Tropical cyclone exposure and risk of adverse birth outcomes in urban and rural areas of Georgia

Tropical cyclones (TCs) are highly destructive weather disasters. Prior studies of TCs and birth outcomes often examined single storms or single TC characteristics (e.g. maximum wind speed) and rarely assessed urban/rural differences. To better understand TC impacts on perinatal health, we evaluated associations between multiple TC exposure metrics and several adverse birth outcomes and considered urban–rural variations. We conducted a population-based time series analysis of 2436 478 singleton births in Georgia from 2000–2018, in which individual-level state birth records were aggregated to the county–week level and linked to weekly, county-level TC data from the National Oceanic and Atmospheric Administration and the National Aeronautics and Space Administration. TC exposure metrics included maximum sustained wind speed (>17, 22, 25 m s ^−1 ), cumulative rainfall (>125, 150, 175 mm), storm proximity (