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Early delivery following chronic and acute ambient temperature exposure: a comprehensive survival approach.

Authors :
Hough, Ian
Rolland, Matthieu
Guilbert, Ariane
Seyve, Emie
Heude, Barbara
Slama, Rémy
Lyon-Caen, Sarah
Pin, Isabelle
Chevrier, Cécile
Kloog, Itai
Lepeule, Johanna
Source :
International Journal of Epidemiology; Jun2023, Vol. 52 Issue 3, p761-773, 13p
Publication Year :
2023

Abstract

Background Ambient temperature, particularly heat, is increasingly acknowledged as a trigger for preterm delivery but study designs have been limited and results mixed. We aimed to comprehensively evaluate the association between ambient temperature throughout pregnancy and preterm delivery. Methods We estimated daily temperature throughout pregnancy using a cutting-edge spatiotemporal model for 5347 live singleton births from three prospective cohorts in France, 2002–2018. We performed Cox regression (survival analysis) with distributed lags to evaluate time-varying associations with preterm birth simultaneously controlling for exposure during the first 26 weeks and last 30 days of pregnancy. We examined weekly mean, daytime, night-time and variability of temperature, and heatwaves accounting for adaptation to location and season. Results Preterm birth risk was higher following cold (5th vs 50th percentile of mean temperature) 7–9 weeks after conception [relative risk (RR): 1.3, 95% CI: 1.0–1.6 for 2°C vs 11.6°C] and 10–4 days before delivery (RR: 1.6, 95% CI: 1.1–2.1 for 1.2°C vs 12.1°C). Night-time heat (95th vs 50th percentile of minimum temperature; 15.7°C vs 7.4°C) increased risk when exposure occurred within 5 weeks of conception (RR: 2.0, 95% CI: 1.05–3.8) or 20–26 weeks after conception (RR: 2.9, 95% CI: 1.2–6.8). Overall and daytime heat (high mean and maximum temperature) showed consistent effects. We found no clear associations with temperature variability or heatwave indicators, suggesting they may be less relevant for preterm birth. Conclusions In a temperate climate, night-time heat and chronic and acute cold exposures were associated with increased risk of preterm birth. These results suggest night-time heat as a relevant indicator. In the context of rising temperatures and more frequent weather hazards, these results should inform public health policies to reduce the growing burden of preterm births. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
03005771
Volume :
52
Issue :
3
Database :
Complementary Index
Journal :
International Journal of Epidemiology
Publication Type :
Academic Journal
Accession number :
164368377
Full Text :
https://doi.org/10.1093/ije/dyac190