ArticleEnvironmental research2022
Exposure to heat during pregnancy and preterm birth in North Carolina: Main effect and disparities by residential greenness, urbanicity, and socioeconomic status.
Article in Environmental research, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.
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Who cites it
18 citing papers in PubMed.
- Association between extreme heat exposure and risk of preterm birth and its effect modifiers: a systematic review and meta-analysis.Journal of exposure science & environmental epidemiology · 2026Article
- Climate Change and Reproductive Health.Endocrine reviews · 2025Review
- A case-crossover analysis of short-term PMCommunications medicine · 2025Article
- Improved High Resolution Heat Exposure Assessment With Personal Weather Stations and Spatiotemporal Bayesian Models.GeoHealth · 2025Article
- Metrics of Urbanicity and Rurality in US-Based Epidemiologic Studies of Ambient Temperature and Health: A Scoping Review.Current environmental health reports · 2025Article
- Prenatal exposure to ambient temperature and preterm birth: a historical cohort.International journal of epidemiology · 2025Article
- Heat Waves and Early Birth: Exploring Vulnerability by Individual- and Area-Level Factors.GeoHealth · 2025Article
- Scoping review of climate drivers on maternal health: current evidence and clinical implications.AJOG global reports · 2025Review
- Mental health disparities among maternal populations following heatwave exposure in North Carolina (2011-2019): a matched analysis.Lancet regional health. Americas · 2025Article
- Association of Postpartum Temperature Exposure with Postpartum Depression: A Retrospective Cohort Study in Southern California.Environmental health perspectives · 2024Article
- Preterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas.JAMA network open · 2024Article
- Disparities in the association between ambient temperature and preterm birth according to individual and regional characteristics: a nationwide time-stratified case-crossover study.Environmental health : a global access science source · 2024Article
- Examining modification of the associations between air pollution and birth outcomes by neighborhood deprivation in a North Carolina birth cohort, 2011-2015.Frontiers in reproductive health · 2024Article
- Disparities in preterm birth following the July 1995 Chicago heat wave.Annals of epidemiology · 2023Article
- Association of Daytime-Only, Nighttime-Only, and Compound Heat Waves With Preterm Birth by Urban-Rural Area and Regional Socioeconomic Status in China.JAMA network open · 2023Article
- Compound Risk of Air Pollution and Heat Days and the Influence of Wildfire by SES across California, 2018-2020: Implications for Environmental Justice in the Context of Climate Change.Climate (Basel, Switzerland) · 2022Article
- Racial Disparities in Climate Change-Related Health Effects in the United States.Current environmental health reports · 2022Review
- Impact of extreme heat and heatwaves on children's health: A scoping review.The journal of climate change and healthReview
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Authors and funding
4 authors.
Funding
Abstract
backgroundAlthough previous literature suggested that several factors may be associated with higher risk of adverse health outcomes related to heat, research is limited for birth outcomes.
objectivesWe investigated associations between exposure to heat/heat waves during the last week of gestation and preterm birth (PTB) in North Carolina (NC) and evaluated effect modification by residential greenness, urbanicity, and socioeconomic status (SES).
methodsWe obtained individual-level NC birth certificate data for May-September 2003-2014. We estimated daily mean temperature at each maternal residential address using Parameter-elevation Regressions on Independent Slopes Model (PRISM) data. We created 3 definitions of heat waves (daily temperature ≥95th, 97th, 99th percentile for NC warm season temperature, for ≥2 consecutive days). Normalized Difference Vegetation Index (NDVI) was used to assess residential greenness. Community-level modifiers (e.g., income, urbanicity) were considered. We applied Cox proportional hazard models to estimate the association between exposure to heat/heat waves and PTB, controlling for covariates. Stratified analyses were conducted to evaluate whether the association between heat and PTB varied by several individual and community characteristics.
resultsOf the 546,441 births, 8% were preterm. Heat exposure during the last week before delivery was significantly associated with risk of PTB. The hazard ratio for a 1 °C increase in temperature during the last week before delivery was 1.01 (95% CI: 1.00, 1.02). Higher heat-PTB risk was associated with some characteristics (e.g., areas that were urbanized, low SES, or in the Coastal Plain). We also found significant PTB-heat risk in areas with low greenness for urbanized area. For heat waves, we did not find significantly positive associations with PTB. DISCUSSION: Findings provide evidence that exposure to heat during pregnancy increases risk of PTB and suggest disparities in these risks. Our results have implications for future studies of disparity in heat and birth outcomes associations.
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