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Q&A

Fetus

Poster Session 2

(520) Could Environmental Heat Exposure Contribute to Fetal Growth Dysregulation?

Tuesday, February 13, 2024
3:30 PM – 5:00 PM  
Location: Prince George's Exhibit Hall CDE, Lower Atrium Level
Objective:

Evidence suggests increased heat exposure is associated with adverse fetal outcomes such as preterm birth & stillbirth. Less is known about the impacts of heat exposure on fetal growth restriction (FGR).  We investigated if 1st trimester (Tri1) or 2nd trimester (Tri2) maximum (Tmax), minimum (Tmin), average (Tavg), or ambient (AT) temperatures experienced during pregnancy were associated with a diagnosis of FGR.

Study Design:

We performed a retrospective cohort study of pregnant subjects who received prenatal care & delivered at an urban hospital between 1/2016-3/2022. Those diagnosed with FGR 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 FGR using the Wilcoxon Rank Sum Test. Categorical variables were compared using Chi Square Test.

Results:

Of N=14336 subjects, 10.5% (n=1499) had FGR (Table 1a). Those with FGR had a higher Tri2 Tmax & Tavg vs without FGR (Table 1b). No significant differences in Tri1 Tmax, Tri1/Tri2 Tmin or AT were noted among those with & without FGR (Table 1b). We also investigated whether low birth weight (LBW) defined as birth weight (BW) < 2500 kg or very low birth weight (VLBW) defined as BW < 1500kg associated with heat exposure. Those with VLBW vs without had a higher Tri2 AT (20.27[IQR 12.55-26.18] vs 18.87[IQR 11.89-25.54], p=.05) & Tavg (19.56 [IQR 12.48-24.5] vs 18.34 [IQR 11.97-24.05], p=.05).

Conclusion:

Our data innovatively suggests higher heat exposure in the 2nd trimester may mechanistically impact placental function & fetal growth dysregulation. Our data utilized ICD-10 coding for FGR diagnosis; hence, FGR could have been under-coded & therefore the association may even be stronger, a possibility highlighted by the stronger relationship between VLBW & heat exposure. These hypothesis generating data demonstrate significant need for future studies to investigate the role of heat exposure in fetal growth and development.