Climate Change and Congenital Anomalies: A Population-Based Study of the Effect of Prolonged Extreme Heat Exposure on the Risk of Neural Tube Defects in France

IF 1.6 4区医学 Q4 DEVELOPMENTAL BIOLOGY

Birth Defects Research Pub Date : 2024-08-30 DOI:10.1002/bdr2.2397

Tim A. Bruckner, Nhung T. H. Trinh, Nathalie Lelong, Kaveh Madani, Rémy Slama, Joanne Given, Babak Khoshnood

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Abstract

Background

Exposure to long-lasting extreme ambient temperatures in the periconceptional or early pregnancy period might increase the risk of neural tube defects (NTDs). We tested whether prolonged severe heat exposure as experienced during the 2003 extreme heatwave in France, affected the risk of NTDs.

Methods

We retrieved NTD cases spanning from January 1994 to December 2018 from the Paris Registry of Congenital Malformations. The 2003 heatwave was characterized by the long duration and high intensity of nine consecutive days with temperatures ≥35°C. We classified monthly conceptions occurring in August 2003 as “exposed” to prolonged extreme heat around conception (i.e., periconceptional period). We assessed whether the risk of NTDs among cohorts exposed to the prolonged severe heatwave of 2003 in the periconceptional period differed from expected values using Poisson/negative binomial regression.

Findings

We identified 1272 NTD cases from January 1994 to December 2018, yielding a monthly mean count of 4.24. Ten NTD cases occurred among births conceived in August 2003. The risk of NTD was increased in the cohort with periconceptional exposure to the August 2003 heatwave (relative risk = 2.14, 95% confidence interval: 1.46 to 3.13), compared to non-exposed cohorts. Sensitivity analyses excluding July and September months or restricting to summer months yielded consistent findings.

Interpretation

Evidence from the “natural experiment” of an extreme climate event suggests an elevated risk of NTDs following exposure to prolonged extreme heat during the periconceptional period.

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气候变化与先天性畸形：法国长期极端高温对神经管畸形风险影响的人群研究

背景围孕期或孕早期长期暴露于极端环境温度下可能会增加罹患神经管畸形（NTD）的风险。我们测试了法国在 2003 年极端热浪期间经历的长时间高温是否会影响 NTD 的风险。方法我们从巴黎先天性畸形登记处检索了 1994 年 1 月至 2018 年 12 月期间的 NTD 病例。2003年热浪的特点是持续时间长、强度大，连续9天气温≥35°C。我们将 2003 年 8 月的每月受孕情况归类为 "暴露 "于受孕前后（即围受孕期）的长期极端高温。我们使用泊松/负二项回归法评估了在围孕期暴露于 2003 年长期严重热浪的人群患 NTD 的风险是否与预期值不同。研究结果我们确定了 1994 年 1 月至 2018 年 12 月期间的 1272 例 NTD 病例，月平均计数为 4.24。2003年8月受孕的新生儿中有10例NTD病例。与未受到2003年8月热浪影响的人群相比，围孕期受到热浪影响的人群患NTD的风险增加（相对风险=2.14，95%置信区间：1.46至3.13）。排除 7 月和 9 月或仅限于夏季月份的敏感性分析也得出了一致的结果。解释来自极端气候事件 "自然实验 "的证据表明，在围孕期暴露于长时间的极端高温环境下，患 NTD 的风险会升高。

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来源期刊

Birth Defects Research Medicine-Embryology

CiteScore

3.60

自引率

9.50%

发文量

153

期刊介绍： The journal Birth Defects Research publishes original research and reviews in areas related to the etiology of adverse developmental and reproductive outcome. In particular the journal is devoted to the publication of original scientific research that contributes to the understanding of the biology of embryonic development and the prenatal causative factors and mechanisms leading to adverse pregnancy outcomes, namely structural and functional birth defects, pregnancy loss, postnatal functional defects in the human population, and to the identification of prenatal factors and biological mechanisms that reduce these risks. Adverse reproductive and developmental outcomes may have genetic, environmental, nutritional or epigenetic causes. Accordingly, the journal Birth Defects Research takes an integrated, multidisciplinary approach in its organization and publication strategy. The journal Birth Defects Research contains separate sections for clinical and molecular teratology, developmental and reproductive toxicology, and reviews in developmental biology to acknowledge and accommodate the integrative nature of research in this field. Each section has a dedicated editor who is a leader in his/her field and who has full editorial authority in his/her area.