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Bruckner TA, Trinh NTH, Lelong N, Madani K, Slama R, Given J, Khoshnood B. Climate Change and Congenital Anomalies: A Population-Based Study of the Effect of Prolonged Extreme Heat Exposure on the Risk of Neural Tube Defects in France. Birth Defects Res 2024; 116:e2397. [PMID: 39215441 DOI: 10.1002/bdr2.2397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2024] [Revised: 07/11/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
BACKGROUND Exposure to long-lasting extreme ambient temperatures in the periconceptional or early pregnancy period might increase the risk of neural tube defects (NTDs). We tested whether prolonged severe heat exposure as experienced during the 2003 extreme heatwave in France, affected the risk of NTDs. METHODS We retrieved NTD cases spanning from January 1994 to December 2018 from the Paris Registry of Congenital Malformations. The 2003 heatwave was characterized by the long duration and high intensity of nine consecutive days with temperatures ≥35°C. We classified monthly conceptions occurring in August 2003 as "exposed" to prolonged extreme heat around conception (i.e., periconceptional period). We assessed whether the risk of NTDs among cohorts exposed to the prolonged severe heatwave of 2003 in the periconceptional period differed from expected values using Poisson/negative binomial regression. FINDINGS We identified 1272 NTD cases from January 1994 to December 2018, yielding a monthly mean count of 4.24. Ten NTD cases occurred among births conceived in August 2003. The risk of NTD was increased in the cohort with periconceptional exposure to the August 2003 heatwave (relative risk = 2.14, 95% confidence interval: 1.46 to 3.13), compared to non-exposed cohorts. Sensitivity analyses excluding July and September months or restricting to summer months yielded consistent findings. INTERPRETATION Evidence from the "natural experiment" of an extreme climate event suggests an elevated risk of NTDs following exposure to prolonged extreme heat during the periconceptional period.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California, Irvine, California, USA
| | - Nhung T H Trinh
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
- PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy, University of Oslo, Norway
| | - Nathalie Lelong
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
| | - Kaveh Madani
- United Nations University Institute for Water, Environment and Health (UNU-INWEH), Richmond Hill, Ontario, Canada
| | - Rémy Slama
- University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences, Grenoble, France
| | - Joanne Given
- Institute of Nursing and Health Research, Ulster University, Belfast, UK
| | - Babak Khoshnood
- Université de Paris, Epidemiology and Statistics Research Center - CRESS, INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Paris, France
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Singh P, Gailey S, Das A, Bruckner TA. National Trends in Suicides and Male Twin Live Births in the US, 2003 to 2019: An Updated Test of Collective Optimism and Selection in Utero. Twin Res Hum Genet 2023; 26:1-8. [PMID: 38099411 PMCID: PMC11178679 DOI: 10.1017/thg.2023.49] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2024]
Abstract
Prior research based on Swedish data suggests that collective optimism, as measured by monthly incidence of suicides, correlates inversely with selection in utero against male twins in a population. We test this finding in the US, which reports the highest suicide rate of all high-income countries, and examine whether monthly changes in overall suicides precede changes in the ratio of male twin to male singleton live births. Consistent with prior work, we also examine as a key independent variable, suicides among women aged 15-49 years. We retrieved monthly data on suicides and the ratio of male twin to singleton live births from CDC WONDER, 2003 to 2019, and applied Box-Jenkins iterative time-series routines to detect and remove autocorrelation from both series. Results indicate that a 1% increase in monthly change in overall suicides precedes a 0.005 unit decline in male twin live births ratio 6 months later (coefficient = -.005, p value = .004). Results remain robust to use of suicides among reproductive-aged women as the independent variable (coefficient = -.0012, p value = .014). Our study lends external validity to prior research and supports the notion that a decline in collective optimism corresponds with greater selection in utero.
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Affiliation(s)
- Parvati Singh
- Division of Epidemiology, College of Public Health, The Ohio State University, Ohio, USA
| | - Samantha Gailey
- Department of Forestry, Michigan State University, East Lansing, Michigan, USA
| | - Abhery Das
- Program in Public Health, University of California, Irvine, California, USA
| | - Tim A. Bruckner
- Program in Public Health, University of California, Irvine, California, USA
- Center for Population, Inequality, and Policy, University of California, Irvine, California, USA
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Bruckner TA, Catalano R, Das A, Lu Y. Cohort Selection In Utero against Male Twins and Childhood Cancers: A Population-Based Register Study. Cancer Epidemiol Biomarkers Prev 2021; 30:1834-1840. [PMID: 34272267 PMCID: PMC8974355 DOI: 10.1158/1055-9965.epi-21-0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 03/28/2021] [Accepted: 06/15/2021] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Cancer ranks as the second leading cause of death among children ages 1 to 14 years in the United States. Previous research finds that strong cohort selection in utero against males precedes a reduction in live-born males considered frail. We examine whether such cohort selection in utero may similarly affect the frequency of childhood cancers among male live births. METHODS We examined 1,368 childhood cancers among males born in Sweden over 144 months, from January 1990 to December 2001, and followed to age 15 in the Swedish Cancer Registry. We retrieved the count of male twins by birth month from the Swedish Birth Registry. We applied autoregressive, integrated, moving average time-series methods to identify and control for temporal patterns in monthly childhood cancers and to evaluate robustness of results. RESULTS Fewer childhood cancers occur among monthly male birth cohorts with elevated selection in utero (i.e., a low count of live-born male twins). This association appears in the concurrent month (coef = 0.04; 95% CI, 0.001-0.079) as well as in the following month in which most births from the twin's conception cohort are "scheduled" to be born (coef = 0.055; 95% CI, 0.017-0.094). CONCLUSIONS Elevated cohort selection in utero may reduce the number of frail male gestations that would otherwise have survived to birth and received a cancer diagnosis during childhood. IMPACT This novel result warrants further investigation of prenatal exposures, including those at the population level, that may induce cohort selection in utero for some cancer types but not others.
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Affiliation(s)
- Tim A. Bruckner
- Program in Public Health, University of California, Irvine, Irvine, California.,Center for Population, Inequality, and Policy, University of California, Irvine, Irvine, California.,Corresponding Author: Tim A. Bruckner, Program in Public Health, University of California, Irvine, Irvine, CA 92617. E-mail:
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Abhery Das
- Program in Public Health, University of California, Irvine, Irvine, California
| | - Yunxia Lu
- Program in Public Health, University of California, Irvine, Irvine, California
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Rettaroli R, Scalone F. The human sex ratio at birth and late fetal mortality: the Italian case. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2021; 66:172-190. [PMID: 34182854 DOI: 10.1080/19485565.2021.1879627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
This study explores the short-term relationships between sex ratio at birth and late fetal mortality in Italy from 1910 to 2016. As the leading scholars' attention traditionally focused on long-term trends and variations in the sex ratios at birth among different populations, less interest regarded short-term fluctuations as they were mainly seen as an effect of random variability. We detrended the national series of males proportion among live births and stillbirths by their medium-term component to consider the annual deviations from a normal trend. After controlling for fertility tendencies and wars effects, regression models seem to show the effects of stillbirth on the proportion of male newborns. A sensitivity analysis was also carried out to assess the effects of the perinatal deaths on the proportion of males at birth, combining stillbirths and early neonatal losses to control the possible misspecification between stillborn infants and early neonatal deaths. The significance of late fetal mortality reflects the mortality excess among male fetuses during the intrauterine life, showing evidence for the in utero hypothesis selection.
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Affiliation(s)
- Rosella Rettaroli
- Department of Statistical Sciences, Alma Mater Studiorum,University of Bologna, Bologna, Italy
| | - Francesco Scalone
- Department of Statistical Sciences, Alma Mater Studiorum,University of Bologna, Bologna, Italy
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Abstract
The ratio of boys to girls (sex ratio) at birth (SRB) is about 1.01-1.05 in most populations and is influenced by various factors, such as maternal stress, maternal inflammation, and endocrine disruption. Male fetus is biologically weaker and more vulnerable to prenatal events than female fetuses. Hence, premature death (and consequently decline the SRB) is higher in boys than girls. The recent coronavirus disease 2019 (COVID-19) has been known to have a variety of stressful and psychological impacts. This stress may consequently enhance maternal inflammation, pregnancy complication, and fetal loss. Also, male fetuses have more adverse outcomes than female fetuses among asymptomatic pregnant women with SARS-Cov-2 infection. Inasmuch as the male fetus are more vulnerable to prenatal events and premature death, it is proposed that the SRB can decline in pregnant women following the COVID-19 stress. However, future studies are needed to define the impact of the COVID-19 on SRB rate.
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Affiliation(s)
- Amir Abdoli
- Department of Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.,Zoonoses Research Center, Jahrom University of Medical Sciences, Jahrom, Iran
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Catalano R, Casey JA, Bruckner TA. A test of oscillation in the human secondary sex ratio. EVOLUTION MEDICINE AND PUBLIC HEALTH 2020; 2020:225-233. [PMID: 33376596 PMCID: PMC7750984 DOI: 10.1093/emph/eoaa012] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Revised: 04/07/2020] [Accepted: 04/08/2020] [Indexed: 01/03/2023]
Abstract
Background and objectives The sex ratio of human birth cohorts predicts the health and longevity of their members. Most literature invokes natural selection in support of the argument that heritable tendencies to produce male or female offspring induce oscillation in the sex ratio and its sequelae. Tests of the argument remain exceedingly rare because they require vital statistics describing many generations of a population both unaffected by migration and exposed to an exogenous stressor virulent enough to change the sex ratio at birth. We contribute to the literature by using time-series modeling to detect oscillation in the best data currently available for such a test. Methodology We apply rigorous time-series methods to data describing Sweden from 1751 through 1830, a period when the population not only aged in place without migration, but also exhibited the effects of an Icelandic volcanic eruption including a historically low secondary sex ratio. That very low sex ratio should have induced oscillation if heritable mechanisms appear in humans. Results We detected oscillation in the ratio but not that predicted by heritable tendencies to produce males or females. We found peak-to-trough oscillation at 14 rather than the approximately 32 years expected from the heritable tendencies argument. Conclusions and implications Our findings suggest that mechanisms other than perturbation of heritable tendencies to produce males or females induce oscillation in the human secondary sex ratio. These other mechanisms may include reproductive suppression and selection in utero. LAY SUMMARY The male to female ratio in human birth cohorts predicts longevity but its variation over time remains unexplained. We test the long-held theory that the ratio oscillates due to heritable tendencies to produce males or females. We find oscillation, but it appears due to social processes rather than heritable mechanisms.
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Affiliation(s)
- Ralph Catalano
- School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Joan A Casey
- Environmental Health Sciences, Columbia University, New York, NY, USA
| | - Tim A Bruckner
- Program in Public Health, University of California, Irvine, Irvine, CA, USA
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Bruckner TA, Singh P, Lelong N, Khoshnood B. Down syndrome among primiparae at older maternal age: A test of the relaxed filter hypothesis. Birth Defects Res 2019; 111:1611-1617. [PMID: 31321913 DOI: 10.1002/bdr2.1553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Revised: 06/30/2019] [Accepted: 07/02/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND Down syndrome (DS) ranks as one of the most common birth defects in the United States. The relaxed filter hypothesis (RFH) asserts that mothers with no previous children but nearing reproductive senescence reduce fetal selectivity against DS pregnancies in the first trimester given the high probability of having no offspring at all if the DS pregnancy is not carried to term. We test the parity prediction of RFH-specifically, that pregnancies to older mothers with no previous live births show an elevated prevalence of DS above values expected from the separate contributions of older maternal age and primiparity. METHODS We retrieved maternal age and parity information on 2,748 DS cases (live, stillborn, or terminated due to anomaly) from the Paris Birth Defects Registry, 1983-2015. We used two waves of the Enquête Fertility Survey (n = 5,460) and counts of stillbirths to calculate total prevalence of DS by maternal age and parity. RESULTS Primiparous mothers 35+ years show the greatest prevalence of any parity group (9.78 cases per 1,000 deliveries). Tests for additive interaction of primiparity and older maternal age reject the null (relative excess risk due to interaction = 1.01; 95% confidence interval: 0.33, 1.69; null value on additive scale is 0). CONCLUSIONS Relaxed selection may account for 10% of the increase in the prevalence, among older primiparous mothers, of DS detected during or after the 11th week. Future work may hold implications for understanding, among older mothers, the strength of this maternal screen against other defects.
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Affiliation(s)
- Tim A Bruckner
- Program in Public Health, University of California Irvine (UCI), Irvine, California
| | - Parvati Singh
- Program in Public Health, University of California Irvine (UCI), Irvine, California
| | - Nathalie Lelong
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne, Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
| | - Babak Khoshnood
- INSERM UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology, Research Team (EPOPé), Center for Epidemiology and Statistics, Sorbonne, Paris Cité (CRESS), DHU Risks in Pregnancy, Paris Descartes University, Paris, France
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Bruckner TA, Catalano R. Selection in utero and population health: Theory and typology of research. SSM Popul Health 2018; 5:101-113. [PMID: 29928686 PMCID: PMC6008283 DOI: 10.1016/j.ssmph.2018.05.010] [Citation(s) in RCA: 50] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Revised: 05/30/2018] [Accepted: 05/31/2018] [Indexed: 01/05/2023] Open
Abstract
Public health researchers may assume, based on the fetal origins literature, that "scarring" of birth cohorts describes the population response to modern-day stressors. We contend, based on extensive literature concerned with selection in utero, that this assumption remains questionable. At least a third and likely many more of human conceptions fail to yield a live birth. Those that survive to birth, moreover, do not represent their conception cohort. Increasing data availability has led to an improved understanding of selection in utero and its implications for population health. The literature describing selection in utero, however, receives relatively little attention from social scientists. We aim to draw attention to the rich theoretical and empirical literature on selection in utero by offering a typology that organizes this diverse work along dimensions we think important, if not familiar, to those studying population health. We further use the typology to identify important gaps in the literature. This work should interest social scientists for two reasons. First, phenomena of broad scholarly interest (i.e., social connectivity, bereavement) affect the extent and timing of selection in utero. Second, the life-course health of a cohort depends in part on the strength of such selection. We conclude by identifying new research directions and with a reconciliation of the apparent contradiction between the "fetal origins" literature and that describing selection in utero.
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Affiliation(s)
- Tim A. Bruckner
- Program in Public Health, University of California, Irvine, 653 E. Peltason Dr. Suite 2046, 2nd Floor, Irvine, CA 92697-3957, USA
| | - Ralph Catalano
- School of Public Health, University of California, Berkeley, 15 University Hall, Berkeley, CA 94720, USA
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