertheless, many research gaps remain, such as the association between these non-traditional risk factors and subtypes of CVD, such as acute myocardial infarction (AMI). The objective of this study was to investigate the association between daily ambient temperature and AMI hospitalisations using a case-crossover design in Gothenburg, Sweden (1985-2010). A secondary analysis was also performed for out-of-hospital ischemic heart disease (IHD) deaths. Susceptible groups by age and sex were explored. The entire year as well as the warm (April-September) and cold periods (October-March) were considered. In total 28,215 AMI hospitalisations (of 22,475 people) and 21,082 out-of-hospital IHD deaths occurred during the 26-year study period. A linear exposure-response corresponding to a 3% and 7% decrease in AMI hospitalisations was observed for an inter-quartile range (IQR) increase in the 2-day cumulative average of temperature during the entire year (11°C) and the warm period (6°C), respectively, with and without adjustment for PM₁₀, NO₂, NOx or O₃. No heat waves occurred during the warm period. No evidence of an association in the cold period nor any association between temperature and IHD deaths in the entire year, warm or cold periods--with and without adjusting for PM₁₀, NO₂, NOx or O₃ was found. No susceptible groups, based on age or sex, were identified either. The inverse association between temperature and AMI hospitalisations (entire year and warm period) in Gothenburg is in accordance with the majority of the few other studies that investigated this subtype of CVD.
| S-EPMC3639986 | biostudies-literature
Project description:The purpose of the present study was to examine the risk of stillbirth associated with ambient air pollution during pregnancy. Using live birth and fetal death data from New Jersey from 1998 to 2004, the authors assigned daily concentrations of air pollution to each birth or fetal death. Generalized estimating equation models were used to estimate the relative odds of stillbirth associated with interquartile range increases in mean air pollutant concentrations in the first, second, and third trimesters and throughout the entire pregnancy. The relative odds of stillbirth were significantly increased with each 10-ppb increase in mean nitrogen dioxide concentration in the first trimester (odds ratio (OR) = 1.16, 95% confidence interval (CI): 1.03, 1.31), each 3-ppb increase in mean sulfur dioxide concentration in the first (OR = 1.13, 95% CI: 1.01, 1.28) and third (OR = 1.26, 95% CI: 1.03, 1.37) trimesters, and each 0.4-ppm increase in mean carbon monoxide concentration in the second (OR = 1.14, 95% CI: 1.01, 1.28) and third (OR = 1.14, 95% CI: 1.06, 1.24) trimesters. Although ambient air pollution during pregnancy appeared to increase the relative odds of stillbirth, further studies are needed to confirm these findings and examine mechanistic explanations.
| S-EPMC3491970 | biostudies-literature
Project description:Most studies on the fertility transition have focused either on macro-level trends or on micro-level patterns with limited geographic scope. Much less attention has been given to the interplay between individual characteristics and contextual conditions, including geographic location. Here we investigate the relevance of geography and socioeconomic status for understanding fertility variation in the initial phase of the Swedish fertility transition. We conduct spatially sensitive multilevel analyses on full-count individual-level census data. Our results show that the elite constituted the vanguard group in the fertility decline and that the shift in fertility behavior occurred quickly among them in virtually all parts of Sweden. Other socioeconomic status groups experienced the decline with some delay, and their decline patterns were more clustered around early centers of the decline. Long-distance migrants initially had higher fertility than people living close to their birthplace. However, as the fertility decline unfolded, this advantage was either reduced or reversed. This supports the view that migration and fertility are linked in this process. Our results confirm that socioeconomic status differences were of considerable relevance in structuring the fertility transition. The degree to which spatial distance fostered spatial variation in the fertility decline seems to have been negatively correlated with socioeconomic status, with the pattern of decline among the elite showing the lowest degree of spatial variation.
| S-EPMC6514273 | biostudies-literature
Project description:BackgroundThe hand is the second most fractured region in children. It is therefore important to update fracture epidemiology to be able to identify time trends for adequate health care planning. This study reports pediatric hand fracture incidence 2014-2016 and, using published data, also long-term time trends in 1950-2016.Patients and methodsThe Swedish city of Malmö, with 328,494 inhabitants in 2016, has only one hospital. We used the hospital radiological archive, medical charts, and diagnosis registry to identify hand fractures in city residents < 16 years in 2014-2016. These data were compared to those from three published studies that evaluated periods in 1950-2006. Differences between two periods were calculated as both unadjusted and age- and sex-adjusted incident rate ratios (IRR) with 95% confidence intervals (95% CI). We used joinpoint regression to estimate time trends during the entire period and present annual percent changes (APC) with 95% CI.ResultsIn 2014-2016 phalangeal fractures accounted for 71% of all hand fractures, metacarpal fractures for 24%, and carpal fractures for 5%. We identified 615 hand fractures (419 in boys and 196 in girls) during 181,617 person-years in 2014-2016, resulting in an unadjusted pediatric hand fracture incidence of 339/100,000 person-years (boys 452/100,000 person-years and girls 220/100,000 person-years). The age-adjusted incidence 2014-2016 was similar to 2005-2006, the most recently evaluated period (IRR in boys 0.9; 95% CI 0.8 to 1.01, and in girls 1.0; 95% CI 0.8 to 1.2). Looking at the entire period 1950-2016, we found that age-adjusted incidence increased in 1950-1979, in boys by APC + 3.8%; 95% CI 3.0 to 4.5 and in girls by + 3.9%; 95% CI 2.8 to 5.0, but decreased in 1979-2016, in boys by - 0.7%; 95% CI - 1.4 to - 0.003, and girls by - 1.3%; 95% CI - 2.4 to - 0.1.ConclusionsPhalangeal fractures accounted for about three quarters of all hand fractures. The age-adjusted hand fracture incidence increased in both sexes in 1950-1979 and decreased in 1979-2016.Level of evidenceIII.
| S-EPMC8034127 | biostudies-literature
Project description:Background and purpose - Pediatric fracture incidence may not be stable. We describe recent pediatric fracture epidemiology and etiology and compare this to earlier data. Patients and methods - The city of Malmö (population 271,271 in 2005) in Sweden is served by 1 hospital. Using the hospital diagnosis registry, medical charts, and the radiographic archive, we identified fractures in individuals <16 years that had occurred during 2005 and 2006. We also retrieved previously collected fracture data from between 1950 and 1994, from the hospital's pediatric fracture database. We used official population data to estimate period-specific fracture incidence (the number of fractures per 105 person-years) and also age- and sex-adjusted incidence. Differences are reported as rate ratios (RRs) with 95% confidence intervals. Results - The pediatric fracture incidence during the period 2005-2006 was 1,832 per 105 person-years (2,359 in boys and 1,276 in girls), with an age-adjusted boy-to-girl ratio of 1.8 (1.6-2.1). Compared to the period 1993-1994, age-adjusted rates were unchanged (RR =0.9, 95% CI: 0.8-1.03) in 2005-2006, with lower rates in girls (RR =0.8, 95% CI: 0.7-0.99) but not in boys (RR =1.0, 95% CI: 0.9-1.1). We also found that the previously reported decrease in unadjusted incidence in Malmö from 1976-1979 to 1993-1994 was based on changes in demography, as the age-adjusted incidences were similar in the 2 periods (RR =1.0, 95% CI: 0.9-1.1). Interpretation - In Malmö, pediatric fracture incidence decreased from 1993-1994 to 2005-2006 in girls but not in boys. Changes in demography, and also other factors, influence the recent time trends.
| S-EPMC5499338 | biostudies-literature
Project description:Interventions: This trial is a secondary analysis of existing data collected as part of a previous prospective trial investigating the efficacy and tolerability of different bowel preparations in both inflammatory bowel disease patients and the general population.
In the original trial, patients were randomised to two different types of bowel preparation (Moviprep or Prep Kit C).
We added ambient temperature as the minimum and maximum temperature documented by the local Bureau of Meteorology weather observation station on the day prior to the scheduled colonoscopy.
No additional participant involvement was required.
Primary outcome(s): Quality of bowel preparation as determined using the validated Ottawa Bowel Preparation Score. This grades the quality of bowel preparation from 0 to 4 (with 0 being no fluid and 4 pertaining to fluid/faecal material unable to be cleared) in three colonic segments (right, left and rectosigmoid) to reach a total score out of 14. All endoscopists attended calibrating sessions prior to study commencement. Two endoscopists assessed the efficacy of bowel cleansing regime independently at the time of the procedure. An average score was then calculated. Inadequate bowel preparation is defined as an Ottawa Bowel Preparation Score equal to or greater than 8.[At time of colonoscopy. ]
| 2470704 | ecrin-mdr-crc