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The Association of Season and Temperature with Adverse Pregnancy Outcome in Two German States, a Time-Series Analysis

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  • Jennyfer Wolf
  • Ben Armstrong

Abstract

Background: A seasonality of low birth weight (LBW) and preterm birth (PTB) has been described for most regions and there is evidence that this pattern is caused by ambient outdoor temperature. However, the association as such, the direction of effect and the critical time of exposure remain controversial. Methods: Logistic, time-series regression was performed on nearly 300,000 births from two German states to study the association between season and daily mean temperature and changes in daily proportions of term LBW (tLBW) or PTB. Analyses were adjusted for time-varying factors. Temperature exposures were examined during different periods of pregnancy. Results: Weak evidence for an association between season of conception, season of birth or ambient outdoor temperature and tLBW or PTB was found. Results of analyses of temperature were not consistent between the two states. Different sources of bias which would have artificially led to stronger findings were detected and are described. Conclusions: No clear evidence for an association between season of conception, season of birth or temperature and tLBW or PTB was found. In the study of pregnancy outcome different sources of bias can be identified which can potentially explain heterogeneous findings of the past.

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  • Jennyfer Wolf & Ben Armstrong, 2012. "The Association of Season and Temperature with Adverse Pregnancy Outcome in Two German States, a Time-Series Analysis," PLOS ONE, Public Library of Science, vol. 7(7), pages 1-8, July.
    • Handle: RePEc:plo:pone00:0040228
    DOI: 10.1371/journal.pone.0040228
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    1. Mangold, W.D., 1981. "Neonatal mortality by the day of the week in the 1974-75 Arkansas live birth cohort," American Journal of Public Health, American Public Health Association, vol. 71(6), pages 601-605.
    2. Porter, K.R. & Thomas, S.D. & Whitman, S., 1999. "The relation of gestation length to short-term heat stress," American Journal of Public Health, American Public Health Association, vol. 89(7), pages 1090-1092.
    3. Bantje, Han, 1987. "Seasonality of births and birthweights in Tanzania," Social Science & Medicine, Elsevier, vol. 24(9), pages 733-739, January.
    4. Lajinian, S. & Hudson, S. & Applewhite, L. & Feldman, J. & Minkoff, H.L., 1997. "An association between the heat-humidity index and preterm labor and delivery: A preliminary analysis," American Journal of Public Health, American Public Health Association, vol. 87(7), pages 1205-1207.
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    1. Bruckner, Tim A. & van den Berg, Gerard J. & Smith, Kirk R. & Catalano, Ralph A., 2014. "Ambient temperature during gestation and cold-related adult mortality in a Swedish cohort, 1915–2002," Social Science & Medicine, Elsevier, vol. 119(C), pages 191-197.
    2. M. Luke Smith & Rachel R. Hardeman, 2020. "Association of Summer Heat Waves and the Probability of Preterm Birth in Minnesota: An Exploration of the Intersection of Race and Education," IJERPH, MDPI, vol. 17(17), pages 1-12, September.
    3. Sarah Syed & Tracey L. O’Sullivan & Karen P. Phillips, 2022. "Extreme Heat and Pregnancy Outcomes: A Scoping Review of the Epidemiological Evidence," IJERPH, MDPI, vol. 19(4), pages 1-16, February.
    4. Gulcan Cil & Trudy Ann Cameron, 2017. "Potential Climate Change Health Risks from Increases in Heat Waves: Abnormal Birth Outcomes and Adverse Maternal Health Conditions," Risk Analysis, John Wiley & Sons, vol. 37(11), pages 2066-2079, November.
    5. Leeann Kuehn & Sabrina McCormick, 2017. "Heat Exposure and Maternal Health in the Face of Climate Change," IJERPH, MDPI, vol. 14(8), pages 1-13, July.
    6. Ana M. Vicedo-Cabrera & David Olsson & Bertil Forsberg, 2015. "Exposure to Seasonal Temperatures during the Last Month of Gestation and the Risk of Preterm Birth in Stockholm," IJERPH, MDPI, vol. 12(4), pages 1-17, April.

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