Citation:

Zhang, W., T. Spero, Chris Nolte, V. Garcia, Z. Lin, P. Romitti, G. Shaw, S. Sheridan, M. Feldkamp, A. Woomert, S. Hwang, S. Fisher, M. Browne, Y. Hao, AND S. Lin. Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States. Journal of the American Heart Association (JAHA). American Heart Association, Dallas, TX, 8(3):e010995, (2019). https://doi.org/10.1161/JAHA.118.010995

Impact/Purpose:

Recent literature by the lead authors at SUNY Albany and others has suggested an association between maternal exposure to extreme heat during a critical gestational period (3-8 weeks post-conception) with an increased incidence of congenital heart defects (CHDs). This paper applies that association to projections of temperature and population to estimate an increase in the CHD burden at 2030.

Description:

Background More intense and longer‐lasting heat events are expected in the United States as a consequence of climate change. This study aimed to project the potential changes in maternal heat exposure during early pregnancy (3–8 weeks post conception) and the associated burden of congenital heart defects (CHDs) in the future. Methods and Results This study expanded on a prior nationwide case‐control study that evaluated the association between CHDs and maternal heat exposure during early pregnancy in summer and spring. We defined multiple indicators of heat exposure, and applied published odds ratios obtained for the matching season of the baseline (1995–2005) into the projection period (2025–2035) to estimate potential changes in CHD burden throughout the United States. Increases in maternal heat exposure were projected across the United States and to be larger in the summer. The Midwest will potentially have the highest increase in summer maternal exposure to excessively hot days (3.42; 95% CI, 2.99–3.88 per pregnancy), heat event frequency (0.52; 95% CI, 0.44–0.60) and heat event duration (1.73; 95% CI, 1.49–1.97). We also found large increases in specific CHD subtypes during spring, including a 34.0% (95% CI, 4.9%–70.8%) increase in conotruncal CHD in the South and a 38.6% (95% CI, 9.9%–75.1%) increase in atrial septal defect in the Northeast. Conclusions Projected increases in maternal heat exposure could result in an increased CHD burden in certain seasons and regions of the United States.

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