The Effect of Heat Waves on Preterm Birth Rates in Metropolitan Atlanta Open Access

Abstract

Few studies have been conducted analyzing the changing climate's effects on health outcomes, particularly for vulnerable populations like pregnant women. This analysis will focus on understanding how elevated heat affects expectant mothers, a particularly vulnerable population. The study question addresses how heat waves in the metropolitan Atlanta, GA area affect preterm birth rates during the warm season between the years of 1994 through 2006. The null hypothesis is that there is no difference between preterm birth rates on heat wave days compared to non-heat wave days. Because rates of preterm birth differ by race and education, and because these population subgroups show different seasonal patterns of conception and birth, preterm birth counts were divided by race and education level and were controlled as potential confounders and assessed as potential effect modifiers in the Poisson regression model. A heat wave was defined using maximum temperature as a period of 2 or more consecutive days with maximum temperatures above the 95^th percentile; only the second or later day above the 95^th percentile is considered part of the heat wave. The overall rate of preterm births on heat wave days was 0.98 times that of the preterm birth rate on non-heat wave days (95% CI: 0.94-1.03; p-value=0.5361). The model including interaction terms between heat wave and education yielded significantly different rate ratios for heat wave and preterm births among the three levels of education (p-value=0.0445). Among women with less than a high school education, the rate ratio comparing heat wave days to non-heat wave days was 1.07 (95% CI: 0.98-1.16). While the overall model provided no evidence of a heat wave effect on preterm birth, there was suggestion that certain population subgroups may be more susceptible to the effects of heat waves. This could be due to access to resource issues due to potential lower socioeconomic status. Further analyses into elevated temperatures effects on birth outcomes would be beneficial in understanding the processes or vulnerabilities that may trigger early delivery.

Table of Contents

Table of Contents

Introduction…………………………………………………………………………………………………………..…..…1

Background……………………………………………………………………………………………………..........….…1

Significance……………………………………………………………………………………………….……........……..5

Methods……………………………………………………………………………………………………………….....…...9

Hypothesis……………………………………………………………………………………………………….............…9

Specific Aims………………………………………………………………………..……………………..….….........…9

Study Design……………………………………………………………………………………………………............…9

Data…………………………………………………………………………………………………………….…............…10

Analysis……………………………………………………………………………………………………..…...........……11

Results………………………………………………………………………………………………………………...…...…12

Discussion and Conclusions…………………………………………………………………………..…..……14

Tables…………………………………………………………………………………………………………………….…..…16

References………………………………………………………………………………………………………….………..20

About this Master's Thesis

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School	Rollins School of Public Health
Department	Environmental Health
Degree	MSPH
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology Environmental Sciences Health Sciences, Public Health
Keyword	Heat Waves Preterm Birth
Committee Chair / Thesis Advisor	Darrow, Lyndsey, Emory University
Committee Members	Tolbert, Paige, Emory University
Partnering Agencies	Does not apply (no collaborating organization)

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