Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis
AbstractObjectiveTo assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.DesignSystematic review and random effects meta-analysis.Data sourcesMedline and Web of Science searched up to September 2018, updated i...
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| creator | Chersich, Matthew Francis Pham, Minh Duc Areal, Ashtyn Haghighi, Marjan Mosalam Manyuchi, Albert Swift, Callum P Wernecke, Bianca Robinson, Matthew Hetem, Robyn Boeckmann, Melanie Hajat, Shakoor |
| description | AbstractObjectiveTo assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.DesignSystematic review and random effects meta-analysis.Data sourcesMedline and Web of Science searched up to September 2018, updated in August 2019.Eligibility criteria for selecting studiesClinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths.Results14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings.ConclusionsAlthough summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health.Systematic review registrationPROSPERO CRD 42019140136 and CRD 42018118113. |
| doi_str_mv | 10.1136/bmj.m3811 |
| format | Article |
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In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings.ConclusionsAlthough summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health.Systematic review registrationPROSPERO CRD 42019140136 and CRD 42018118113.</description><identifier>ISSN: 1756-1833</identifier><identifier>ISSN: 0959-8138</identifier><identifier>EISSN: 1756-1833</identifier><identifier>DOI: 10.1136/bmj.m3811</identifier><identifier>PMID: 33148618</identifier><language>eng</language><publisher>England: BMJ Publishing Group LTD</publisher><subject>Adaptation ; Birth weight ; Citation indexes ; Climate change ; Female ; Global warming ; Heat ; High temperature ; Hot Temperature - adverse effects ; Humans ; Infant, Low Birth Weight ; Infant, Newborn ; Low birth weight ; Low income groups ; Meta-analysis ; Physiology ; Pregnancy ; Premature birth ; Premature Birth - epidemiology ; Reviews ; Risk Factors ; Stillbirth ; Stillbirth - epidemiology ; Womens health</subject><ispartof>BMJ (Online), 2020-11, Vol.371, p.m3811</ispartof><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.</rights><rights>2020 Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. BMJ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ . Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. 2020 BMJ</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-b470t-2d0b75820a1cf2102e2860e5c47759ebcb39d0d9b619de8cbd6c79f3c18780283</citedby><cites>FETCH-LOGICAL-b470t-2d0b75820a1cf2102e2860e5c47759ebcb39d0d9b619de8cbd6c79f3c18780283</cites><orcidid>0000-0002-4320-9168</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,550,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33148618$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:145090500$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Chersich, Matthew Francis</creatorcontrib><creatorcontrib>Pham, Minh Duc</creatorcontrib><creatorcontrib>Areal, Ashtyn</creatorcontrib><creatorcontrib>Haghighi, Marjan Mosalam</creatorcontrib><creatorcontrib>Manyuchi, Albert</creatorcontrib><creatorcontrib>Swift, Callum P</creatorcontrib><creatorcontrib>Wernecke, Bianca</creatorcontrib><creatorcontrib>Robinson, Matthew</creatorcontrib><creatorcontrib>Hetem, Robyn</creatorcontrib><creatorcontrib>Boeckmann, Melanie</creatorcontrib><creatorcontrib>Hajat, Shakoor</creatorcontrib><creatorcontrib>Climate Change and Heat-Health Study Group</creatorcontrib><title>Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis</title><title>BMJ (Online)</title><addtitle>BMJ</addtitle><description>AbstractObjectiveTo assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.DesignSystematic review and random effects meta-analysis.Data sourcesMedline and Web of Science searched up to September 2018, updated in August 2019.Eligibility criteria for selecting studiesClinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths.Results14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings.ConclusionsAlthough summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health.Systematic review registrationPROSPERO CRD 42019140136 and CRD 42018118113.</description><subject>Adaptation</subject><subject>Birth weight</subject><subject>Citation indexes</subject><subject>Climate change</subject><subject>Female</subject><subject>Global warming</subject><subject>Heat</subject><subject>High temperature</subject><subject>Hot Temperature - adverse effects</subject><subject>Humans</subject><subject>Infant, Low Birth Weight</subject><subject>Infant, Newborn</subject><subject>Low birth weight</subject><subject>Low income groups</subject><subject>Meta-analysis</subject><subject>Physiology</subject><subject>Pregnancy</subject><subject>Premature birth</subject><subject>Premature Birth - epidemiology</subject><subject>Reviews</subject><subject>Risk Factors</subject><subject>Stillbirth</subject><subject>Stillbirth - epidemiology</subject><subject>Womens 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between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis</title><author>Chersich, Matthew Francis ; Pham, Minh Duc ; Areal, Ashtyn ; Haghighi, Marjan Mosalam ; Manyuchi, Albert ; Swift, Callum P ; Wernecke, Bianca ; Robinson, Matthew ; Hetem, Robyn ; Boeckmann, Melanie ; Hajat, Shakoor</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-b470t-2d0b75820a1cf2102e2860e5c47759ebcb39d0d9b619de8cbd6c79f3c18780283</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adaptation</topic><topic>Birth weight</topic><topic>Citation indexes</topic><topic>Climate change</topic><topic>Female</topic><topic>Global warming</topic><topic>Heat</topic><topic>High temperature</topic><topic>Hot Temperature - adverse effects</topic><topic>Humans</topic><topic>Infant, Low Birth Weight</topic><topic>Infant, Newborn</topic><topic>Low birth weight</topic><topic>Low income groups</topic><topic>Meta-analysis</topic><topic>Physiology</topic><topic>Pregnancy</topic><topic>Premature birth</topic><topic>Premature Birth - epidemiology</topic><topic>Reviews</topic><topic>Risk Factors</topic><topic>Stillbirth</topic><topic>Stillbirth - epidemiology</topic><topic>Womens health</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Chersich, Matthew Francis</creatorcontrib><creatorcontrib>Pham, Minh Duc</creatorcontrib><creatorcontrib>Areal, Ashtyn</creatorcontrib><creatorcontrib>Haghighi, Marjan Mosalam</creatorcontrib><creatorcontrib>Manyuchi, Albert</creatorcontrib><creatorcontrib>Swift, Callum P</creatorcontrib><creatorcontrib>Wernecke, Bianca</creatorcontrib><creatorcontrib>Robinson, Matthew</creatorcontrib><creatorcontrib>Hetem, Robyn</creatorcontrib><creatorcontrib>Boeckmann, Melanie</creatorcontrib><creatorcontrib>Hajat, 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(Online)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Chersich, Matthew Francis</au><au>Pham, Minh Duc</au><au>Areal, Ashtyn</au><au>Haghighi, Marjan Mosalam</au><au>Manyuchi, Albert</au><au>Swift, Callum P</au><au>Wernecke, Bianca</au><au>Robinson, Matthew</au><au>Hetem, Robyn</au><au>Boeckmann, Melanie</au><au>Hajat, Shakoor</au><aucorp>Climate Change and Heat-Health Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis</atitle><jtitle>BMJ (Online)</jtitle><addtitle>BMJ</addtitle><date>2020-11-04</date><risdate>2020</risdate><volume>371</volume><spage>m3811</spage><pages>m3811-</pages><issn>1756-1833</issn><issn>0959-8138</issn><eissn>1756-1833</eissn><abstract>AbstractObjectiveTo assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth.DesignSystematic review and random effects meta-analysis.Data sourcesMedline and Web of Science searched up to September 2018, updated in August 2019.Eligibility criteria for selecting studiesClinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths.Results14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings.ConclusionsAlthough summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health.Systematic review registrationPROSPERO CRD 42019140136 and CRD 42018118113.</abstract><cop>England</cop><pub>BMJ Publishing Group LTD</pub><pmid>33148618</pmid><doi>10.1136/bmj.m3811</doi><orcidid>https://orcid.org/0000-0002-4320-9168</orcidid><oa>free_for_read</oa></addata></record> |
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| source | Jstor Complete Legacy; MEDLINE; SWEPUB Freely available online |
| subjects | Adaptation Birth weight Citation indexes Climate change Female Global warming Heat High temperature Hot Temperature - adverse effects Humans Infant, Low Birth Weight Infant, Newborn Low birth weight Low income groups Meta-analysis Physiology Pregnancy Premature birth Premature Birth - epidemiology Reviews Risk Factors Stillbirth Stillbirth - epidemiology Womens health |
| title | Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis |
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