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Hajdu T. Temperature exposure and sleep duration: Evidence from time use surveys. ECONOMICS AND HUMAN BIOLOGY 2024; 54:101401. [PMID: 38795699 DOI: 10.1016/j.ehb.2024.101401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 05/07/2024] [Accepted: 05/09/2024] [Indexed: 05/28/2024]
Abstract
The Earth's climate is projected to warm significantly in the 21st century, and this will affect human societies in many ways. Since sleep is a basic human need and part of everyone's life, the question of how temperature affects human sleep naturally arises. This paper examines the effect of daily mean temperature on sleep duration using nationally representative Hungarian time use surveys between 1976 and 2010. Compared to a day with an average temperature of 5-10 °C, colder temperatures do not influence sleep duration. However, as daily mean temperatures rise, sleep duration starts to strongly decline. The effect of a hot (>25 °C) day is -13.3 minutes, but if preceded by a few other hot days, the effect is even stronger, -24.7 minutes. The estimated sleep loss is especially large on weekends and public holidays, for older individuals, and men. Combining the estimated effects with temperature projections of twenty-four climate models shows that the warming climate will substantially decrease sleep duration. The projected impacts are especially large when taking into account the effects of heatwave days. This study also shows that different groups in society are likely to be affected in significantly different ways by a warming climate.
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Affiliation(s)
- Tamás Hajdu
- HUN-REN Centre for Economic and Regional Studies, postal address: 1097 Tóth Kálmán u. 4., Budapest, Hungary.
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Bonell A, Ioannou LG, Hirst JE, Flouris A. Understanding the physiological and biological response to ambient heat exposure in pregnancy: protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e085314. [PMID: 38969375 PMCID: PMC11227802 DOI: 10.1136/bmjopen-2024-085314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Climate change increases not only the frequency, intensity and duration of extreme heat events but also annual temperatures globally, resulting in many negative health effects, including harmful effects on pregnancy and pregnancy outcomes. As temperatures continue to increase precipitously, there is a growing need to understand the underlying biological pathways of this association. This systematic review will focus on maternal, placental and fetal changes that occur in pregnancy due to environmental heat stress exposure, in order to identify the evidence-based pathways that play a role in this association. METHODS AND ANALYSIS We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search PubMed and Ovid Embase databases from inception using tested and validated search algorithms. Inclusion of any studies that involve pregnant women and have measured environmental heat stress exposure and either maternal, placental or fetal physiological or biochemical changes and are available in English. Modelling studies or those with only animals will be excluded. The risk of bias will be assessed using the Office of Health Assessment and Translation tool. Abstract screening, data extraction and risk of bias assessment will be conducted by two independent reviewers.Environmental parameters will be reported for each study and where possible these will be combined to calculate a heat stress indicator to allow comparison of exposure between studies. A narrative synthesis will be presented following standard guidelines. Where outcome measures have at least two levels of exposure, we will conduct a dose-response meta-analysis should there be at least three studies with the same outcome. A random effects meta-analysis will be conducted where at least three studies give the same outcome. ETHICS AND DISSEMINATION This systematic review and meta-analysis does not require ethical approval. Dissemination will be through peer-reviewed journal publication and presentation at international conferences/interest groups. PROSPERO REGISTRATION NUMBER CRD42024511153.
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Affiliation(s)
- Ana Bonell
- Medical Research Council Unit The Gambia, London School of Hygiene & Tropical Medicine, London, UK
| | - Leonidas G Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Jane Elizabeth Hirst
- The George Institute for Global Health, Imperial College London, London, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Andreas Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
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Brink N, Lakhoo DP, Solarin I, Maimela G, von Dadelszen P, Norris S, Chersich MF. Impacts of heat exposure in utero on long-term health and social outcomes: a systematic review. BMC Pregnancy Childbirth 2024; 24:344. [PMID: 38704541 PMCID: PMC11069224 DOI: 10.1186/s12884-024-06512-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 04/11/2024] [Indexed: 05/06/2024] Open
Abstract
BACKGROUND Climate change, particularly global warming, is amongst the greatest threats to human health. While short-term effects of heat exposure in pregnancy, such as preterm birth, are well documented, long-term effects have received less attention. This review aims to systematically assess evidence on the long-term impacts on the foetus of heat exposure in utero. METHODS A search was conducted in August 2019 and updated in April 2023 in MEDLINE(PubMed). We included studies on the relationship of environmental heat exposure during pregnancy and any long-term outcomes. Risk of bias was assessed using tools developed by the Joanna-Briggs Institute, and the evidence was appraised using the GRADE approach. Synthesis without Meta-Analysis (SWiM) guidelines were used. RESULTS Eighteen thousand six hundred twenty one records were screened, with 29 studies included across six outcome groups. Studies were mostly conducted in high-income countries (n = 16/25), in cooler climates. All studies were observational, with 17 cohort, 5 case-control and 8 cross-sectional studies. The timeline of the data is from 1913 to 2019, and individuals ranged in age from neonates to adults, and the elderly. Increasing heat exposure during pregnancy was associated with decreased earnings and lower educational attainment (n = 4/6), as well as worsened cardiovascular (n = 3/6), respiratory (n = 3/3), psychiatric (n = 7/12) and anthropometric (n = 2/2) outcomes, possibly culminating in increased overall mortality (n = 2/3). The effect on female infants was greater than on males in 8 of 9 studies differentiating by sex. The quality of evidence was low in respiratory and longevity outcome groups to very low in all others. CONCLUSIONS Increasing heat exposure was associated with a multitude of detrimental outcomes across diverse body systems. The biological pathways involved are yet to be elucidated, but could include epigenetic and developmental perturbations, through interactions with the placenta and inflammation. This highlights the need for further research into the long-term effects of heat exposure, biological pathways, and possible adaptation strategies in studies, particularly in neglected regions. Heat exposure in-utero has the potential to compound existing health and social inequalities. Poor study design of the included studies constrains the conclusions of this review, with heterogenous exposure measures and outcomes rendering comparisons across contexts/studies difficult. TRIAL REGISTRATION PROSPERO CRD 42019140136.
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Affiliation(s)
- Nicholas Brink
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa.
| | - Darshnika P Lakhoo
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Ijeoma Solarin
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | - Gloria Maimela
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
| | | | - Shane Norris
- MRC Developmental Pathways for Health Research Unit, University of the Witwatersrand, Johannesburg, South Africa
| | - Matthew F Chersich
- Climate and Health Directorate, Wits RHI, University of the Witwatersrand, Johannesburg, South Africa
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Bonell A, Part C, Okomo U, Cole R, Hajat S, Kovats S, Sferruzzi-Perri AN, Hirst JE. An expert review of environmental heat exposure and stillbirth in the face of climate change: Clinical implications and priority issues. BJOG 2024; 131:623-631. [PMID: 37501633 DOI: 10.1111/1471-0528.17622] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 07/11/2023] [Indexed: 07/29/2023]
Abstract
Exposure to extreme heat in pregnancy increases the risk of stillbirth. Progress in reducing stillbirth rates has stalled, and populations are increasingly exposed to high temperatures and climate events that may further undermine health strategies. This narrative review summarises the current clinical and epidemiological evidence of the impact of maternal heat exposure on stillbirth risk. Out of 20 studies, 19 found an association between heat and stillbirth risk. Recent studies based in low- to middle-income countries and tropical settings add to the existing literature to demonstrate that all populations are at risk. Additionally, both short-term heat exposure and whole-pregnancy heat exposure increase the risk of stillbirth. A definitive threshold of effect has not been identified, as most studies define exposure as above the 90th centile of the usual temperature for that population. Therefore, the association between heat and stillbirth has been found with exposures from as low as >12.64°C up to >46.4°C. The pathophysiological pathways by which maternal heat exposure may lead to stillbirth, based on human and animal studies, include both placental and embryonic or fetal impacts. Although evidence gaps remain and further research is needed to characterise these mechanistic pathways in more detail, preliminary evidence suggests epigenetic changes, alteration in imprinted genes, congenital abnormalities, reduction in placental blood flow, size and function all play a part. Finally, we explore this topic from a public health perspective; we discuss and evaluate the current public health guidance on minimising the risk of extreme heat in the community. There is limited pregnancy-specific guidance within heatwave planning, and no evidence-based interventions have been established to prevent poor pregnancy outcomes. We highlight priority research questions to move forward in the field and specifically note the urgent need for evidence-based interventions that are sustainable.
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Affiliation(s)
- Ana Bonell
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Cherie Part
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Uduak Okomo
- Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Fajara, The Gambia
| | - Rebecca Cole
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Shakoor Hajat
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Sari Kovats
- Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Amanda N Sferruzzi-Perri
- Department of Physiology, Development and Neuroscience, Centre for Trophoblast Research, University of Cambridge, Cambridge, UK
| | - Jane E Hirst
- Nuffield Department of Women's and Reproductive Health, University of Oxford, Oxford, UK
- The George Institute for Global Health, Imperial College London, London, UK
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Delap N, Brunton KM, Metcalf K. The climate emergency is a matter of reproductive justice. BMJ 2024; 384:q354. [PMID: 38346798 DOI: 10.1136/bmj.q354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
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Das S, Sagar S, Chowdhury S, Akter K, Haq MZ, Hanifi SMA. The risk of miscarriage is associated with ambient temperature: evidence from coastal Bangladesh. Front Public Health 2023; 11:1238275. [PMID: 38026421 PMCID: PMC10656765 DOI: 10.3389/fpubh.2023.1238275] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 10/17/2023] [Indexed: 12/01/2023] Open
Abstract
Background Exposure to high ambient temperature is reported to cause adverse pregnancy outcomes. However, considering myriad temperature and climatic conditions as well as different contextual factors, the paucity of studies from the developing regions impedes the development of a clear understanding of the heat-pregnancy outcome relationship. Materials and methods This study was conducted in Chakaria, a coastal region of Bangladesh, where International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) administers a health and demographic surveillance system (HDSS). The surveillance workers visit the households every three months as a part of the routine surveillance activity. Between 2012 and 2020, the surveillance workers documented histories of 23,482 pregnancies among 13,376 women and the women were followed up for their pregnancy outcomes. The temperature records were obtained from the Bangladesh Meteorological Department's weather station at Cox's Bazar. The dates of pregnancy outcome were linked with the daily average temperature on the day of pregnancy outcome. A logistic regression model was employed to examine the relationship between temperature and the incidence of miscarriage. Results Out of 23,482 pregnancy outcomes, 3.7% were induced abortions. Among the remaining 22,624 pregnancy outcomes, 86.2% were live births, 10.7% were miscarriages and 3.1% were stillbirths. Miscarriages peaked between 8-14 weeks of gestation and varied according to temperature. For women exposed to temperatures between 28°C and 32°C, the risk of miscarriage was 25% greater (adjusted OR 1.25, 95% CI 1.07-1.47) compared to those exposed to temperatures from 16°C to 21°C. Conclusion The study establishes a connection between miscarriage and high ambient temperatures in a coastal region of Bangladesh. Implementing timely and appropriate adaptation strategies to prevent miscarriages is of paramount importance for a densely populated country like Bangladesh.
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Affiliation(s)
- Susmita Das
- Health Systems and Population Studies Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b), Dhaka, Bangladesh
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Mehta M, Basu R, Ghosh R. Adverse effects of temperature on perinatal and pregnancy outcomes: methodological challenges and knowledge gaps. Front Public Health 2023; 11:1185836. [PMID: 38026314 PMCID: PMC10646498 DOI: 10.3389/fpubh.2023.1185836] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 09/19/2023] [Indexed: 12/01/2023] Open
Abstract
Evidence linking temperature with adverse perinatal and pregnancy outcomes is emerging. We searched for literature published until 30 January 2023 in PubMed, Web of Science, and reference lists of articles focusing on the outcomes that were most studied like preterm birth, low birth weight, stillbirth, and hypertensive disorders of pregnancy. A review of the literature reveals important gaps in knowledge and several methodological challenges. One important gap is the lack of knowledge of how core body temperature modulates under extreme ambient temperature exposure during pregnancy. We do not know the magnitude of non-modulation of body temperature during pregnancy that is clinically significant, i.e., when the body starts triggering physiologic counterbalances. Furthermore, few studies are conducted in places where extreme temperature conditions are more frequently encountered, such as in South Asia and sub-Saharan Africa. Little is also known about specific cost-effective interventions that can be implemented in vulnerable communities to reduce adverse outcomes. As the threat of global warming looms large, effective interventions are critically necessary to mitigate its effects.
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Affiliation(s)
- Maitry Mehta
- Sawyer Business School, Suffolk University, Boston, MA, United States
| | - Rupa Basu
- California Environmental Protection Agency, Office of Environmental Health Hazard Assessment, Oakland, CA, United States
| | - Rakesh Ghosh
- Sawyer Business School, Suffolk University, Boston, MA, United States
- Institute for Health and Aging, University of California, San Francisco, San Francisco, CA, United States
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Leathersich SJ, Roche CS, Walls M, Nathan E, Hart RJ. Season at the time of oocyte collection and frozen embryo transfer outcomes. Hum Reprod 2023; 38:1714-1722. [PMID: 37407029 DOI: 10.1093/humrep/dead137] [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: 03/23/2023] [Revised: 05/28/2023] [Indexed: 07/07/2023] Open
Abstract
STUDY QUESTION Does the meteorological season at the time of oocyte retrieval affect live birth rates in subsequent frozen embryo transfers? SUMMARY ANSWER Frozen embryo transfers resulting from oocytes retrieved in summer have 30% increased odds of live birth compared to frozen embryo transfers resulting from oocytes retrieved in autumn, regardless of the season at the time of embryo transfer. WHAT IS KNOWN ALREADY Season at the time of frozen embryo transfer does not appear to be associated with live birth rate. One study in the northern hemisphere found increased odds of live birth with frozen embryo transfer resulting from oocytes collected in summer when compared to those collected in winter. STUDY DESIGN, SIZE, DURATION Retrospective cohort study including all frozen embryo transfers performed by a single clinic over eight years, from January 2013 to December 2021. There were 3659 frozen embryo transfers with embryos generated from 2155 IVF cycles in 1835 patients. Outcome data were missing for two embryo transfers, which were excluded from analysis. Outcomes were analysed by the season, temperatures, and measured duration of sunshine at the time of oocyte collection and at the time of frozen embryo transfer. PARTICIPANTS/MATERIALS, SETTING, METHODS There were no significant differences between patients with oocyte collection or embryo transfers in different seasons. Meteorological conditions on the day of oocyte collection and the day of frozen embryo transfer, and in the preceding 14- and 28-day periods, were collected including mean, minimum, and maximum temperatures, and recorded duration of sunshine hours. Clinical and embryological outcomes were analysed for their association with seasons, temperatures, and duration of sunshine with correction for repeated cycles per participant, age at the time of oocyte retrieval, and quadratic age. MAIN RESULTS AND THE ROLE OF CHANCE Compared to frozen embryo transfers with oocyte retrieval dates in autumn, transfers with oocyte retrieval dates in summer had 30% increased odds of live birth (odds ratio (OR): 1.30, 95% CI: 1.04-1.62) which remained consistent after adjustment for season at the time of embryo transfer. A high duration of sunshine hours (in the top tertile) on the day of oocyte retrieval was associated with a 28% increase in odds of live birth compared to duration of sunshine hours in the lowest tertile (OR 1.28, 95% CI: 1.06-1.53). Temperature on the day of oocyte retrieval did not independently affect the odds of live birth. The odds of live birth were decreased by 18% when the minimum temperature on the day of embryo transfer was high, compared with low (OR: 0.82, 95% CI: 0.69-0.99), which was consistent after correction for the conditions at the time of oocyte retrieval. LIMITATIONS, REASONS FOR CAUTION This was a retrospective cohort study, however, all patients during the study period were included and data was missing for only two patients. Given the retrospective nature, causation is not proven and there are other factors that may affect live birth rates and for which we did not have data and were unable to adjust, including pollutants and behavioural factors. We were also not able to stratify results based on specific patient populations (such as poor- or hyper-responders) nor report the cumulative live birth rate per commenced cycle. WIDER IMPLICATIONS OF THE FINDINGS These findings may be particularly relevant for patients planning oocyte or embryo cryopreservation. Given the increasing utilization of cryopreservation, identification of factors that influence outcomes in subsequent frozen embryo transfers has implications for future therapeutic and management options. Further studies to clarify the physiology underlying the influence of sunshine hours or season on subsequent frozen embryo transfer outcomes are required, including identification of specific populations that may benefit from these factors. STUDY FUNDING/COMPETING INTERESTS No funding was provided for this study. S.L. has received educational travel assistance from Besins, Merck and Organon outside the submitted work. R.H. is National Medical Director of City Fertility and Medical Director of Fertility Specialists of Western Australia, has received honoraria from MSD, Merck Serono, Origio and Ferring outside the submitted work, and has equity interests in CHA SMG. C.R., M.W., and E.N. declare that they have no conflicts of interest. TRIAL REGISTRATION NUMBER N/A.
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Affiliation(s)
- S J Leathersich
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
| | - C S Roche
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
| | - M Walls
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
| | - E Nathan
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
| | - R J Hart
- Department of Reproductive Medicine, King Edward Memorial Hospital, Subiaco, Australia
- City Fertility Australia, Claremont, Australia
- Fertility Specialists of Western Australia, Claremont, Australia
- Division of Obstetrics and Gynaecology, The University of Western Australia, Crawley, Australia
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Fogel AS, Oduor PO, Nyongesa AW, Kimwele CN, Alberts SC, Archie EA, Tung J. Ecology and age, but not genetic ancestry, predict fetal loss in a wild baboon hybrid zone. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2023; 180:618-632. [PMID: 38445762 DOI: 10.1002/ajpa.24686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 12/08/2022] [Accepted: 12/15/2022] [Indexed: 03/07/2024]
Abstract
OBJECTIVES Pregnancy failure represents a major fitness cost for any mammal, particularly those with slow life histories such as primates. Here, we quantified the risk of fetal loss in wild hybrid baboons, including genetic, ecological, and demographic sources of variance. We were particularly interested in testing the hypothesis that hybridization increases fetal loss rates. Such an effect would help explain how baboons may maintain genetic and phenotypic integrity despite interspecific gene flow. MATERIALS AND METHODS We analyzed outcomes for 1020 pregnancies observed over 46 years in a natural yellow baboon-anubis baboon hybrid zone. Fetal losses and live births were scored based on records of female reproductive state and the appearance of live neonates. We modeled the probability of fetal loss as a function of a female's genetic ancestry (the proportion of her genome estimated to be descended from anubis [vs. yellow] ancestors), age, number of previous fetal losses, dominance rank, group size, climate, and habitat quality using binomial mixed effects models. RESULTS Female genetic ancestry did not predict fetal loss. Instead, the risk of fetal loss is elevated for very young and very old females. Fetal loss is most robustly predicted by ecological factors, including poor habitat quality prior to a home range shift and extreme heat during pregnancy. DISCUSSION Our results suggest that gene flow between yellow and anubis baboons is not impeded by an increased risk of fetal loss for hybrid females. Instead, ecological conditions and female age are key determinants of this component of female reproductive success.
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Affiliation(s)
- Arielle S Fogel
- University Program in Genetics and Genomics, Duke University, Durham, North Carolina, USA
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
| | - Peter O Oduor
- Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Albert W Nyongesa
- Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Charles N Kimwele
- Department of Veterinary Anatomy and Physiology, University of Nairobi, Nairobi, Kenya
| | - Susan C Alberts
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
- Department of Biology, Duke University, Durham, North Carolina, USA
- Duke Population Research Institute, Duke University, Durham, North Carolina, USA
| | - Elizabeth A Archie
- Department of Biological Sciences, University of Notre Dame, Notre Dame, Indiana, USA
| | - Jenny Tung
- Department of Evolutionary Anthropology, Duke University, Durham, North Carolina, USA
- Department of Biology, Duke University, Durham, North Carolina, USA
- Duke Population Research Institute, Duke University, Durham, North Carolina, USA
- Canadian Institute for Advanced Research, Toronto, Ontario, Canada
- Department of Primate Behavior and Evolution, Max Planck Institute for Evolutionary Anthropology, Leipzig, Saxony, Germany
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Part C, le Roux J, Chersich M, Sawry S, Filippi V, Roos N, Fairlie L, Nakstad B, de Bont J, Ljungman P, Stafoggia M, Kovats S, Luchters S, Hajat S. Ambient temperature during pregnancy and risk of maternal hypertensive disorders: A time-to-event study in Johannesburg, South Africa. ENVIRONMENTAL RESEARCH 2022; 212:113596. [PMID: 35661733 DOI: 10.1016/j.envres.2022.113596] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/10/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
Hypertensive disorders in pregnancy are a leading cause of maternal and perinatal mortality and morbidity. We evaluate the effects of ambient temperature on risk of maternal hypertensive disorders throughout pregnancy. We used birth register data for all singleton births (22-43 weeks' gestation) recorded at a tertiary-level hospital in Johannesburg, South Africa, between July 2017-June 2018. Time-to-event analysis was combined with distributed lag non-linear models to examine the effects of mean weekly temperature, from conception to birth, on risk of (i) high blood pressure, hypertension, or gestational hypertension, and (ii) pre-eclampsia, eclampsia, or HELLP (hemolysis, elevated liver enzymes, low platelets). Low and high temperatures were defined as the 5th and 95th percentiles of daily mean temperature, respectively. Of 7986 women included, 844 (10.6%) had a hypertensive disorder of which 432 (51.2%) had high blood pressure/hypertension/gestational hypertension and 412 (48.8%) had pre-eclampsia/eclampsia/HELLP. High temperature in early pregnancy was associated with an increased risk of pre-eclampsia/eclampsia/HELLP. High temperature (23 °C vs 18 °C) in the third and fourth weeks of pregnancy posed the greatest risk, with hazard ratios of 1.76 (95% CI 1.12-2.78) and 1.79 (95% CI 1.19-2.71), respectively. Whereas, high temperatures in mid-late pregnancy tended to protect against pre-eclampsia/eclampsia/HELLP. Low temperature (11°) during the third trimester (from 29 weeks' gestation) was associated with an increased risk of high blood pressure/hypertension/gestational hypertension, however the strength and statistical significance of low temperature effects were reduced with model adjustments. Our findings support the hypothesis that high temperatures in early pregnancy increase risk of severe hypertensive disorders, likely through an effect on placental development. This highlights the need for greater awareness around the impacts of moderately high temperatures in early pregnancy through targeted advice, and for increased monitoring of pregnant women who conceive during periods of hot weather.
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Affiliation(s)
- Chérie Part
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom.
| | - Jean le Roux
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Matthew Chersich
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Shobna Sawry
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Véronique Filippi
- Department of Infectious Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Nathalie Roos
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Lee Fairlie
- Wits Reproductive Health and HIV Institute, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
| | - Britt Nakstad
- Division of Paediatrics and Adolescent Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Jeroen de Bont
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden; Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Massimo Stafoggia
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Sari Kovats
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
| | - Stanley Luchters
- Institute of Human Development, Aga Khan University, Nairobi, Kenya; Department of Public Health and Primary Care, Ghent University, Ghent, Belgium; Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Shakoor Hajat
- Department of Public Health, Environments and Society, London School of Hygiene & Tropical Medicine, London, United Kingdom
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The Effect of Prenatal Exposure to Climate Anomaly on Adulthood Cognitive Function and Job Reputation. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052523. [PMID: 35270216 PMCID: PMC8909085 DOI: 10.3390/ijerph19052523] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 02/18/2022] [Accepted: 02/19/2022] [Indexed: 02/01/2023]
Abstract
Background: The long-term effect of abnormal climate on cognitive function and socioeconomic status remains elusive. We explored the association between prenatal exposure to climate anomaly and adulthood cognitive function and job reputation. Methods: We obtained repeated cognitive and job reputation measurements from 17,105 subjects for the years 2010, 2014, and 2018, and ascertained their birth date and other covariates. We used sea surface temperature (SST) anomalies in the Southern Pacific Ocean as the indicator for global climate anomaly in the main analyses. We calculated its averaged values for different gestational periods and analyzed its possible nonlinear associations with adulthood cognitive function and job reputation. We also calculated associated economic loss due to prenatal exposure to abnormal climate. Results: We found an inverted U-shaped curve between climate anomaly and adulthood cognition. During the entire pregnancy, for SST anomalies increasing/decreasing 1 °C from 0 °C, newborn individuals will have adulthood cognition (measured by math test) changed by −2.09% (95% confidence interval (CI): −2.31%, −1.88%) and −3.98% (95% CI: −4.32%, −3.65%), respectively. We observed a similar inverted U-shaped pattern for cognitive function measured by word test and job reputation. Such an association is likely to be mediated by regional meteorological conditions, not local ones. Subgroup analyses identified females and people from less-developed regions as even more vulnerable to prenatal abnormal climate, finding an interactive effect with other social factors. The economic loss was assessed as the salary reduction due to declined cognition among all newborn individuals in China. For SST anomalies increasing/decreasing by 1 °C from 0 °C, individuals born each year in China would earn 0.33 (95% CI: 0.40, 0.25) and 1.09 (95% CI: 1.23, 0.94) billion U.S. dollars equivalent less in their annual salary at adulthood because of lowered cognitive function, respectively. Conclusion: Prenatal exposure to abnormal global climate patterns can result in declined adulthood cognitive function, lowered job reputation, and subsequent economic loss.
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Barroga E, Matanguihan GJ. Creating Logical Flow When Writing Scientific Articles. J Korean Med Sci 2021; 36:e275. [PMID: 34664802 PMCID: PMC8524230 DOI: 10.3346/jkms.2021.36.e275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 09/22/2021] [Indexed: 11/20/2022] Open
Abstract
Numerous guidelines on how to write a scientific article have been published. Many books and articles giving detailed instructions on how to develop a research question, perform a literature search, or design a study protocol are widely available. However, there are few guidelines on how to create logical flow when writing a scientific article. Logical flow is the key to achieving a smooth and orderly progression of ideas, sentences, paragraphs, and content towards a convincing conclusion. This article provides guidelines for creating logical flow when writing the text and main sections of a scientific article. The first step is creating a draft outline of the whole article. Once completed, the draft outline is developed into a single, coherent article that logically explains the study. Logical flow in the text is created by using precise and concise words, composing clear sentences, and connecting well-structured paragraphs. The use of transitions connects sentences and paragraphs, ensuring clarity and coherence when presenting academic arguments and conclusions. Logical flow in the main sections of a scientific article is achieved by presenting the whole story of the article sequentially in the introduction, methods, results, and discussion, focusing attention on the most important points in each section, and connecting all of these to the main purpose of the study.
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Affiliation(s)
- Edward Barroga
- Department of General Education, Graduate School of Nursing Science, St. Luke's International University, Tokyo, Japan.
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