Identifying critical periods of susceptibility for maternal exposure to biothermal stress and the risks of stillbirth and spontaneous preterm birth in Western Australia

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dc.contributor.authorNyadanu, S.D.
dc.contributor.authorTessema, G.A.
dc.contributor.authorMullins, B.
dc.contributor.authorGasparrini, A.
dc.contributor.authorPereira, G.
dc.date.issued2025
dc.description.abstractA few studies investigated critical periods of temperature and the risks of stillbirth and preterm birth. This study aimed to identify critical periods of composite biothermal stress (Universal Thermal Climate Index, UTCI) for stillbirth and spontaneous preterm birth (sPTB). From the Midwives Notification System, 415 271 singleton births between January 1, 2000, and December 31, 2015, were linked to spatiotemporal UTCI in Western Australia. Covariate-adjusted weekly and monthly distributed lag nonlinear Cox regression from 12 weeks before conception to birth was performed. Relative to median exposure (14.2 °C), extreme UTCI levels (1st-10th and 90th-99th centiles) were associated with higher hazards of stillbirth and sPTB, especially stronger at lower than higher exposures. Critical susceptible periods at 1st centile (10.2 °C) exposure were found during gestational weeks 21 to 42, with the strongest hazard of 1.14 (95% CI, 1.03-1.27) in the 42nd week for stillbirth, and during gestational weeks 26 to 36, with the strongest hazard of 1.09 (95% CI, 1.06-1.12) in the 36th week for sPTB. Monthly exposure showed a similar pattern but with greater magnitude. Mid to late gestation showed critical susceptible periods of biothermal stress on the birth outcomes, suggesting further studies and timely climate-related health care interventions.
dc.description.statementofresponsibilitySylvester Dodzi Nyadanu, Gizachew A Tessema, Ben Mullins, Antonio Gasparrini, Gavin Pereira
dc.identifier.citationAmerican Journal of Epidemiology, 2025; 194(9):2580-2589
dc.identifier.doi10.1093/aje/kwae431
dc.identifier.issn0002-9262
dc.identifier.issn1476-6256
dc.identifier.orcidTessema, G.A. [0000-0002-4784-8151]
dc.identifier.urihttps://hdl.handle.net/2440/147671
dc.language.isoen
dc.publisherOxford University Press
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1195716
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1099655
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1173991
dc.rights© The Author(s) 2024. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.
dc.source.urihttps://doi.org/10.1093/aje/kwae431
dc.subjecttemperature; climate change; Universal Thermal Climate Index; birth outcomes; heat stress; cold stress; Sustainable Development Goals
dc.subject.meshHumans
dc.subject.meshPremature Birth
dc.subject.meshProportional Hazards Models
dc.subject.meshRisk Factors
dc.subject.meshMaternal Exposure
dc.subject.meshGestational Age
dc.subject.meshPregnancy
dc.subject.meshAdult
dc.subject.meshInfant, Newborn
dc.subject.meshWestern Australia
dc.subject.meshFemale
dc.subject.meshStillbirth
dc.titleIdentifying critical periods of susceptibility for maternal exposure to biothermal stress and the risks of stillbirth and spontaneous preterm birth in Western Australia
dc.typeJournal article
pubs.publication-statusPublished

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