Extreme heat events and pregnancy duration: a national study

极端高温事件与怀孕持续时间：一项全国性研究

• 批准号: 9914101
• 负责人: Howard H Chang
• 金额: $ 53.16万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2018
• 资助国家: 美国
• 起止时间: 2018-05-01 至 2023-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/9914101
• 关键词: 37 weeks gestation; Age Distribution; Air; Air Conditioning; Air Pollutants; Air Pollution; Bayesian Modeling; Birth; Birth Records; California; Characteristics; Child; Cities; Climate; Code; Colorado; Communities; Conceptions; County; Data; Data Set; Data Sources; Databases; Date of birth; Education; Ethnic Origin; Event; Exposure to; Florida; Frequencies; Future; Geography; Gestational Age; Goals; Health; Heat Waves; Heterogeneity; High temperature of physical object; Hour; Humidity; Income; Individual; Infant; Infant Mortality; Investments; Length; Location; Measurement; Measures; Mediating; Mediation; Medical; Meteorology; Methodology; Modeling; Monitor; Morbidity - disease rate; Neighborhoods; Neurologic; New Jersey; Ohio; Output; Pattern; Planet Earth; Population; Poverty; Pregnancy; Pregnant Women; Premature Birth; Prevalence; Principal Investigator; Public Health; Race; Reproductive Health; Research; Research Personnel; Residential Mobility; Resolution; Resources; Risk; Risk Factors; Sampling; Seasons; Socioeconomic Status; Source; Statistical Models; Surface; System; Temperature; Term Birth; Testing; Texas; Time; Uncertainty; United States National Center for Health Statistics; Washington; Weather; Work; adverse birth outcomes; atmospheric sciences; base; climate impact; data centers; disability; extreme heat; innovation; pollutant; rural area; socioeconomics; urban area

PROJECT SUMMARY/ABSTRACT Recent studies suggest high ambient temperatures increase the risk of preterm birth (<37 completed weeks of gestation), a leading cause of infant mortality and long-term neurological disabilities. Infants born early term (37-38 weeks) also have more morbidity compared to full term births. Under climate projections, heat waves are expected to increase in frequency, intensity, and duration, and many will cause increases in ambient air pollutant concentrations. The proposed research seeks to use large existing databases and robust methodological approaches at multiple spatial scales to test the overarching hypothesis that extreme heat events increase the risk of preterm birth and early term birth, with stronger associations hypothesized to be observed following heat events of longer duration and greater intensity. Using national birth record data from the National Center for Health Statistics, we will assess these relationships in 114 large U.S. cities (covering 54% of the population) at a county-level spatial resolution over a 36-year period (1981-2016). We will additionally obtain birth record data from eight populous and geographically representative U.S. states (covering 40% of the population) over the period 1990-2016 to assess relationships at ZIP code or finer resolution and to examine possible mediation of heat wave associations by accompanying changes in air pollution levels. Meteorology will be characterized by integrating hourly data from multiple weather station networks and satellite-resources, harnessing the strengths of each dataset to maximize spatial and temporal coverage and minimize exposure prediction error. Ambient concentrations of 12 pollutants for the eight selected states will be also characterized by combining Community Multiscale Air Quality Model (CMAQ) outputs with monitor measurements. The statistical models for preterm and early term birth will account for seasonal patterns of conception (a possible source of bias in previous studies), and two-stage analyses using Bayesian hierarchical models will be used to combine information across study locations and assess heterogeneity by climate region, timing of the heat event (within season or across decades), maternal characteristics (educational attainment, race/ethnicity), and location-specific attributes (e.g., contextual socioeconomic indicators, air conditioning prevalence, urbanicity). Precise estimation of this heterogeneity is possible due to the exceptionally large sample, which also allows for examination of heat events defined using higher intensity and duration thresholds than previously assessed. The multi-scale approach facilitates assessment and propagation of uncertainty due to exposure prediction errors, spatial aggregation, and residential mobility during pregnancy. Results can be used to inform local public health warning systems such as heat advisories that target pregnant women with the ultimate goal of reducing early birth and its sequelae. The study will also yield lasting benefits for future studies of climate and health through the creation of an integrated, spatial and temporally-resolved, publically-available meteorology dataset for the continental U.S.

项目概要/摘要 最近的研究表明，高环境温度会增加早产风险（<37 完整周） 妊娠），这是婴儿死亡和长期神经功能障碍的主要原因。早产儿 与足月出生相比，（37-38 周）的发病率也更高。根据气候预测，热浪 预计频率、强度和持续时间都会增加，其中许多会导致环境空气质量增加 污染物浓度。拟议的研究旨在利用现有的大型数据库和强大的 在多个空间尺度上的方法论方法来检验极端高温的总体假设 事件会增加早产和早产的风险，假设有更强的关联性 在持续时间较长、强度较大的高温事件后观察到。使用来自以下国家的国家出生记录数据 根据国家卫生统计中心的数据，我们将评估美国 114 个大城市的这些关系（涵盖 54%的人口）在36年期间（1981-2016）的县级空间分辨率。我们将 另外还获取美国八个人口稠密且具有地理代表性的州的出生记录数据 （覆盖 40% 的人口）在 1990-2016 年期间评估邮政编码或更精细的关系 分辨率并通过伴随的空气变化来检查热浪关联的可能调解 污染程度。气象学的特点是整合来自多个气象站的每小时数据 网络和卫星资源，利用每个数据集的优势来最大化空间和时间 覆盖范围并最大限度地减少曝光预测误差。 8月份12种污染物的环境浓度 选定的州还将结合社区多尺度空气质量模型（CMAQ）来表征 输出带有监视器测量值。早产和早产的统计模型将考虑 受孕的季节性模式（先前研究中可能存在偏差的来源），以及使用的两阶段分析 贝叶斯分层模型将用于组合跨研究地点的信息并评估 气候区域的异质性、高温事件发生的时间（季节内或跨几十年）、孕产妇 特征（教育程度、种族/民族）和特定地点的属性（例如，背景 社会经济指标、空调普及率、城市化程度）。这种异质性的精确估计是 由于样本特别大，这也允许检查使用定义的热事件 比之前评估的强度和持续时间阈值更高。多尺度方法有利于 由于暴露预测误差、空间聚集和影响而导致的不确定性的评估和传播 怀孕期间的居住流动。结果可用于告知当地公共卫生预警系统，例如 作为针对孕妇的高温建议，其最终目标是减少早产及其后遗症。 该研究还将通过创建一个模型，为未来的气候和健康研究带来持久的好处。 美国大陆的综合、空间和时间解析、公开可用的气象数据集