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Temperature, placental abruption and stillbirth.

Amal Rammah1, Kristina W Whitworth2, Inkyu Han1

  • 1Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston (UTHealth) School of Public Health, 1200 Pressler St., Houston, TX 77030, USA; Southwest Center for Occupational and Environmental Health (SWCOEH), UTHealth School of Public Health, 1200 Pressler St., Houston, TX 77030, USA.

Environment International
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Rising apparent temperatures increase stillbirth risk, particularly for Hispanic and Black women. Increased temperature in the week before delivery is linked to higher stillbirth rates, especially with placental abruption.

Keywords:
Placental abruptionStillbirthTemperature

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Area of Science:

  • Environmental Health
  • Reproductive Epidemiology
  • Perinatal Research

Background:

  • Pregnant women face risks from rising ambient temperatures and climate change.
  • Elevated temperatures are linked to placental abruption, a known stillbirth risk factor.

Purpose of the Study:

  • To investigate the association between acute apparent temperature exposure and stillbirths.
  • To analyze temperature's impact on stillbirth risk, considering placental abruption and maternal race/ethnicity.

Main Methods:

  • A case-crossover study of 708 stillbirths in Harris County, Texas (2008-2013).
  • Maternal exposure to daily average apparent temperature (lag days 1-6) was estimated.
  • Conditional logistic regression adjusted for air pollutants (PM2.5, NO2, O3) and examined race/ethnicity disparities.

Main Results:

  • A 10°F increase in apparent temperature the week before delivery raised stillbirth risk by 45% (aOR=1.45).
  • Elevated risks were observed during summer months (June-August) and for Hispanic and non-Hispanic Black women.
  • Stillbirths due to placental abruption showed higher risks with preceding temperature increases, peaking on lag day 1 (aOR=1.93).

Conclusions:

  • Apparent temperature increases in the week before delivery are associated with elevated stillbirth risk, independent of air pollution.
  • Stillbirth risk associated with temperature varied significantly by maternal race/ethnicity.
  • This study, the first to link temperature to placental abruption, found higher risks in mothers with this complication.