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Published on: November 20, 2015
High ambient temperature during pregnancy and offspring cerebral palsy: A population-based case-control study in
Haoran Zhuo1, Joshua L Warren2, Giselle Bellia1
1Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT, USA; Yale Center for Perinatal, Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, USA.
Insights
Prenatal exposure to high ambient temperatures in early pregnancy is linked to an increased risk of cerebral palsy (CP) in children. This finding highlights the impact of environmental factors on neurodevelopmental outcomes.
Area of Science:
- Environmental Epidemiology
- Neurodevelopmental Disorders
- Pediatric Health
Background:
- Cerebral palsy (CP) is a leading cause of childhood neuromotor disability.
- Environmental factors are increasingly recognized for their role in CP etiology.
- The impact of prenatal heat exposure on CP risk requires further investigation.
Purpose of the Study:
- To examine the association between prenatal exposure to high ambient temperatures and the risk of cerebral palsy (CP) in offspring.
- To quantify the risk of CP associated with different levels and durations of heat exposure during pregnancy.
Main Methods:
- A nested case-control study was conducted in California (2005-2015) including 5,938 CP cases and 1,092,313 controls.
- Gestational temperatures were estimated using high-resolution data at maternal residences.
- Logistic regression with distributed lag models and sibling analyses were employed to assess heat exposure and CP risk.
Main Results:
- Increased CP risk was associated with a 5°C rise in weekly ambient temperature (OR: 1.02, 95% CI: 1.01-1.05) and extreme heat exposure (OR: 1.04-1.05, 95% CI: 1.00-1.13) in early pregnancy.
- Cumulative heat exposure over time showed stronger associations with CP risk (ORs: 1.08-1.18).
- Sibling analyses supported the observed trends, indicating robustness of findings.
Conclusions:
- Early pregnancy exposure to elevated ambient temperatures is associated with a higher risk of developing cerebral palsy.
- Findings underscore the need for monitoring neurodevelopmental disorders in the context of climate change.
- Public health strategies may need to consider mitigating heat exposure during pregnancy.
Background:
Cerebral palsy (CP) is the most common neuromotor disorder in childhood and environmental factors may play important etiological roles. We aimed to investigate whether prenatal exposure to high ambient temperature was associated with CP risk in the offspring.
Methods:
We conducted a nested case-control study in California that included CP cases from a statewide system on developmental disabilities and randomly selected 20 % births without CP as controls during 2005-2015. Gestational weekly-average temperatures were calculated from high-resolution (1 km) daily mean temperatures at the maternal residential address at birth. We implemented a distributed lag model within a logistic framework to estimate the associations between per 5 °C increase of temperature, extreme heat that above the 90th percentile of the local temperature distribution, and CP risk in gestational week 0-31 and final seven weeks preceding birth. Further, we performed a sibling analysis to consider the influence of uncontrolled confounding.
Results:
The study population included 5938 CP cases and 1,092,313 controls. There was an increased risk of CP associated with per 5 °C increase of weekly ambient temperature (odds ratio, ORs: 2 %, 95 % credible interval: 1 %-5 %) or extreme heat (ORs of 4-5 %, 95 % credible interval: 0 %-13 %) in the early pregnancy. Stronger associations were observed if such exposures happened cumulatively over time (ORs of 8 %-18 %). A similar trend was also suggested in the sibling analyses.
Conclusions:
Early-pregnancy exposure to high ambient temperature was associated with increased risk of childhood CP. Our findings urge further monitoring of childhood neurodevelopmental disorders in the context of changing climate.
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