Evidence map›Paper›PMID 40641135›Full record

ArticlePaediatric and perinatal epidemiology2025

A Case-Crossover Study of Extreme Heat and Psychiatric Emergency Encounters Among Vulnerable Pregnant People.

Kaylin A Vrkljan, Rachel Oblath, Flannery Black-Ingersoll, Stephanie T Grady, Kate Burrows, M Patricia Fabian, Samantha E Parker, Amruta Nori-Sarma, Mary D Willis

Abstract read
In one paragraph

Article in Paediatric and perinatal epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Kaylin A VrkljanDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0009-0000-8645-6161
Rachel OblathDepartment of Psychiatry, Boston Medical Center, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-2729-6932
Flannery Black-IngersollDepartment of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-9639-7035
Stephanie T GradyDepartment of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-1544-358X
Kate BurrowsDepartment of Public Health Sciences, University of Chicago, Chicago, Illinois, USA.ORCID https://orcid.org/0000-0002-0530-6776
M Patricia FabianDepartment of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-1658-3349
Samantha E ParkerDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-7193-077X
Amruta Nori-SarmaDepartment of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0003-2335-6811
Mary D WillisDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.ORCID https://orcid.org/0000-0002-0247-7983

Funding

Pilot Program CoreP30ES027792 · NIEHS · UNIVERSITY OF CHICAGO · PI Gokhan M. Mutlu, Gail S Prins · 2017 to 2026
$13.6M
PRIME-Boston (Prevention of and Response to Incidents of Heat-Related Mental Health Emergencies in Low-income Communities in Boston, MA)R21ES035890 · NIEHS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI NORI-SARMA, AMRUTASRI ASHWINI, OBLATH, RACHEL · 2024 to 2025
$466k
EPA R840480NIEHS NIH HHSNIEHS NIH HHS P30 ES027792NIEHS NIH HHS R21 ES035890NIH HHSU.S. Environmental Protection Agency
6 · The paper itself

Abstract

backgroundExtreme ambient heat has been linked to maternal and neonatal mortality and morbidity. However, less is known regarding the impact of extreme ambient heat on mental health outcomes, particularly among socially vulnerable pregnant people.

objectivesWe aimed to estimate the effect of ambient heat exposure on psychiatric emergency services encounters among pregnant people served by a public program in the metropolitan Boston area. We hypothesised that days of extreme heat would have higher odds of an encounter with psychiatric emergency services when compared to normal temperature days.

methodsUsing electronic health records from the Boston Emergency Services Team program, we identified 861 geocodable encounters for pregnant people who utilised psychiatric emergency services between 2005-2009 and 2017-2021. Using a time-stratified case-crossover design, we matched each case (psychiatric emergency services encounter) with 3-5 control dates (matched by day-of-week and month). We obtained daily temperature (degrees Celsius) measures (mean, minimum, maximum) at an 800 m gridded resolution for cases/controls. Extreme heat exposure was defined at the 95th percentile, and exposure-response relationships were analysed using distributed lag nonlinear models with a 5-day lag period. We used conditional logistic regression models to estimate the association between ambient temperature exposure and odds of psychiatric emergency services encounters, controlling for U.S. federal holidays, relative humidity, and week of case/control date. Effect measure modification by time was examined (e.g., 2005-2009, 2017-2021).

resultsAmong socially vulnerable pregnant people, we found no evidence of an association between days of extreme heat and the odds of psychiatric emergency services encounters, compared to normal temperature days.

conclusionsThis study does not support our a priori hypothesis. Future research is needed to confirm to what extent this association is truly null, as opposed to being obscured by selection bias into psychiatric emergency services, among socially vulnerable pregnant people.

Indexed as

Emergency Services, PsychiatricExtreme HeatMental DisordersPregnancy ComplicationsPregnant PeopleVulnerable PopulationsAdultBostonCase-Control StudiesCross-Over StudiesFemaleHumansPregnancycase‐crossoverheatmental healthpregnancyurban

Identifiers

PMID40641135
PMCPMC12338078

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.