2025
Associations between PM2.5 exposure and birth outcomes and effect modification by extreme heat events during pregnancy in a North Carolina cohort
Krajewski A, Alman B, Vaidyanathan A, Warren J, Luben T, Rappazzo K. Associations between PM2.5 exposure and birth outcomes and effect modification by extreme heat events during pregnancy in a North Carolina cohort. Atmospheric Environment 2025, 362: 121500. DOI: 10.1016/j.atmosenv.2025.121500.Peer-Reviewed Original ResearchBirth outcomesPreterm birthPM2.5 exposureExposure to extreme heat eventsPoor health outcomesBirth registry dataEffect measure modificationAdverse birth outcomesInteraction termsNorth Carolina cohortEntire pregnancyHealth outcomesGeocoded addressesSingleton birthsMeasure modificationEffect modificationBirth recordsCensus tractsRegistry dataTLBWRisk differenceNeonatal mortalityEnvironmental exposuresExposure dataWeeks gestationTime-to-event analysis of preterm birth accounting for gestational age uncertainties
Zhang Y, Warren J, Hao H, Chang H. Time-to-event analysis of preterm birth accounting for gestational age uncertainties. The Annals Of Applied Statistics 2025, 19: 2155-2170. DOI: 10.1214/25-aoas2040.Peer-Reviewed Original ResearchTime-varying exposureTime-to-event analysisMCMC algorithmGestational agePreterm birthSimulation studyConvergence assessmentObstetric estimateThird trimesterHealth effect estimatesPreterm birth risk factorsLMP-based gestational ageOverall preterm birth rateBirth risk factorsRisk of preterm birthPopulation-based studyThird trimester of pregnancyJoint estimationAnalysis of preterm birthGestational age misclassificationPreterm birth rateDiscrete-time hazard modelsTrimester of pregnancyOutcome misclassificationSupplementary materialsPreterm and early-term delivery after heat waves in eight US states: A case-crossover study using the High-resolution Urban Meteorology for Impacts Dataset (HUMID).
Fitch A, Huang M, Strickland M, Newman A, Kalb C, Warren J, Zheng X, Chang H, Darrow L. Preterm and early-term delivery after heat waves in eight US states: A case-crossover study using the High-resolution Urban Meteorology for Impacts Dataset (HUMID). Environmental Health Perspectives 2025 PMID: 40392097, DOI: 10.1289/ehp15953.Peer-Reviewed Original ResearchEarly-term birthEarly-termAssociated with earlier birthEarly-term deliveryPreterm birth ORSingleton pretermPreterm birthPretermPooled ORHeat wavesPooled resultsOdds ratioInverse-variance weightingUrban meteorologyEarly birthBirthImpact datasetsMean temperatureElevated oddsThreshold categoriesVital recordsCase-crossover studyORAcute relationshipsSurface temperature data
2024
Influenza Activity and Preterm Birth in the Atlanta Metropolitan Area: A Time-Series Analysis from 2010 to 2017
Zheng X, Wang T, Hao H, D’Souza R, Strickland M, Warren J, Darrow L, Chang H. Influenza Activity and Preterm Birth in the Atlanta Metropolitan Area: A Time-Series Analysis from 2010 to 2017. Epidemiology 2024, 36: 141-148. PMID: 39588975, PMCID: PMC11785485, DOI: 10.1097/ede.0000000000001819.Peer-Reviewed Original ResearchInfluenza-like illnessExposure lagTest positivityPreterm birthPregnant peopleRisk of adverse birth outcomesIncreased risk of adverse birth outcomesInfluenza activityAssociated with increased risk of preterm birthInterquartile range increaseAdverse birth outcomesTime-varying confoundersComposite measureRisk of preterm birthShort-term associationsAssociated with increased riskPublic health burdenPoisson log-linear modelSymptoms of influenza-like illnessEstimate associationsBirth outcomesEffect modificationAnnual influenza epidemicsRange increaseMaternal characteristicsExposure range matters: considering nonlinear associations in the meta-analysis of environmental pollutant exposure using examples of per- and polyfluoroalkyl substances and birth outcomes
Guo P, Warren J, Deziel N, Liew Z. Exposure range matters: considering nonlinear associations in the meta-analysis of environmental pollutant exposure using examples of per- and polyfluoroalkyl substances and birth outcomes. American Journal Of Epidemiology 2024, 194: 1043-1051. PMID: 39227151, DOI: 10.1093/aje/kwae309.Peer-Reviewed Original ResearchNon-linear associationMeta-analysisHeterogeneity of effect estimatesEffect estimatesPotential non-linear associationsExposure-outcome relationshipsRisk of preterm birthSubgroup meta-analysisBirth outcomesPollution exposureMeta-analytic approachMeta-analysesEffect sizeEnvironmental pollutant exposureResults heterogeneityExposure levelsHealth effectsPreterm birthEvidence-based policymakingPrenatal exposurePotential heterogeneityMean birth weightBirth weightMethodological challengesCut-off choicePreterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas
Darrow L, Huang M, Warren J, Strickland M, Holmes H, Newman A, Chang H. Preterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas. JAMA Network Open 2024, 7: e2412055. PMID: 38787560, PMCID: PMC11127119, DOI: 10.1001/jamanetworkopen.2024.12055.Peer-Reviewed Original ResearchConceptsEarly-term birthPreterm birthCohort studyMetropolitan statistical areasAssociated with pregnancy outcomesEarly-term deliveryRate ratiosRates of pretermYears of ageNational Center for Health StatisticsGestational weeksCenter for Health StatisticsInduced deliveryPregnancy outcomesSingleton birthsPretermSocioeconomically disadvantaged subgroupsUS birthsEligible birthsPerinatal healthEthnic minority groupsBirth recordsConsecutive daysBirthHeat waves
2023
Effects of air pollution on adverse birth outcomes and pregnancy complications in the U.S. state of Kansas (2000–2015)
Hao H, Yoo S, Strickland M, Darrow L, D’Souza R, Warren J, Moss S, Wang H, Zhang H, Chang H. Effects of air pollution on adverse birth outcomes and pregnancy complications in the U.S. state of Kansas (2000–2015). Scientific Reports 2023, 13: 21476. PMID: 38052850, PMCID: PMC10697947, DOI: 10.1038/s41598-023-48329-5.Peer-Reviewed Original ResearchConceptsGestational diabetes mellitusAdverse birth outcomesLow birth weightGestational hypertensionBirth outcomesBirth weightPregnancy complicationsPreterm birthFirst trimesterRisk of GDMMaternal medical complicationsSingleton live birthsWeeks of pregnancyO3 exposureAdverse pregnancyPregnancy exposurePregnancy outcomesDiabetes mellitusMedical complicationsAdverse birthThird trimesterNeonatal mortalityResidential census tractsSocio-economic status factorsDiscrete-time survivalAssociations between weekly gestational exposure of fine particulate matter, ozone, and nitrogen dioxide and preterm birth in a North Carolina Birth Cohort, 2003–2015
Krajewski A, Luben T, Warren J, Rappazzo K. Associations between weekly gestational exposure of fine particulate matter, ozone, and nitrogen dioxide and preterm birth in a North Carolina Birth Cohort, 2003–2015. Environmental Epidemiology 2023, 7: e278. PMID: 38912391, PMCID: PMC11189686, DOI: 10.1097/ee9.0000000000000278.Peer-Reviewed Original ResearchPreterm birthGestational exposureWeeks of pregnancyRisk of PTBInterquartile range increasePM 2.5 exposurePoisson regression modelsGestational weeksPotential confoundersFine particulate matterAssociation magnitudeRisk differenceNull associationBirth cohortExposure windowsResidential addressesMultipollutant modelsBirthWeeksPositive associationAssociationExposurePM 2.5Regression modelsCensus tractsSeason of Conception and Risk of Cerebral Palsy
Zhuo H, Ritz B, Warren J, Liew Z. Season of Conception and Risk of Cerebral Palsy. JAMA Network Open 2023, 6: e2335164. PMID: 37738049, PMCID: PMC10517373, DOI: 10.1001/jamanetworkopen.2023.35164.Peer-Reviewed Original ResearchConceptsCerebral palsySeason of conceptionCalifornia birth recordsCohort studyPreterm birthRelative riskBirth recordsRisk of CPStatewide cohort studyEtiological risk factorsHigher Social Vulnerability IndexLength of gestationDiagnostic recordsNeighborhood-level factorsSummer conceptionsRisk factorsStratified analysisLive birthsMAIN OUTCOMEHigh riskCP riskPoisson regressionCP statusDevelopmental servicesNeuromotor disabilities
2022
Associations between traffic-related air pollutants and preterm birth in a North Carolina birth cohort, 2003-2015
Krajewski A, Luben T, Warren J, Jimenez M, Rappazzo K. Associations between traffic-related air pollutants and preterm birth in a North Carolina birth cohort, 2003-2015. ISEE Conference Abstracts 2022, 2022 DOI: 10.1289/isee.2022.p-1179.Peer-Reviewed Original Research
2019
Critical window variable selection: estimating the impact of air pollution on very preterm birth
Warren JL, Kong W, Luben TJ, Chang HH. Critical window variable selection: estimating the impact of air pollution on very preterm birth. Biostatistics 2019, 21: 790-806. PMID: 30958877, PMCID: PMC7422642, DOI: 10.1093/biostatistics/kxz006.Peer-Reviewed Original ResearchConceptsHierarchical Bayesian frameworkBayesian frameworkStatistical modelVariable selectionImproved estimationCritical windowPreterm birthRisk parametersVery preterm birthAdverse birth outcomesControl analysisExposure-disease relationshipsDifferent reproductive outcomesBirth outcomesPregnant womenReproductive outcomesCase/control analysis
2015
Assessment of critical exposure and outcome windows in time-to-event analysis with application to air pollution and preterm birth study
Chang HH, Warren JL, Darrow LA, Reich BJ, Waller LA. Assessment of critical exposure and outcome windows in time-to-event analysis with application to air pollution and preterm birth study. Biostatistics 2015, 16: 509-521. PMID: 25572998, PMCID: PMC5963471, DOI: 10.1093/biostatistics/kxu060.Peer-Reviewed Original ResearchConceptsPreterm birthAir pollution exposureGestational air pollution exposureRisk of PTBPollution exposurePreterm Birth StudyCourse of pregnancyTime-varying exposureOngoing pregnancyBirth StudyGestational exposureReproductive epidemiologyWeek 30PregnancyWeekly exposureBirth recordsVulnerable periodPopulation studiesPositive associationCritical periodExposureInconsistent findingsAssociationExposure lengthFine particulate matter
2014
A Distributed Lag Model for Assessing Critical Exposure and Outcome Windows in a Study of Air Pollution and Preterm Birth
Chang* H, Warren J, Darrow L, Reich B, Waller L. A Distributed Lag Model for Assessing Critical Exposure and Outcome Windows in a Study of Air Pollution and Preterm Birth. ISEE Conference Abstracts 2014, 2014 DOI: 10.1289/isee.2014.p3-604.Peer-Reviewed Original ResearchPreterm birth
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