ArticleBMJ open2020
Time series analysis of total and direct associations between high temperatures and preterm births in Detroit, Michigan.
Article in BMJ open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 21 citations in OpenAlex.
- Thermal indices for assessing the impact of outdoor thermal environments on human health: a systematic review of epidemiological studies.International journal of biometeorology · 2025Pooled it
- Prenatal exposure to ambient temperature and preterm birth: a historical cohort.International journal of epidemiology · 2025Article
- Scoping review of climate drivers on maternal health: current evidence and clinical implications.AJOG global reports · 2025Review
- A scoping review on heat indices used to measure the effects of heat on maternal and perinatal health.BMJ public health · 2024Article
- Racial Disparities in Climate Change-Related Health Effects in the United States.Current environmental health reports · 2022Review
- Physiological mechanisms of the impact of heat during pregnancy and the clinical implications: review of the evidence from an expert group meeting.International journal of biometeorology · 2022Review
- Exposure to heat during pregnancy and preterm birth in North Carolina: Main effect and disparities by residential greenness, urbanicity, and socioeconomic status.Environmental research · 2022Article
- Extreme Heat and Pregnancy Outcomes: A Scoping Review of the Epidemiological Evidence.International journal of environmental research and public health · 2022Article
- Association between Maternal Exposure to Ambient Air Pollution and the Risk of Preterm Birth: A Birth Cohort Study in Chongqing, China, 2015-2020.International journal of environmental research and public health · 2022Article
- Effect of Elevated Ambient Temperature on Maternal, Foetal, and Neonatal Outcomes: A Scoping Review.International journal of environmental research and public health · 2022Article
- Association between maximum temperature and PMEnvironmental epidemiology (Philadelphia, Pa.) · 2021Article
- Toxicant Disruption of Immune Defenses: Potential Implications for Fetal Membranes and Pregnancy.Frontiers in physiology · 2020Article
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 2 countries.
Funding
Abstract
objectivesPreterm births (PTBs) represent significant health risks, and several studies have found associations between high outdoor temperatures and PTB. We estimated both the total and natural direct effects (independent of particulate matter, ozone and nitrogen dioxide air pollutants) of the prior 2-day mean apparent temperature (AT) on PTB. We evaluated effect modification by maternal age, race, education, smoking status and prenatal care. DESIGN AND
settingWe obtained birth records and meteorological data for the Detroit, Michigan, USA area, for the warm months (May to September), 1991 to 2001. We used a time series Poisson regression with splines of AT, wind speed, solar radiation and citywide average precipitation to estimate total effects. To accommodate multiple mediators and exposure-mediator interactions, AT inverse odds weights, predicted by meteorological and air pollutant covariates, were added in a subsequent model to estimate direct effects.
resultsAt 24.9°C relative to 18.6°C, 10.6% (95% CI: 3.8% to 17.2%) of PTBs were attributable to the total effects of AT, and 10.4% (95% CI: 2.2% to 17.5%) to direct effects. Relative excess risks of interaction indicated that the risk of PTB with increasing temperature above 18.6°C was significantly lower among black mothers and higher among mothers less than 19, older than 30, with late or no prenatal care and who smoked.
conclusionThis additional evidence of a direct association between high temperature and PTB may motivate public health interventions to reduce extreme heat exposures among pregnant women, particularly among those who may have enhanced vulnerability.
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