Maternal exposure to heatwave and preterm birth inBrisbane,Australia

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Abstract
Objective: To quantify the short‐term effects of maternal exposure to heatwave on preterm birth.Design: An ecological study.Setting: A population‐based study inBrisbane,Australia.Population: All pregnant women who had a spontaneous singleton live birth inBrisbane betweenNovember andMarch in 2000–2010 were studied.Methods: Daily data on pregnancy outcomes, meteorological factors, and ambient air pollutants were obtained. TheCox proportional hazards regression model with time‐dependent variables was used to examine the short‐term impact of heatwave on preterm birth. A series of cut‐off temperatures and durations were used to define heatwave. Multivariable analyses were also performed to adjust for socio‐economic factors, demographic factors, meteorological factors, and ambient air pollutants.Main outcome measure: Spontaneous preterm births.Results: The adjusted hazard ratios (HRs) ranged from 1.13 (95%CI1.03–1.24) to 2.00 (95%CI1.37–2.91) by using different heatwave definitions, after controlling for demographic, socio‐economic, and meteorological factors, and air pollutants.Conclusions: Heatwave was significantly associated with preterm birth: the associations were robust to the definitions of heatwave. The threshold temperatures, instead of duration, could be more likely to influence the evaluation of birth‐related heatwaves. The findings of this study may have significant public health implications as climate change progresses.

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