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Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome
INTRODUCTION: This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS: This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temp...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Public Library of Science
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234374/ https://www.ncbi.nlm.nih.gov/pubmed/32421729 http://dx.doi.org/10.1371/journal.pone.0232877 |
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author | Shashar, Sagi Kloog, Itai Erez, Offer Shtein, Alexandra Yitshak-Sade, Maayan Sarov, Batia Novack, Lena |
author_facet | Shashar, Sagi Kloog, Itai Erez, Offer Shtein, Alexandra Yitshak-Sade, Maayan Sarov, Batia Novack, Lena |
author_sort | Shashar, Sagi |
collection | PubMed |
description | INTRODUCTION: This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS: This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In “Warm” pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS: 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during “warm” pregnancies, an elevation of one IQR of the average temperature in the 1(st) or the 3(rd) trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1(st) trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3(rd) trimester 1.94(95%CI 1.34;2.81); Bedouins: 1(st) trimester: RR = 2.91(95%CI 1.98;4.28), 3(rd) trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In “cold” pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49–0.94) for 1(st) trimester and RR = 0.62 (95% CI 0.44–0.87) for 3(rd) trimester. CONCLUSIONS: 1) Elevated averaged temperature during the 1(st) or 3(rd) trimesters in “warm” pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health. |
format | Online Article Text |
id | pubmed-7234374 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-72343742020-06-02 Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome Shashar, Sagi Kloog, Itai Erez, Offer Shtein, Alexandra Yitshak-Sade, Maayan Sarov, Batia Novack, Lena PLoS One Research Article INTRODUCTION: This study aims to determine the association between temperature and preeclampsia and whether it is affected by seasonality and rural/urban lifestyle. METHODS: This cohort study included women who delivered at our medical center from 2004 to 2013 (31,101 women, 64,566 deliveries). Temperature values were obtained from a spatiotemporally resolved estimation model performing predictions at a 1×1km spatial resolution. In “Warm” pregnancies >50% of gestation occurred during the spring-summer period. In cold pregnancies >50% of gestation occurred during the fall and winter. Generalized estimating equation multivariable models were used to estimate the association between temperature and incidence of preeclampsia. RESULTS: 1) The incidence of preeclampsia in at least one pregnancy was 7% (2173/64,566); 2) during “warm” pregnancies, an elevation of one IQR of the average temperature in the 1(st) or the 3(rd) trimesters was associated with an increased risk to develop preeclampsia [patients with Jewish ethnicity: 1(st) trimester: relative risk (RR) of 2.38(95%CI 1.50; 3.80), 3(rd) trimester 1.94(95%CI 1.34;2.81); Bedouins: 1(st) trimester: RR = 2.91(95%CI 1.98;4.28), 3(rd) trimester: RR = 2.37(95%CI 1.75;3.20)]; 3) In “cold” pregnancies, an elevation of one IQR of average temperature was associated with a lower risk to develop preeclampsia among patients with Bedouin-Arab ethnicity RR = 0.68 (95% CI 0.49–0.94) for 1(st) trimester and RR = 0.62 (95% CI 0.44–0.87) for 3(rd) trimester. CONCLUSIONS: 1) Elevated averaged temperature during the 1(st) or 3(rd) trimesters in “warm” pregnancies confer an increased risk for the development of preeclampsia, especially in nomadic patients; 2) Of interest, during cold pregnancies, elevated averaged temperature was associated with a lower risk to develop preeclampsia for nomadic patients. 3) These findings suggest temperature might be associated with perturbations in maternal heat homeostasis resulting in reallocation of energy resources and their availability to the fetus that may increase the risk for preeclampsia. This observation is especially relevant in the context of global warming and its effects on maternal/fetal reproductive health. Public Library of Science 2020-05-18 /pmc/articles/PMC7234374/ /pubmed/32421729 http://dx.doi.org/10.1371/journal.pone.0232877 Text en © 2020 Shashar et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Shashar, Sagi Kloog, Itai Erez, Offer Shtein, Alexandra Yitshak-Sade, Maayan Sarov, Batia Novack, Lena Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title | Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title_full | Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title_fullStr | Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title_full_unstemmed | Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title_short | Temperature and preeclampsia: Epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
title_sort | temperature and preeclampsia: epidemiological evidence that perturbation in maternal heat homeostasis affects pregnancy outcome |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7234374/ https://www.ncbi.nlm.nih.gov/pubmed/32421729 http://dx.doi.org/10.1371/journal.pone.0232877 |
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