ArticleThe Lancet regional health. Western Pacific2022
Effects of extreme temperature on the risk of preterm birth in China: A population-based multi-center cohort study.
Article in The Lancet regional health. Western Pacific, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
24 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- A systematic review and meta-analysis on heat thresholds for maternal health and birth outcomes.Nature communications · 2026Pooled it
- Building the model: a review of input structures in extreme temperature-health.Environmental health : a global access science source · 2026Pooled it
- Hourly level analysis of the effects of temperature extremes on emergency ambulance calls.Journal of global health · 2025Pooled it
- 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
- Exposure to extreme temperatures may increase the risk of preterm birth: findings from a contemporary US cohort.International journal of epidemiology · 2026Article
- Climate-Related Pathways to Child Stunting: Implications for Community Health Nursing - A Scoping Review.F1000Research · 2026Article
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- Seasonal Influences on Human Placental Transcriptomes Associated with Spontaneous Preterm Birth.Cells · 2025Article
- The Influence of Heat on Pediatric and Perinatal Health: Risks, Evidence, and Future Directions.Journal of clinical medicine · 2025Review
- Scoping review of climate drivers on maternal health: current evidence and clinical implications.AJOG global reports · 2025Review
- Maternal exposure to ambient temperature and risk of preterm birth in Chengdu, China, from 2017 to 2020: a cohort study.BMC public health · 2025Article
- Local Weather Types (LWTs) associated with Urban Heat Islands (UHIs) and hot days in the Grenoble area, France.PloS one · 2025Article
- Ambient temperature and ozone exposure increases the risk of preterm birth in Northeast China: a time series analysis.Frontiers in public health · 2025Article
- Exposure to acute ambient temperature extremes and neonatal intensive care unit admissions: A case-crossover study.The Science of the total environment · 2024Article
- Establishing a Multifaceted Comprehensive Maternity Cohort Facilitates Understanding of How Environmental Exposures Impact Perinatal Health.Environment & health (Washington, D.C.) · 2024Review
- Fine Particulate Matter, Its Constituents, and Spontaneous Preterm Birth.JAMA network open · 2024Article
- Heat exposure induced risks of preterm birth mediated by maternal hypertension.Nature medicine · 2024Article
- Social-economic transitions and vulnerability to extreme temperature events from 1960 to 2020 in Chinese cities.iScience · 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
Corrections and comments
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Authors and funding
13 authors at 8 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Extreme temperatures are associated with the risk of preterm birth (PTB), but evidence on the effects of different clinical subtypes and across different regions is limited. We aimed to evaluate the effects of maternal exposure to extreme temperature on PTB and its clinical subtypes in China, and to identify effect modification of regional factors in dimensions of population, economy, medical resources and environmental factors. Methods: This was a prospective population-based cohort of 210,798 singleton live births from 16 counties in eight provinces across China during 2014-2018. We used an extended Cox regression with time-varying variables to evaluate the effects of extreme heat and cold on PTB and its subtypes in the entire pregnancy, each trimester, the last gestational month and week. Meta-analysis and meta-regression were conducted to estimate the pooled effects of each city and effect modification by regional characteristics. Findings: Exposure to heat and cold during the entire pregnancy significantly increased the risk of PTB. The effects varied with subtypes, for medically indicated and spontaneous PTB, hazard ratios were 1·84 (95% CI: 1·29, 2·61) and 1·50 (95% CI: 1·11, 2·02) for heat, 2·18 (95% CI: 1·83, 2·60) and 2·15 (95% CI: 1·92, 2·41) for cold. The associations were stronger for PTB less than 35 weeks than those during weeks 35-36. The effects varied across locations, and GDP per capita (β=-0·16) and hospital beds per 1000 persons (β=-0·25) were protective factors for the effects. Interpretation: Extreme temperature can increase the risk of medically indicated and spontaneous PTB, and higher regional socio-economic status may moderate such effects. In the context of climate change, such findings may have important implications for protecting the health of vulnerable groups, especially newborns. Funding: National Key R&D Program of China (2018YFA0606200), National Natural Science Foundation of China (42175183), Strategic Priority Research Program of the Chinese Academy of Sciences (XDA20030302), National Natural Science Foundation of China (42071377).
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