ArticleNature medicine2024
Heat exposure induced risks of preterm birth mediated by maternal hypertension.
Article in Nature medicine, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- From conception to care: a systematic review of the impact of the climate crisis on reproductive justice.Sexual and reproductive health matters · 2025Pooled it
- Association between heat and air pollution (PMBMJ paediatrics open · 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
- Heat Stress and Placental Abruption: A Space-Time Stratified Case-Crossover Study.BJOG : an international journal of obstetrics and gynaecology · 2026Article
- Maternal Heat Shock Protein as a Potential Biomarker of Adaptation to Heat Stress during Pregnancy and Its Relation to Preterm Birth.Environmental science & technology · 2026Article
- Environmental Determinants of Sleep and Hypertension: A Critical Review of Evidence and Mechanisms.Current hypertension reports · 2026Review
- Dynamic Associations between Ambient PMEnvironment & health (Washington, D.C.) · 2026Article
- Dynamic associations between ambient air pollution and transitions of biochemical pregnancy, clinical pregnancy, and live birth among women treated with IVF/ICSI.Journal of assisted reproduction and genetics · 2026Article
- Histidine Metabolic Pathway Modifies the Relationships Between 6:2 Cl-PFESA Exposure and Preterm Birth.Toxics · 2026Article
- Perinatal vulnerability: its impact on oral and craniofacial hard tissue development.Frontiers in physiology · 2026Review
- Impacts of the Pacific Northwest Heat Dome on preterm birth rates in Oregon and Washington State.medRxiv : the preprint server for health sciences · 2025Article
- Street view-derived city built environment and vulnerability to temperature extremes: a nationally representative population-based cohort study.BMC medicine · 2025Article
- Effects of projected increases in heat exposure on linguistic development in two-year-old children: A longitudinal modified treatment policy analysis.Environmental epidemiology (Philadelphia, Pa.) · 2025Article
- Association of maternal VDR and VDBP gene polymorphisms with spontaneous preterm birth risks: a nested case-control study in China.BMC pregnancy and childbirth · 2025Article
- Prenatal greenness exposure and the decreased risk of low birthweight and small for gestational age: modification and mediation effects of air pollution.BMC public health · 2025Article
- Extreme temperature events exposure and risks of stillbirths: nationwide large birth cohort study in China.Environment international · 2025Article
- Association of maternal prenatal phthalate exposure and genetic polymorphisms of metabolic enzyme genes with spontaneous preterm birth: a nested case-control study in China.BMC pregnancy and childbirth · 2025Article
- The graded heat-health risk forecast and early warning with full-season coverage across China: a predicting model development and evaluation study.The Lancet regional health. Western Pacific · 2025Article
- Ambient temperature and ozone exposure increases the risk of preterm birth in Northeast China: a time series analysis.Frontiers in public health · 2025Article
- The effects of cervical cerclage on the vaginal microbiota and its metabolites in pregnant women.Frontiers in cellular and infection microbiology · 2025Article
Corrections and comments
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Authors and funding
10 authors.
Funding
Abstract
Heat exposure is associated with an increased risk of preterm birth (PTB), with previous work suggesting that maternal blood pressure may play a role in these associations. Here we conducted a cohort study of 197,080 singleton live births across 8 provinces in China from 2015 to 2018. The study first estimated the associations between heat exposure, maternal hypertension and clinical subtypes of PTB, and then quantified the role of maternal hypertension in heat and PTB using mediation analyses. We show that heat exposure (>85th, 90th and 95th percentiles of local temperature distributions) spanning from conception to the 20th gestational week was associated with a 15-21% increase in PTB, and a 20-22% increase in medically indicated PTB. Heat exposure is likely to increase the risk of maternal hypertension and elevated blood pressure. Maternal hypertension mediated 15.7% and 33.9% of the effects of heat exposure (>90th percentile) on PTB and medically indicated PTB, respectively. Based on this large-population study, we found that exposure to heat in early pregnancy can increase the risk of maternal hypertension, thereby affecting the incidence of PTB.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.