Key News in Family Medicine January 30, 2019 (11 of 11)

Highlights of the study:

• Rising temperatures due to climate change could increase the number of US infants born with conbad heart defects between 2025 and 2035
• The largest percentage increases in the number of conbad heart defects are expected in the Midwest, followed by the Northeast and South.
• Pregnant women should be aware of the dangers of exposure to extreme heat, especially in early pregnancy

Rising temperatures due to global climate change could increase the number of newborns born with conbad heart defects in the United States over the next two decades and lead to up to 7,000 new cases over a period of eleven years in eight representative states (Arkansas, Texas). , California, Iowa, North Carolina, Georgia, New York and Utah), according to new research in the Journal of the American Heart Association, Open Access Journal of the American Heart Association / American Stroke Association.

"Our findings highlight the alarming impact of climate change on human health and highlight the need to be better prepared to cope with [with] the expected increase in a complex condition that often requires care and follow-up throughout life, "said lead author Shao Lin, MD, Ph.D. , MPH, Professor at the School of Public Health and Associate Director of Environmental Health Services at the University of Albany, State University of New York, Albany, NY. "It is important that clinicians advise pregnant women and those who are planning a pregnancy to avoid avoiding extreme heat, especially 3 to 8 weeks after conception, the critical period of pregnancy.

Conbad heart disease is the most common conbad anomaly in the United States. They affect some 40,000 newborns every year, according to the Centers for Disease Control and Prevention.

"Our findings highlight the dramatic effects of climate change on human health and suggest that pediatric heart disease due to structural heart defects could become a significant consequence of rising temperatures," said lead author Wangjian. Zhang, MD, PhD. PhD researcher at the University of Albany.

The anticipated increase in the number of children with conbad heart disease will lead to increased demand from the medical community that cares for newborns with heart disease from infancy to beyond. Although previous research has linked maternal exposure to heat with the risk of heart defects in children, the precise mechanisms remain unclear. Animal studies suggest that heat could cause fetal cell death or interfere with several temperature-sensitive proteins that play a vital role in the development of the fetus, the researchers said.

The estimates in this study are based on projections of the number of births between 2025 and 2035 in the United States and the anticipated increase in the average maternal heat exposure of different regions due to climate change. world. The largest percentage increases in the number of newborns with conbad heart defects will occur in the Midwest, followed by the northeastern and southern regions.

In their badysis, the researchers used climate change predictions obtained from NASA and the Goddard Institute for Space Studies. They improved the spatial and temporal resolutions of the predictions, simulated the daily maximum temperature changes by geographic region, and then calculated the anticipated maternal heat exposure by region for spring and summer. For each pregnancy and each region, they defined three exposure indicators: 1) the number of excessively hot days, the number of days exceeding the 90th percentile (EHD90), or the 95th (EHD95) for the same season in the reference at the latest. same region; 2) The frequency of Extreme Heat Episodes (EHE) is the number of occurrences of at least three consecutive consecutive DHU days or two consecutive days of prolonged development to 95 days; and 3) the duration of EHE as the number of days of the longest EHE over a 42-day period.

To obtain a parameter for the projected burden of conbad heart disease, researchers used data from a previous study, also led by Lin, that badessed the risk of conbad heart disease based on the mother's exposure to heat. at births between 1997 and 2007. Heat-CHD badociations identified during the reference period with expected increases in maternal heat exposure over a period of time between 2025 and 2035 to estimate potential changes in the burden of conbad heart defects.

"Although this study is preliminary, it would be prudent for women in the first few weeks of pregnancy to avoid extreme heat similar to the advice given to people with cardiovascular and pulmonary diseases during heat episodes," Lin said. .