Zheng Jia, Jesse M Balinas
Teaching Strategies in Psychiatric Nursing Based on Bloom's Taxonomy of Educational Objectives
Cureus
heat waves increasing frequency intensity duration may acutely associated pregnancy outcomes examine changes daily rates preterm earlyterm birth heat waves 25year nationwide study cohort study singleton births used birth records 1993 2017 50 populous us metropolitan statistical areas msas study included 53 million births covering 528 us births period data analyzed october 2022 march 2023 national center health statistics daily temperature data daymet 1km2 resolution averaged msa using population weighting heat waves defined 4 days lag 03 days 7 days lag 06 days preceding birth daily counts preterm birth 28 37 weeks earlyterm birth 37 39 weeks ongoing pregnancies gestational week day enumerated msa rate ratios heat wave metrics obtained timeseries models restricted warm season may september adjusting msa year day season day week offset pregnancies risk 53 154 816 eligible births 50 msas 1993 2017 2 153 609 preterm births 5 795 313 earlyterm births occurring warm season analyzed total 300 mothers younger 25 years 538 25 34 years 163 35 years older heat waves positively associated daily rates preterm earlyterm births showing doseresponse association heat wave duration temperatures stronger associations acute 4day window 4 consecutive days mean temperatures exceeding local 975th percentile rate ratio preterm birth 102 95 ci 100103 rate ratio earlyterm birth 101 95 ci 101102 exposure among 29 years age younger high school education less belonged racial ethnic minority group rate ratios 104 95 ci 102106 preterm birth 103 95 ci 102105 earlyterm birth results robust alternative heat wave definitions excluding medically induced deliveries alternative statistical model specifications cohort study preterm earlyterm birth rates increased heat waves particularly among socioeconomically disadvantaged subgroups extreme heat events implications perinatal health