Short-term effects of ambient temperature on preterm birth: a time-series analysis in Xuzhou, China
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RESEARCH ARTICLE
Short-term effects of ambient temperature on preterm birth: a time-series analysis in Xuzhou, China Peng Cheng 1 & Lei Peng 2 & Jingwen Hao 1 & Sha Li 1 & Chao Zhang 1 & Lianjie Dou 1 & Weinan Fu 1 & Fan Yang 1 & Jiahu Hao 1 Received: 31 May 2020 / Accepted: 9 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
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. Keywords Ambient temperature . Cumulative effects . Distributed lag non-linear model . Preterm birth . Time series
Peng Cheng and Lei Peng contributed equally to this work. Responsible Editor: Lotfi Aleya Electronic supplementary material The online version of this article (https://doi.org/10.1007/s11356-020-11201-4) contains supplementary material, which is available to authorized users. * Jiahu Hao [email protected]
Lianjie Dou [email protected]
Peng Cheng [email protected]
Weinan Fu [email protected]
Lei Peng [email protected] Jingwen Hao [email protected]
Fan Yang [email protected] 1
Department of Maternal Child and Adolescent Health, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei 230032, Anhui, China
2
Xuzhou Maternal and Child Health Family Planning Service Center, 46 Heping Road, Xuzhou 221000, Jiangsu, China
Sha Li [email protected] Chao Zhang [email protected]
Environ Sci Pollut Res
Introduction
Materials and methods
Preterm birth (PTB), defined as any live birth < 37 completed weeks of gestation, is still a major global public health problem (Goldenberg et al. 2008; Vogel et al. 2018). According t
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