{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T06:04:30Z","timestamp":1792562670974,"version":"4.5.0"},"reference-count":35,"publisher":"American Medical Association (AMA)","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"<jats:sec id=\"ab-zoi240429-4\"><jats:title>Importance<\/jats:title><jats:p>Heat waves are increasing in frequency, intensity, and duration and may be acutely associated with pregnancy outcomes.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-5\"><jats:title>Objective<\/jats:title><jats:p>To examine changes in daily rates of preterm and early-term birth after heat waves in a 25-year nationwide study.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cohort study of singleton births used birth records from 1993 to 2017 from the 50 most populous US metropolitan statistical areas (MSAs). The study included 53 million births, covering 52.8% of US births over the period. Data were analyzed between October 2022 and March 2023 at the National Center for Health Statistics.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-7\"><jats:title>Exposures<\/jats:title><jats:p>Daily temperature data from Daymet at 1-km<jats:sup>2<\/jats:sup> resolution were averaged over each MSA using population weighting. Heat waves were defined in the 4 days (lag, 0-3 days) or 7 days (lag, 0-6 days) preceding birth.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-8\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>Daily counts of preterm birth (28 to &amp;amp;lt;37 weeks), early-term birth (37 to &amp;amp;lt;39 weeks), and ongoing pregnancies in each gestational week on each day were enumerated in each MSA. Rate ratios for heat wave metrics were obtained from time-series models restricted to the warm season (May to September) adjusting for MSA, year, day of season, and day of week, and offset by pregnancies at risk.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-9\"><jats:title>Results<\/jats:title><jats:p>There were 53\u202f154\u202f816 eligible births in the 50 MSAs from 1993 to 2017; 2\u202f153\u202f609 preterm births and 5\u202f795\u202f313 early-term births occurring in the warm season were analyzed. A total of 30.0% of mothers were younger than 25 years, 53.8% were 25 to 34 years, and 16.3% were 35 years or older. Heat waves were positively associated with daily rates of preterm and early-term births, showing a dose-response association with heat wave duration and temperatures and stronger associations in the more acute 4-day window. After 4 consecutive days of mean temperatures exceeding the local 97.5th percentile, the rate ratio for preterm birth was 1.02 (95% CI, 1.00-1.03), and the rate ratio for early-term birth was 1.01 (95% CI, 1.01-1.02). For the same exposure, among those who were 29 years of age or younger, had a high school education or less, and belonged to a racial or ethnic minority group, the rate ratios were 1.04 (95% CI, 1.02-1.06) for preterm birth and 1.03 (95% CI, 1.02-1.05) for early-term birth. Results were robust to alternative heat wave definitions, excluding medically induced deliveries, and alternative statistical model specifications.<\/jats:p><\/jats:sec><jats:sec id=\"ab-zoi240429-10\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>In this cohort study, preterm and early-term birth rates increased after heat waves, particularly among socioeconomically disadvantaged subgroups. Extreme heat events have implications for perinatal health.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.12055","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T15:31:34Z","timestamp":1716564694000},"page":"e2412055","source":"Crossref","is-referenced-by-count":42,"title":["Preterm and Early-Term Delivery After Heat Waves in 50 US Metropolitan Areas"],"prefix":"10.1001","volume":"7","author":[{"given":"Lyndsey A.","family":"Darrow","sequence":"first","affiliation":[{"name":"Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada, Reno"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mengjiao","family":"Huang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Biostatistics, and Environmental Health, School of Public Health, University of Nevada, Reno"},{"name":"Geriatric Research and Education Clinical Center, Veterans Affairs Health 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