Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (12): 134-142.doi: 10.6040/j.issn.1671-7554.0.2021.1200

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Effect of ambient temperature during pregnancy on the risk of preterm birth

DU Shuang1, HAN Dexin2, LIN Shaoqian3, BAI Shuoxin1, ZHAO Xiaodong3, WANG Zhaojun4, WANG Zhiping1   

  1. 1. School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Community Health Service Center of Dangjia Subdistrict Office in Shizhong District of Jinan City, Jinan 250116, Shandong, China;
    3. Immunization Institute of Jinan Municipal Center for Disease Control and Prevention, Jinan 250021, Shandong, China;
    4. Shandong Jianan Ecological Environment Monitoring Center, Jinan 250101, Shandong, China
  • Published:2021-12-29

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Abstract: Objective To explore the effect of maternal ambient temperature exposure during pregnancy on the risk of preterm birth in Jinan City, and to identify the critical window period of exposure and sensitive population. Methods The study was based on the baseline population of the birth cohort conducted in Jinan from January 2018 to December 2019. The study subjects were the mother of infant, and the study outcome was preterm birth. The daily ambient temperature data during the study period were collected. The distributed lag nonlinear model(DLNM)combined with Cox proportional hazards model was used to estimate the effect of ambient temperature during pregnancy on the risk of preterm birth and identify the critical window period of exposure. A likelihood ratio test was used to analyze whether there was interaction between housewives and ambient temperature. Then, stratified analysis was carried out according to whether the subjects were housewives to observe the effect modification. Results (1) This study included 6,501 mothers. Of these, 285 had preterm birth, accounting for 4.38%. (2) Compared with the middle temperature on the duration of pregnancy, the lower and higher temperature were statistically associated with the risk of preterm birth. The critical window period at lower temperature was from the 1st to 27th gestational weeks, while that at higher temperature was from the 1st to 29th gestational weeks, and its peak hazard ratio were found in the 13th to 18th gestational weeks(HR = 1.13, 95%CI: 1.07-1.20). (3) A likelihood ratio test showed that housewives and temperature had an interaction effect(χ2 =8.73, P=0.013). (4) Among housewives, the peak effect for extreme 0 ℃ was 4.00(95%CI:1.63-9.82), which was higher than that of non-housewives ［1.71(95%CI:1.08-2.73)］; the peak effect for extreme 30 ℃ was 3.45(95%CI:1.56-7.60), which was higher than that of non-housewives ［1.79(95%CI:1.12-2.84)］. Conclusion Exposure to low or high ambient temperature during pregnancy may increase the risk of preterm birth, and the critical window periods were the 1st-27th gestational weeks and the 1st-29th gestational weeks, respectively. The housewives may more sensitive to extreme temperatures.

Key words: Ambient temperature, Preterm birth, Distributed lag nonlinear model, Housewives, Effect modification

CLC Number: 

  • R122
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