TY - JOUR
T1 - Extreme temperature events exposure and risks of stillbirths
T2 - nationwide large birth cohort study in China
AU - Li, Zhan
AU - Li, Shuangying
AU - Su, Shaofei
AU - Morawska, Lidia
AU - Jalaludin, Bin
AU - Dharmage, Shyamali
AU - Lin, Shao
AU - Gao, Meng
AU - Li, Juan
AU - Xie, Shuanghua
AU - Zhang, Enjie
AU - Hu, Minhui
AU - Wu, Shaowen
AU - Liu, Jianhui
AU - Heazell, Alexander E.P.
AU - Yin, Chenghong
AU - Dong, Guang Hui
AU - Liu, Ruixia
N1 - Publisher Copyright:
© 2025 Published by Elsevier Ltd.
Funding Information:
This study was supported by the National Key Research and Development Program of China (2016YFC1000101). The authors are grateful to Wentao Yue (Department of Research Management, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing, 100026, China), Huiping Zhu (School of Public Health, Capital Medical University, Beijing 100069, China) and Jinghan Yu (Department of Central Laboratory, Beijing Obstetrics and Gynecology Hospital, Capital Medical University. Beijing Maternal and Child Health Care Hospital, Beijing 100026, China) for their support in the data collection. We would like to thank Lebing Wang (Ph.D., Joint International Research Laboratory of Environment and Health, Ministry of Education, Guangdong Provincial Engineering Technology Research Center of Environmental Pollution and Health Risk Assessment, Department of Occupational and Environmental Health, School of Public Health, Sun Yat-sen University, Guangzhou 510080, China) for his help with data analysis.
PY - 2025/10
Y1 - 2025/10
N2 - Extreme temperature events (ETEs) are associated with an increased risk of stillbirth. We conducted a nationwide cohort study based on China Birth Cohort Study (CBCS) across 17 provinces in 2018–2022. A set of cutoff temperature thresholds (2.5th, 5th, 7.5th, 10th, 90th, 92.5th, 95th and 97.5th percentiles of daily apparent temperature of each province during the study period) and durations (at least 2, 3, and 4 consecutive days) were utilized to define 24 distinct ETEs. We show that heatwave exposure was associated with a 36–83% increase in stillbirth. Overall, the adverse impact of cold spells on stillbirths is not significant. The effects varied across regions, and lower population density and greater medical resource were protective factors for the effects. Furthermore, when exposed to ETEs, small vulnerable newborns (SVN) are more likely to experience stillbirth. Our study highlights the need for adaptive and mitigative strategies against ETEs’ adverse effects on stillbirth.
AB - Extreme temperature events (ETEs) are associated with an increased risk of stillbirth. We conducted a nationwide cohort study based on China Birth Cohort Study (CBCS) across 17 provinces in 2018–2022. A set of cutoff temperature thresholds (2.5th, 5th, 7.5th, 10th, 90th, 92.5th, 95th and 97.5th percentiles of daily apparent temperature of each province during the study period) and durations (at least 2, 3, and 4 consecutive days) were utilized to define 24 distinct ETEs. We show that heatwave exposure was associated with a 36–83% increase in stillbirth. Overall, the adverse impact of cold spells on stillbirths is not significant. The effects varied across regions, and lower population density and greater medical resource were protective factors for the effects. Furthermore, when exposed to ETEs, small vulnerable newborns (SVN) are more likely to experience stillbirth. Our study highlights the need for adaptive and mitigative strategies against ETEs’ adverse effects on stillbirth.
KW - Extreme temperature events
KW - Heatwave
KW - Cold spell
KW - Stillbirth
UR - https://www.scopus.com/pages/publications/105019957886
U2 - 10.1016/j.envint.2025.109854
DO - 10.1016/j.envint.2025.109854
M3 - Journal article
C2 - 41101031
AN - SCOPUS:105019957886
SN - 0160-4120
VL - 204
JO - Environment International
JF - Environment International
M1 - 109854
ER -
SDG 3 Good Health and Well-being