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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...

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Autores principales: Shashar, Sagi, Kloog, Itai, Erez, Offer, Shtein, Alexandra, Yitshak-Sade, Maayan, Sarov, Batia, Novack, Lena
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2020
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.
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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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