Background-More 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 Results-This study expanded on a prior nationwide case-control study that evaluated the association between CHDs 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 (20252035) to estimate potential changes in CHD burden 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 specific CHD subtypes during spring, including a 34.0% (95% CI, 4.9%-70.8%) increase in conotruncal CHD in the South and a 38.6% (95% CI, 9.9%-75.1%) increase in atrial septal defect in the Northeast.
Conclusions-Projected increases in maternal heat exposure could result in an increased CHD burden in certain seasons and regions of the United States.
1.Sun Yat Sen Univ, Sch Publ Hlth, Dept Med Stat & Epidemiol, Guangzhou, Guangdong, Peoples R China 2.SUNY Albany, Dept Environm Hlth Sci, Rensselaer, NY 12144 USA 3.SUNY Albany, Dept Epidemiol & Biostat, Rensselaer, NY USA 4.US EPA, Natl Exposure Res Lab, Res Triangle Pk, NC 27711 USA 5.SUNY Albany, Dept Math, Albany, NY 12222 USA 6.Univ Iowa, Dept Epidemiol, Iowa City, IA USA 7.Stanford Univ, Sch Med, Stanford, CA 94305 USA 8.Kent State Univ, Dept Geog, Kent, OH 44242 USA 9.Univ Utah, Sch Med, Salt Lake City, UT USA 10.Univ N Carolina, Chapel Hill, NC 27515 USA 11.New York State Dept Hlth, Albany, NY USA
Recommended Citation:
Zhang, Wangjian,Spero, Tanya L.,Nolte, Christopher G.,et al. Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States[J]. JOURNAL OF THE AMERICAN HEART ASSOCIATION,2019-01-01,8(3)