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Associations of hurricane exposure and forecasting with impaired birth outcomes.

ABSTRACT: Early forecasts give people in a storm's path time to prepare. Less is known about the cost to society when forecasts are incorrect. In this observational study, we examine over 700,000 births in the path of Hurricane Irene and find exposure was associated with impaired birth outcomes. Additional warning time was associated with decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at-risk population experienced a type I forecasting error where severe physical storm impacts were anticipated but not experienced. Disaster anticipation disrupted healthcare services by delaying and canceling prenatal care, which may contribute to storm-impacted birth outcomes. Recognizing storm damages depend on human responses to predicted storm paths is critical to supporting the next generation's developmental potential with judicious forecasts that ensure public warning systems mitigate rather than exacerbate climate damages.

SUBMITTER: Hochard J

PROVIDER: S-EPMC9643368 | biostudies-literature | 2022 Nov

REPOSITORIES: biostudies-literature

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Associations of hurricane exposure and forecasting with impaired birth outcomes.

Hochard Jacob J Li Yuanhao Y Abashidze Nino N

Nature communications 20221108 1

Early forecasts give people in a storm's path time to prepare. Less is known about the cost to society when forecasts are incorrect. In this observational study, we examine over 700,000 births in the path of Hurricane Irene and find exposure was associated with impaired birth outcomes. Additional warning time was associated with decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at- ...[more]

PMID: 36347839

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Project description:BackgroundDrinking water is a common source of exposure to inorganic arsenic. In the US, the Safe Drinking Water Act (SDWA) was enacted to protect consumers from exposure to contaminants, including arsenic, in public water systems (PWS). The reproductive effects of preconception and prenatal arsenic exposure in regions with low to moderate arsenic concentrations are not well understood.ObjectivesThis study examined associations between preconception and prenatal exposure to arsenic violations in water, measured via residence in a county with an arsenic violation in a regulated PWS during pregnancy, and five birth outcomes: birth weight, gestational age at birth, preterm birth, small for gestational age (SGA), and large for gestational age (LGA).MethodsData for arsenic violations in PWS, defined as concentrations exceeding 10 parts per billion, were obtained from the Safe Drinking Water Information System. Participants of the Environmental influences on Child Health Outcomes Cohort Study were matched to arsenic violations by time and location based on residential history data. Multivariable, mixed effects regression models were used to assess the relationship between preconception and prenatal exposure to arsenic violations in drinking water and birth outcomes.ResultsCompared to unexposed infants, continuous exposure to arsenic from three months prior to conception through birth was associated with 88.8 g higher mean birth weight (95% CI: 8.2, 169.5), after adjusting for individual-level confounders. No statistically significant associations were observed between any preconception or prenatal violations exposure and gestational age at birth, preterm birth, SGA, or LGA.ConclusionsOur study did not identify associations between preconception and prenatal arsenic exposure, defined by drinking water exceedances, and adverse birth outcomes. Exposure to arsenic violations in drinking water was associated with higher birth weight. Future studies would benefit from more precise geodata of water system service areas, direct household drinking water measurements, and exposure biomarkers.

Project description:It is unclear whether the benefits of tobacco control policies extend to pregnant women and infants, especially among racial/ethnic minority and low socioeconomic populations that are at highest risk for adverse birth outcomes.To examine the associations of state cigarette taxes and the enactment of smoke-free legislation with US birth outcomes according to maternal race/ethnicity and education.Using a quasi-experimental approach, we analyzed repeated cross sections of US natality files with 16,198,654 singleton births from 28 states and Washington, DC, between 2000 and 2010. We first used probit regression to model the associations of 2 tobacco control policies with the probability that a pregnant woman smoked (yes or no). We then used linear or probit regression to estimate the associations of the policies with birth outcomes. We also examined the association of taxes with birth outcomes across maternal race/ethnicity and education.State cigarette taxes and smoke-free restaurant legislation.Birth weight (in grams), low birth weight (<2500 g), preterm delivery (<37 weeks), small for gestational age (<10th percentile for gestational age and sex), and large for gestational age (>90th percentile for gestational age and sex).White and black mothers with the least amount of education (0-11 years) had the highest prevalence of maternal smoking during pregnancy (42.4% and 20.0%, respectively) and the poorest birth outcomes, but the strongest responses to cigarette taxes. Among white mothers with a low level of education, every $1.00 increase in the cigarette tax reduced the level of smoking by 2.4 percentage points (-0.0024 [95% CI, -0.0004 to -0.0001]), and the birth weight of their infants increased by 5.41 g (95% CI, 1.92-8.89 g). Among black mothers with a low level of education, tax increases reduced smoking by 2.1 percentage points (-0.0021 [95% CI, -0.0003 to -0.0001]), and the birth weight of their infants increased by 3.98 g (95% CI, 1.91-6.04 g). Among these mothers, tax increases also reduced the risk of having low-birth-weight, preterm, and small-for-gestational-age babies, but increased the risk of having large-for-gestational-age babies. Associations were weaker among higher-educated black women and largely null among higher educated white women and other groups. We did not find evidence for an association of smoke-free restaurant legislation with birth outcomes.Increases in the cigarette tax are associated with improved health outcomes related to smoking among the highest-risk mothers and infants. Considering that US states increase cigarette taxes for reasons other than to improve birth outcomes, these findings are welcome by-products of state policies.

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Associations of hurricane exposure and forecasting with impaired birth outcomes.

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Associations of hurricane exposure and forecasting with impaired birth outcomes.

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