Abstract
To date, research evidence suggests that extreme ambient temperatures may lead to preterm birth. Since the results of studies in subtropical humid monsoon climate are inconclusive, we investigated the association between extreme ambient temperatures and the risk of preterm birth in Xuzhou, China. We analyzed the association between the birth data of 103,876 singleton deliveries (from July 1, 2016 to June 30, 2019) and ambient temperature. We used a quasi-Poisson model with distributed lag nonlinear models (DLNM) to investigate the delay and nonlinear effects of temperature, taking into account the effects of air pollutants and relative humidity. During the study period, the number of hospitalizations for preterm birth was 4623. Taking the median temperature (16.8 °C) as a reference, the highest risk estimate at extreme cold temperature (− 2.8 °C, 1st percentile) was found at lag 0–1 days. Exposure to extreme cold (− 2.8 °C, 1st percentile), or moderate cold (6.8 °C, 25th percentile) were associated with 1.659 (95% confidence interval [CI] 1.177–2.338) and 1.456 (95% CI 1.183–1.790) increased risks of preterm birth, respectively. In the further stratified analysis of the age of pregnant women, we found that there were significant associations between cold temperatures and preterm birth in both groups (older group ≥ 35; younger group < 35). In a subtropical humid monsoon climate, low ambient temperatures may lead to preterm birth, suggesting that women should stay away from low temperatures during pregnancy.
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Abbreviations
- PTB:
-
preterm birth
- DLNM:
-
distributed lag nonlinear model
- QAIC:
-
quasi-Poisson Akaike information criterion
- RR:
-
relative risk
- CI:
-
confidential interval
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Acknowledgments
The authors would like to thank the Xuzhou Maternal and Child Health Family Planning Service Center and Xuzhou Environmental Protection Bureau for providing the birth data and air pollution data used for the analyses.
Funding
This work was supported by the National Natural Science Foundation of China (No. 81573164 and No. 81872635).
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PC, LP, and CZ conceived and designed research; PC, LP, JWH, SL, LJD, WNF, and FY collected data; PC and LP wrote initial paper; PC and JWH revised the paper; JHH had primary responsibility for final content. All authors read and approved the final manuscript. PC and LP contributed equally to this work.
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Fig. S1
Exposure-response curves of daily mean temperature and cumulative relative risk of daily preterm births (reference temperature at 20 ℃) at lag of 0-1 days. (PNG 227 kb).
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Cheng, P., Peng, L., Hao, J. et al. Short-term effects of ambient temperature on preterm birth: a time-series analysis in Xuzhou, China. Environ Sci Pollut Res 28, 12406–12413 (2021). https://doi.org/10.1007/s11356-020-11201-4
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DOI: https://doi.org/10.1007/s11356-020-11201-4