title: Hurricane Charley Exposure and Hazard of Preterm Delivery, Florida 2004.
abstract: Objective Hurricanes are powerful tropical storm systems with high winds which influence many health effects. Few studies have examined whether hurricane exposure is associated with preterm delivery. We aimed to estimate associations between maternal hurricane exposure and hazard of preterm delivery. Methods We used data on 342,942 singleton births from Florida Vital Statistics Records 2004-2005 to capture pregnancies at risk of delivery during the 2004 hurricane season. Maternal exposure to Hurricane Charley was assigned based on maximum wind speed in maternal county of residence. We estimated hazards of overall preterm delivery (<37 gestational weeks) and extremely preterm delivery (<32 gestational weeks) in Cox regression models, adjusting for maternal/pregnancy characteristics. To evaluate heterogeneity among racial/ethnic subgroups, we performed analyses stratified by race/ethnicity. Additional models investigated whether exposure to multiples hurricanes increased hazard relative to exposure to one hurricane. Results Exposure to wind speeds ≥39 mph from Hurricane Charley was associated with a 9 % (95 % CI 3, 16 %) increase in hazard of extremely preterm delivery, while exposure to wind speed ≥74 mph was associated with a 21 % (95 % CI 6, 38 %) increase. Associations appeared greater for Hispanic mothers compared to non-Hispanic white mothers. Hurricane exposure did not appear to be associated with hazard of overall preterm delivery. Exposure to multiple hurricanes did not appear more harmful than exposure to a single hurricane. Conclusions Hurricane exposure may increase hazard of extremely preterm delivery. As US coastal populations and hurricane severity increase, the associations between hurricane and preterm delivery should be further studied.
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA. sgrabich@email.unc.edu.
authors.forename: Shannon C
authors.initials: SC
authors.lastname: Grabich
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA.
authors.forename: Whitney R
authors.initials: WR
authors.lastname: Robinson
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA.
authors.forename: Stephanie M
authors.initials: SM
authors.lastname: Engel
authors.affiliation: Department of Geography, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: Charles E
authors.initials: CE
authors.lastname: Konrad
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA.
authors.forename: David B
authors.initials: DB
authors.lastname: Richardson
authors.affiliation: Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, 135 Dauer Drive 2101 McGavran-Greenberg Hall, CB #7435, Chapel Hill, NC, 27599, USA.|Department of Epidemiology and Biostatistics, Texas A&M Health Science Center, School of Public Health, College Station, TX, USA.
authors.forename: Jennifer A
authors.initials: JA
authors.lastname: Horney
mesh_terms: D000328:Adult; D055867:Cyclonic Storms / Q000706:statistics & numerical data*; D004190:Disasters / Q000706:statistics & numerical data*; D005260:Female; D005431:Florida / Q000453:epidemiology; D005865:Gestational Age; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D007231:Infant, Newborn; D009035:Mothers; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D016016:Proportional Hazards Models; D044465:White People / Q000706:statistics & numerical data*
keywords: Cox regression; Ethnicity; Hurricane; Preterm birth; Race; Time-varying; Vital statistics