Is there a Link between Preterm Birth and In Utero Exposure to Climate Change?

Aim: The aim of this study is to clarify if there is a link between preterm birth and temperature as a climate factor. Our study comes after a long period of clinical experience that rose the suspicion of a possible correlation between temperature variation and peaks of premature births. Materials and method: We conducted a retrospective study on the number of births registered at the “Dr. I.A. Sbarcea” Clinical Hospital of Obstetrics and Gynecology in Brasov in 2018 and 2019. Data related to premature birth was further correlated to climate information regarding Brasov area obtained from the National Administration of Meteorology, Romania and to results of fertility statistics made publicly available by the Romanian National Institute of Statistics. Results: Our study group included 99 premature births registered at “Dr. I.A. Sbarcea” Clinical Hospital of Obstetrics and Gynecology in Brasov in 2018 and 127 in 2019. The premature birth rate peaks in August for both years of study: 2018 and 2019. Statistical data processing shows there is significant correlation between in utero exposure to extreme temperatures and registration of peaks of premature births. Conclusion: Recognizing a pattern of the raise in the premature birth rate may help the healthcare system to cope with the increased demands of the pediatric care units in time periods marked by specific climate context. Easy recognition of climate conditions that can consequently lead to a peak in the rate of premature birth can be useful for medical staff and patients.

Download Full-text

In utero exposure to threat of evictions and preterm birth: Evidence from the United States

Health Services Research ◽

10.1111/1475-6773.13551 ◽

2020 ◽

Vol 55 (S2) ◽

pp. 823-832

Author(s):

Aayush Khadka ◽

Günther Fink ◽

Ashley Gromis ◽

Margaret McConnell

Keyword(s):

United States ◽

Preterm Birth ◽

The United States ◽

In Utero ◽

In Utero Exposure

Download Full-text

Prematurely delivery — observation tactics with account to gestation terms

Journal of obstetrics and women s diseases ◽

10.17816/jowd90371 ◽

2002 ◽

Vol 51 (2) ◽

pp. 13-17

Author(s):

Vladimir I. Kulakov ◽

Vladimir N. Serov ◽

Vera M. Sidelnikova

Keyword(s):

Preterm Birth ◽

Perinatal Mortality ◽

Gestational Age ◽

Premature Birth ◽

Premature Births ◽

Mortality And Morbidity ◽

Fetal Malformations ◽

Complicated Course ◽

Timely Delivery ◽

Period Of Gestation

Some disputable matters according to the problem of prematurely labor were presented in this article. The urgency of the problem is due to the fact that preterm birth determines the level of perinatal mortality and morbidity. The management of labor is determined by the gestational age. Termination of pregnancy in the period of 22-27 weeks is most often due to infection and fetal malformations, determined by this period of gestation. With a gestational age of 28-33 weeks, the percentage of indicated premature births is extremely high due to a complicated course of pregnancy (preeclampsia, placental insufficiency) and severe extragenital diseases. Premature birth at 34-37 weeks is close to timely delivery in terms of labor outcomes.

Download Full-text

The Antenatal and Postnatal Consequences of Antenatal Exposure to Prolonged Low Dose Indomethacin

Journal of Clinical Medicine ◽

10.3390/jcm10091851 ◽

2021 ◽

Vol 10 (9) ◽

pp. 1851

Author(s):

Vera Donadono ◽

Nicky Manning ◽

Lawrence Impey

Keyword(s):

Preterm Birth ◽

Low Dose ◽

Ductus Arteriosus ◽

In Utero ◽

In Utero Exposure ◽

Neonatal Deaths ◽

Arterial Duct ◽

John Radcliffe Hospital ◽

Low Incidence

Despite its many clinical applications, indomethacin is seldom used in pregnancy, principally because of concerns regarding the potential for constriction of the arterial duct. The aim of this study was to document adverse antenatal effects and postnatal outcomes after in utero exposure to low-dose indomethacin. We studied a retrospective cohort of pregnancies between 2005 and 2016 at the John Radcliffe Hospital, Oxford, UK, in which mothers at extremely high risk of preterm birth were treated as prophylaxis with indomethacin 25 mg, 12 hourly, before 29 weeks. Antenatal effects on the arterial duct and postnatal outcomes were analysed. Overall, 198 fetuses had in utero follow-up, and 13 (6.6%) had ductal constriction, all within 9 days of starting treatment. No ductal constriction was seen in pregnancies when therapy was started before 20 weeks, and all effects were reversed after cessation of therapy. An analysis of postnatal complications was possible in 181 neonates. There were eight (4.4%) neonatal deaths, all but one associated with extreme preterm birth. Seven (5%) patent ductus arteriosus cases occurred in the 140 neonates delivered after 28 weeks who were alive at discharge. Postnatal complications were not more common in neonates in whom antenatal ductal constriction had been demonstrated. In conclusion, fetuses exposed to prolonged low dose indomethacin have a low incidence of in utero complications; these complications can be diagnosed with ultrasound and are reversible. Adverse postnatal events are related to gestation at birth and do not appear more common.

Download Full-text

Early preterm birth: association between in utero exposure to acute inflammation and severe neurodevelopmental disability at 6 years of age

American Journal of Obstetrics and Gynecology ◽

10.1016/j.ajog.2007.12.031 ◽

2008 ◽

Vol 198 (4) ◽

pp. 466.e1-466.e11 ◽

Cited By ~ 67

Author(s):

William W. Andrews ◽

Suzanne P. Cliver ◽

Fred Biasini ◽

A. Myriam Peralta-Carcelen ◽

Richard Rector ◽

...

Keyword(s):

Preterm Birth ◽

Acute Inflammation ◽

In Utero ◽

In Utero Exposure ◽

Neurodevelopmental Disability ◽

Early Preterm Birth

Download Full-text

Prevalence of premature birth in conditions of global warming

Medicni perspektivi (Medical perspectives) ◽

10.26641/2307-0404.2021.3.242167 ◽

2021 ◽

Vol 26 (3) ◽

pp. 152-161

Author(s):

V.I. Tsymbaliuk ◽

S.N. Vadziuk ◽

T.I. Tolokova ◽

P.S. Tabas

Keyword(s):

Global Warming ◽

Preterm Birth ◽

Adverse Effects ◽

Air Temperature ◽

Premature Birth ◽

Preterm Births ◽

Annual Number ◽

Premature Births ◽

Negative Consequences ◽

Homogeneous Regions

The dynamics and likely associative link between global warming and the prevalence of preterm births in Ukraine over the years 2009-2018 was studied. to form modern ideas about the prognosis and prevention of this pathology. Data on medical care for pregnant women, mothers and parturients and adverse effects of pregnancy on preterm birth (form 21) for the period 2009-2018 were obtained from the municipal non-profit enterprise "Ternopil Regional Center of Public Health of Ternopil Regional Council". The correlation between the number of premature births per 100 births according to the average annual air temperature according to the Global Historical Climatology Network from the US Department of Ocean and Atmospheric Research in the climatically homogeneous regions of Ukraine was estimated. Predictive analysis of time series was performed by the method of integrated auto-regression of the moving average (ARIMA). The model error was estimated by calculating the absolute percentage error of the mean (MAPE). Statistical processing of materials was performed using programs Statistica 6.0 (StatSoft, USA) and open statistical package "R". The study meets modern requirements of moral and ethical standards regarding the provisions of legislative acts of Ukraine. Analysis of these reports of women's counseling shows an increase in the average number of preterm births from 2.88 per 100 births in the total number of births in Ukraine – 491445 in 2009 to 3.33, per 100 births in the total number of 309191 in 2018, which testifies to a significant increase in premature births in our country. Since 2009, there has been an annual, varying degree of increase in average annual air temperature in Ukraine. As a result of the correlation analysis, a significant strong direct correlation was established between the average level of premature birth and the average annual air temperature in Ukraine (r=0.84, p<0.05). Regression analysis revealed a significant increase in the number of premature births (per 100 births) in 1, 2, 5, 6, 7, 8 and 10 climatically homogeneous regions and a tendency to increase in, respectively, 3, 4, 9, 11 and 12 climatically homogeneous regions of Ukraine. Based on the analysis of data on the average annual air temperature in Ukraine for 2009-2018, the average annual air temperature in Ukraine is projected to increase by 0.3 ° С in 3 years (MAPE <10%, p<0.05). The annual number of premature births is expected to increase (cases per 100 births) in 3 years by 0.4 cases per 100 births (MAPE <10%, p <0.05). In the context of global warming, the number of negative consequences of pregnancy is increasing, namely idiopathic premature termination of pregnancy with the birth of premature infants. Strong correlations have been established between the annual number of premature births and the average annual air temperature in Ukraine. Regression models of preterm birth showed a significant increase in 1, 2, 5, 6, 7, 8, and 10 climatically homogeneous regions and a tendency to increase in 3, 4, 9, 11 and 12 climatically homogeneous regions. The annual number of premature births in Ukraine is projected to increase by 2023 by 20 cases per 100 births compared to 2018. The strategy for preventing premature births and related adverse effects of pregnancy should include the identification of global warming as a risk factor for increasing level of this pathology.

Download Full-text