EFFECTS TO NEONATAL OUTCOMES  AFTER IN UTERO EXPOSURE TO WILDFIRE SMOKE

Tara Renee Marko

doi:10.7273/000006544

Introduction: Wildfires are increasing in intensity, duration, and frequency with climate change. They are an escalating threat to human health. Particulate matter (PM) 2.5 is particularly dangerous and the mother-fetal dyad is especially vulnerable. This study examined associations between wildfire smoke exposure and neonatal outcomes of gestational age, birth weight, Apgar score, and NICU admission. Methods: In this secondary data analysis, public air quality data was matched with latitude and longitude coordinates of maternal addresses and then compared with state Department of Health birth records from 2010-2018. Linear and logistic regression were utilized to analyze the data, while controlling for potential confounding variables. Results: Aim 1: There was a slight increase in gestational weeks at birth with exposure to wildfire smoke days in trimester 1 (B=.003, p=<.001, [95% CI=.003,.004]), trimester 3 (B=.011, p=<.001, [95% CI=.011, .011]), and full pregnancy (B=.003, p=<.001, [95% CI=.003,.004). There was a slight decrease in gestational weeks in trimester 2 (B=-.002, p= <.001, [95% CI=-.002, .002]). For birthweight, trimester 2 and full pregnancy showed minor increases in grams with smoke day exposure (B=.303, p=<.001, [95% CI=.201, .405]; (B=.148, p=<.001, [95% CI=.086, .210] respectively). Aim 2: For 5- and 10-minute Apgar scores there was no statistical difference with exposure. Aim 3: There was a .003% increase in NICU admission in trimesters 1, and 2 (odds ratio=1.003, [95% CI=1.002-1.004 and 95% CI=1.001-1.004 respectively] and .002% increase for full pregnancy (odds ratio=1.002, [95% CI=1.001-1.003] with exposure to wildfire smoke days. Conclusion: Overall, in utero exposure to wildfire smoke showed slight changes to select neonatal outcomes. There was a small decrease in gestational age and a slight increase in birthweight with trimester 2 exposure, which is consistent with the literature. Although gestational age and birthweight had statistically significant findings, they are likely not clinically significant. There was no effect of smoke exposure on Apgar scores. This study identified a slight statistically significant increase in NICU admission with exposure in the first trimester, second trimester, and full pregnancy. Although small, any additional admission to intensive care has both financial and social implications and warrants further investigation.

EFFECTS TO NEONATAL OUTCOMES AFTER IN UTERO EXPOSURE TO WILDFIRE SMOKE

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