Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jun 1;63(6):396-404.
doi: 10.1097/MLR.0000000000002130. Epub 2025 May 12.

Perinatal Resources and Wildfire Smoke

Michel Boudreaux  1 , Maranna Yoder  2 , Evan Ellicott  3 , Molly Passarella  4 , Scott A Lorch  4
Affiliations

Perinatal Resources and Wildfire Smoke

Michel Boudreaux et al. Med Care. .

Abstract

Background: Pregnant people and infants are vulnerable to wildfire smoke. However, the availability of perinatal resources in communities impacted by smoke is unknown.

Objective: Describe perinatal resources in counties prone to wildfire smoke.

Research study design: Smoke data came from the Hazard Mapping System and perinatal resources were gathered from various sources. Choropleth maps described the geographic distribution of smoke. Unadjusted associations and multivariable regressions compared perinatal resource levels by smoke risk. Subgroup analysis of the most rural counties was conducted.

Subjects: Counties in the contiguous United States (n=3108) during the 2016-2020 period.

Measures: Relative smoke risk was defined as the bottom, middle, and top third of the average annual smoke-days distribution. Perinatal resources included driving distance to the nearest maternity care hospital and NICU, the volume and geographic isolation of the nearest maternity care hospital, and county-based measures of OB-GYN and family medicine physicians.

Results: Average annual smoke-days ranged from 3.8 (SD=2.0) in low-risk to 15.3 (SD=5.5) in high-risk counties. Compared with low-risk counties, high-risk counties had fewer OB-GYNs per 10,000 births (-32.2, 95% CI: -45.7 to -20.6; P<0.001) and were farther to the nearest maternity hospital (10.1 miles, 95% CI: 8.7-11.5; P<0.001). High-risk counties were also farther to the nearest NICU. Associations were not explained by sociodemographics and were observed in the subset of the most rural counties.

Conclusions: Communities prone to wildfire smoke often lack geographic access to the health care resources needed to treat pregnant people and infants in a timely manner.

Keywords: climate change; perinatal care; wildfires.

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

References

    1. Abatzoglou JT, Williams AP. Impact of anthropogenic climate change on wildfire across western US forests. Proc Natl Acad Sci U S A. 2016;113:11770–11775.
    1. Westerling AL. Increasing western US forest wildfire activity: sensitivity to changes in the timing of spring. Philos Trans R Soc Lond B Biol Sci. 2016;371:20160373.
    1. Burke M, Driscoll A, Heft-Neal S, et al. The changing risk and burden of wildfire in the United States. Proc Natl Acad Sci USA. 2021;118:e2011048118.
    1. Radeloff VC, Helmers DP, Kramer HA, et al. Rapid growth of the US wildland-urban interface raises wildfire risk. Proc Natl Acad Sci USA. 2018;115:3314–3319.
    1. Marlon JR, Bartlein PJ, Gavin DG, et al. Long-term perspective on wildfires in the western USA. Proc Natl Acad Sci USA. 2012;109:E535–E543.