Braun School of Public Health and Community Medicine, The Hebrew University of Jerusalem, Israel.
The Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Israel.
Environ Int. 2020 Sep;142:105824. doi: 10.1016/j.envint.2020.105824. Epub 2020 Jun 27.
Preterm birth is a major determinant of adverse health consequences, and early term births are also associated with increased risk of various outcomes. In light of climate change, the effect of ambient temperature on earlier delivery is an important factor to consider. Several studies have focused on associations of ambient air temperature (Ta) on preterm birth, but few have examined associations with early term births.
To investigate the association of prenatal exposure to Ta with preterm birth (<37 completed gestation weeks) and with early-term birth (<39 completed gestation weeks) in a semi-arid climate.
All singleton deliveries at the Soroka Medical Center from the Southern district of Israel, with estimated conception dates between May 1, 2004 and March 31, 2013 (N = 62,547) were linked to prenatal Ta estimates from a spatiotemporally resolved model, with daily 1 km resolution. We used time-dependent Cox regression models with weekly mean Ta throughout gestation, adjusted for calendar month and year of conception, ethnicity, census-level socio-economic status and population density.
Ta was positively associated with late preterm birth (31 + 0/7 - 36 + 6/7 weeks), with increased risk in the upper Ta quintile as compared to the third quintile, hazard ratio (HR) = 1.31, 95% confidence interval (CI) = 1.11-1.56. Ta also associated with early term birth (37 + 0/6 - 38 + 6/7), with increased risk in the upper Ta quintile as compared to the third quintile, HR = 1.24, 95% CI = 1.13-1.36.
Exposure to high ambient temperature during pregnancy is associated with a higher risk of preterm and early term birth in southern Israel.
早产是不良健康后果的主要决定因素，而早期早产也与各种结局的风险增加有关。鉴于气候变化，环境温度对早产的影响是一个需要考虑的重要因素。已有多项研究关注环境空气温度（Ta）与早产之间的关联，但很少有研究探讨其与早期早产之间的关联。
在半干旱气候下，研究产前暴露于 Ta 与早产（<37 周完整妊娠）和早期早产（<39 周完整妊娠）之间的关联。
将以色列南部地区索罗卡医疗中心 2004 年 5 月 1 日至 2013 年 3 月 31 日期间估计受孕日期在这段时间内的所有单胎分娩与时空分辨率模型估算的产前 Ta 数据进行关联，该模型的空间分辨率为 1 公里，时间分辨率为每周。我们使用时间依赖性 Cox 回归模型，以整个妊娠期每周平均 Ta 为自变量，调整了受孕的日历月和年份、种族、人口普查水平社会经济地位和人口密度等因素。
Ta 与晚期早产（31+0/7-36+6/7 周）呈正相关，与第三五分位数相比，上五分位数的风险增加，风险比（HR）=1.31，95%置信区间（CI）=1.11-1.56。Ta 还与早期早产（37+0/6-38+6/7）相关，与第三五分位数相比，上五分位数的风险增加，HR=1.24，95%置信区间（CI）=1.13-1.36。
在以色列南部，怀孕期间暴露于较高的环境温度与早产和早期早产的风险增加有关。
