Extreme temperature exposure increases the risk of preterm birth in women with abnormal pre-pregnancy body mass index: a cohort study in a southern province of China

Frontiers in Public Health

Public Health

Jing Yi¹  Xianqiong Luo²  Lulu Xie²  Qianqian Xiang³  Jialing Qiu⁴  Zhijiang Liang⁴  Qingguo Zhao⁵ 

[1] Department of Obstetrics, Guangdong Women and Children Hospital, Guangzhou, China;Department of Pediatric, Guangdong Women and Children Hospital, Guangzhou, China;Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou, China;Department of Public Health, Guangdong Women and Children Hospital, Guangzhou, China;Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics, Family Planning Research Institute of Guangdong Province, Guangzhou, China;Epidemiological Research Office of Key Laboratory of Male Reproduction and Genetics (National Health and Family Planning Commission), Guangdong Province Fertility Hospital, Guangzhou, China;

关键词: preterm birth;    body mass index;    ambient temperature;    pre-pregnancy;    cohort study;    climate change;   

DOI  :  10.3389/fpubh.2023.1156880

 received in 2023-02-02, accepted in 2023-07-12,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPrior literature has found that extreme temperature exposure is associated with preterm birth (PTB). However, current evidence provides heterogeneous conclusions, and data on extreme cold and across different pre-pregnancy body mass index (BMI) statuses are limited.MethodsWe conducted a population-based retrospective cohort of 251,257 women between 2014 and 2017 in Guangdong, China, to evaluate whether the association between extreme temperature exposure and PTB varied in pre-pregnancy BMI status. Participants were divided into three categories based on pre-pregnancy BMI: underweight (BMI < 18.5 kg/m2), normal weight (18.5–23.9 kg/m2), overweight or obesity (≥ 24.0 kg/m2). We fitted Cox proportional hazards models to assess the association between daily mean temperature and PTB at each trimester for each BMI category separately. The hazard ratios (HRs) at the 5th and 95th percentiles of temperature (defined as low and high temperatures respectively) were provided using the median temperature at each trimester as a reference.Results58,220 (23.2%) were underweight, and 27,865 (11.1%) were overweight or obese. Of the 251,257 women, 18,612 (7.41%) had PTB delivery. Both low-and high-temperature exposure increased the risk of PTB in the third trimester, while cold exposure mostly mitigated the risk for the first and second trimesters. The association with low temperature was the strongest in the third trimester, especially for underweight women (HR: 1.825; 95%CI: 1.529 ~ 2.179), while the association with high temperature was the strongest also in the third trimester, especially for obese or overweight women (HR:1.825; 95%CI:1.502 ~ 2.218). Furthermore, the attributable fractions of PTB risk in the third trimester were estimated as 5.59% (95% CI: 3.58, 7.98%) for cold exposure among underweight women and 3.31% (95% CI: 2.01, 4.88%) for hot exposure among overweight or obese women.ConclusionExposure to either low temperature in the third trimester or high temperature during pregnancy was associated with a higher risk of PTB. Moreover, pre-pregnancy BMI status might affect the susceptibility of pregnant women. Such findings would be useful to develop targeted measures for vulnerable populations.

【 授权许可】

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Copyright © 2023 Qiu, Liang, Yi, Xie, Xiang, Luo and Zhao.