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Hough I, Rolland M, Guilbert A, Seyve E, Heude B, Slama R, Lyon-Caen S, Pin I, Chevrier C, Kloog I, Lepeule J. Early delivery following chronic and acute ambient temperature exposure: a comprehensive survival approach. Int J Epidemiol 2022:6765151. [DOI: 10.1093/ije/dyac190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 09/16/2022] [Indexed: 11/14/2022] Open
Abstract
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.
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Affiliation(s)
- Ian Hough
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev , Be’er Sheva, Israel
| | - Matthieu Rolland
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
| | - Ariane Guilbert
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
| | - Emie Seyve
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS) , Paris, France
| | - Barbara Heude
- Université de Paris Cité, Inserm, INRAE, Centre of Research in Epidemiology and StatisticS (CRESS) , Paris, France
| | - Rémy Slama
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
| | - Sarah Lyon-Caen
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
| | - Isabelle Pin
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
- Department of Paediatric Pneumology, Grenoble Teaching Hospital , La Tronche, France
| | - Cécile Chevrier
- Université Rennes, INSERM, EHESP, IRSET (Research Institute for Environmental and Occupational Health) , Rennes, France
| | - Itai Kloog
- Department of Geography and Environmental Development, Ben-Gurion University of the Negev , Be’er Sheva, Israel
| | - Johanna Lepeule
- Université Grenoble Alpes, INSERM, CNRS, Institute for Advanced Biosciences (IAB), Team of Environmental Epidemiology Applied to Development and Respiratory Health , La Tronche, France
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