High-temperature exposure and risk of spontaneous abortion during early pregnancy: a case–control study in Nanjing, China

Shuangshuang Zhao, Jie Xu,Wen Li,Yingying Lu, Linxiang Huang, Haoyi Xu, Mingxia Shi,Yan Wang, Qiaoying Zhu,Qing Xu

Environmental Science and Pollution Research(2022)

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Abstract
As one of the most common complications of early pregnancy, spontaneous abortion is associated with environmental factors, but reports estimating the effect of ambient temperature on spontaneous abortion are still inconclusive. Herein, a case–control study (1002 cases and 2004 controls) in Nanjing, China, from 2017 to 2021 was conducted to evaluate the association between temperature exposure and the risk of spontaneous abortion by using distributed lag nonlinear model (DLNM). As a result, daily mean temperature exposure and early spontaneous abortion showed a nonlinear relationship in 14-day lag periods. Moreover, taking the median temperature (17 °C) as a reference, gradually increased positive effects of high temperature on spontaneous abortion could be found during the 4 days prior to hospitalization, and the highest odds ratio (OR) of 2.07 (95% confidence interval (CI): 1.36, 3.16) at extremely hot temperature (33 °C) was observed at 1 lag day. The results suggested that high-temperature exposure in short times during early pregnancy might increase the risk of SAB. Thus, our findings highlight the potential risk of short-term high-temperature exposure during early pregnancy, and more evidence was given for the effects of climate change on maternal health.
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Key words
Ambient temperature,Short-term exposure,Early pregnant women,Pregnancy loss,Distributed lag nonlinear model (DLNM),Case–control study
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