Dataset Information

Acute association between heatwaves and stillbirth in six US states.

ABSTRACT:

Background

Heatwaves are becoming more frequent and may acutely increase the risk of stillbirth, a rare and severe pregnancy outcome.

Objectives

Examine the association between multiple heatwave metrics and stillbirth in six U.S. states.

Methods

Data were collected from fetal death and birth records in California (1996-2017), Florida (1991-2017), Georgia (1994-2017), Kansas (1991-2017), New Jersey (1991-2015), and Oregon (1991-2017). Cases were matched to controls 1:4 based on maternal race/ethnicity, maternal education, and county, and exposure windows were aligned (gestational week prior to stillbirth). County-level temperature data were obtained from Daymet and linked to cases and controls by residential county and the exposure window. Five heatwave metrics (1 categorical, 3 dichotomous, 1 continuous) were created using different combinations of the duration and intensity of hot days (mean daily temperature exceeding the county-specific 97.5^th percentile) during the exposure window, as well as a continuous measure of mean temperature during the exposure window modeled using natural splines to allow for nonlinear associations. State-specific odds ratios (ORs) and 95% confidence intervals (CI) were estimated using conditional logistic regression models. State-specific results were pooled using a fixed-effects meta-analysis.

Results

In our data set of 140,428 stillbirths (553,928 live birth controls), three of the five heatwave metrics examined were not associated with stillbirth. However, four consecutive hot days during the previous week was associated with a 3% increase in stillbirth risk (CI: 1.01, 1.06), and a 1 °C average increase over the threshold was associated with a 10% increase in stillbirth risk (CI: 1.04, 1.17). In continuous temperature analyses, there was a slight increased risk of stillbirth associated with extremely hot temperatures (≥ 35 °C).

Discussion

Most heat wave definitions examined were not associated with acute changes in stillbirth risk; however, the most extreme heatwave durations and temperatures were associated with a modest increase in stillbirth risk.

SUBMITTER: Richards M

PROVIDER: S-EPMC9202158 | biostudies-literature | 2022 Jun

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Acute association between heatwaves and stillbirth in six US states.

Richards Megan M Huang Mengjiao M Strickland Matthew J MJ Newman Andrew J AJ Warren Joshua L JL D'Souza Rohan R Chang Howard H HH Darrow Lyndsey A LA

Environmental health : a global access science source 20220616 1

<h4>Background</h4>Heatwaves are becoming more frequent and may acutely increase the risk of stillbirth, a rare and severe pregnancy outcome.<h4>Objectives</h4>Examine the association between multiple heatwave metrics and stillbirth in six U.S. states.<h4>Methods</h4>Data were collected from fetal death and birth records in California (1996-2017), Florida (1991-2017), Georgia (1994-2017), Kansas (1991-2017), New Jersey (1991-2015), and Oregon (1991-2017). Cases were matched to controls 1:4 based ...[more]

PMID: 35710419

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Project description:BackgroundThere is increasing demand for post-acute care services, which is amplified by the COVID-19 pandemic.AimsWe studied the pattern of spatial association between post-acute care services and acute care facilities and evaluated how geographic variability could influence their use.MethodsWe compiled data on CMS-certified acute care and critical access hospitals and post-acute health care services (nursing homes, home health care services, inpatient rehabilitation facilities, long-term care hospitals, and hospice facilities). We used the colocation quotient (CLQ) to measure the magnitude and direction of association (clustering or segregation) between post-acute care providers and hospitals. This metric allows pairwise comparison of categorical data; a value <1 indicates spatial segregation and a value >1 spatial clustering. Unity marks the lack of spatial dependence (random distribution).ResultsWith the exception of nursing homes (CLQ 1.26), all other types of post-acute care providers are spatially segregated from rural critical access hospitals. Long-term care facilities ranked first (had the lowest global CLQ, 0.06), hospice facilities ranked last (had the highest global CLQ estimate, 0.54). Instead, post-acute care services either clustered with (inpatient rehabilitation 2.76, long-term care 2.10, nursing homes 1.37) or were only weakly segregated (home health care 0.86) from acute care hospitals. Home health care (1.44), hospice services (1.46), and nursing homes (1.08) spatially clustered with the same category of services. Results were robust in the sensitivity analysis and we provided illustrative examples of local variation for the states of MA and IA.ConclusionPost-acute care services are isolated from critical access hospitals, and have a clustering pattern with the same category services and acute care hospitals. Such misdistribution of resources may result in both underuse and a substitution effect on the type of post-acute care between rural and urban areas and undermine public health during increasing demand, such as the COVID-19 pandemic.

Project description:ImportanceFirearms are the method of suicide used most often in the US. Acute alcohol use is associated with an increased risk of suicide by firearm. However, the dose-response association between acute alcohol use and the probability of using a firearm as the method of suicide is unknown.ObjectiveTo evaluate the association between the amount of alcohol consumed and the probability of using a firearm as the method of suicide.Design, setting, and participantsThis cross-sectional study used mortality data from the US National Violent Death Reporting System on suicide decedents aged 18 years or older with a positive blood alcohol concentration (BAC; ie, ≥0.01 g/dL). Statistical analysis was performed from January 2003 to December 2020.ExposureAcute alcohol use, ascertained via postmortem toxicologic examination.Main outcomes and measuresProbability of using a firearm as the method of suicide compared with all other methods of suicide.ResultsThe study included 45 959 male suicide decedents (mean [SD] age, 42.6 [14.8] years) and 12 136 female suicide decedents (mean [SD] age, 44.2 [13.8] years) with a positive BAC; of those, 24 720 male decedents (53.8%) and 3599 female decedents (29.7%) used a firearm as the method of suicide. The probability of using a firearm as the method of suicide when alcohol is consumed was higher for male decedents, with the probability starting at just below 0.50 and increasing to approximately 0.75. In contrast, for female decedents, the probability began at just above 0.30 and increased to approximately 0.55. For both male and female decedents, the dose-response curves were an inverted U shape; as BAC increased, the probability of firearm-involved suicide initially increased and then decreased at very high BACs (approximately 0.40 g/dL for male decedents and approximately 0.30 g/dL for female decedents; these BACs were present among only a small percentage of alcohol-involved suicides: male decedents, 589 [1.3%]; female decedents, 754 [6.2%]).Conclusions and relevanceThis cross-sectional study of suicide decedents who had consumed alcohol prior to their death suggests that, as alcohol consumption increased, the probability of a firearm-involved suicide increased until a certain BAC, at which point the probability started to decrease.

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Dataset Information

Acute association between heatwaves and stillbirth in six US states.

Background

Objectives

Methods

Results

Discussion

Publications

Acute association between heatwaves and stillbirth in six US states.

Similar Datasets

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