(533) Elevated 1st Trimester Environmental Temperatures May Underlie Development of Preeclampsia

Elevated environmental temperatures correlate with hypertension & diabetes in the nonpregnant state. Whether elevated temperature values may underlie metabolic disease development during pregnancy is unclear. We investigated if elevated 1st trimester (Tri1) or 2nd trimester (Tri2) maximum (Tmax), minimum (Tmin), average (Tavg) or ambient (AT) temperatures were associated with the development of preeclampsia(PRE).


Study Design:

We conducted a retrospective cohort study of subjects receiving prenatal care at an urban tertiary care center from 1/2016-3/2022. Individuals diagnosed with PRE were identified with ICD-10 codes from an institutional database.  Zip-code level Tri1 & Tri2 Tmax, Tmin, Tavg, & AT were derived from 1 km gridded Daymet products & reported in degrees Celsius. After testing for normality, median temperature values were compared among those with & without PRE using Wilcoxon Rank Sum tests. Categorical variables were compared using Chi Square tests. Generalized linear regression models (GLM) estimated associations between the individual exposures (Tmax/Tmin/ Tavg/AT) and outcome (PRE) while controlling for confounders. 

Results:

Of N=14,336 subjects, 12.48% (n=1,806) were diagnosed with PRE (Table 1a). Those with PRE had a higher Tri1 Tmax(p=0.01), Tmin (p=0.01), Tavg(p=0.01), & AT(p=0.01) compared to those without PRE (Table 1b). Even when performing GLM models controlling for maternal age, race, parity and obesity, the associations remained: Tmax (β=0.001,95% CI 0.00026-0.0019, P=0.01); Tmin (β=0.001, CI 0.0003-0.0019, P=0.006); Tavg (β=0.001, CI 0.0003-0.0019, P=0.008); AT (β=0.001, CI 0.0028-0.0017, P=0.007). No significant differences were noted in Tri2 temperature values.


Conclusion:

This hypothesis generating line of inquiry noted higher environmental temperatures in early pregnancy associated with the development of PRE.  It is imperative for future studies to investigate the mechanistic underpinnings connecting environmental temperature & gestational metabolic disease development, especially as climate change looms in our future.