{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:29:15Z","timestamp":1785522555661,"version":"3.56.0"},"reference-count":44,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2024,8,30]],"date-time":"2024-08-30T00:00:00Z","timestamp":1724976000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Birth Defects Research"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Exposure to long\u2010lasting extreme ambient temperatures in the periconceptional or early pregnancy period might increase the risk of neural tube defects (NTDs). We tested whether prolonged severe heat exposure as experienced during the 2003 extreme heatwave in France, affected the risk of NTDs.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We retrieved NTD cases spanning from January 1994 to December 2018 from the Paris Registry of Congenital Malformations. The 2003 heatwave was characterized by the long duration and high intensity of nine consecutive days with temperatures \u226535\u00b0C. We classified monthly conceptions occurring in August 2003 as \u201cexposed\u201d to prolonged extreme heat around conception (i.e., periconceptional period). We assessed whether the risk of NTDs among cohorts exposed to the prolonged severe heatwave of 2003 in the periconceptional period differed from expected values using Poisson\/negative binomial regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Findings<\/jats:title><jats:p>We identified 1272 NTD cases from January 1994 to December 2018, yielding a monthly mean count of 4.24. Ten NTD cases occurred among births conceived in August 2003. The risk of NTD was increased in the cohort with periconceptional exposure to the August 2003 heatwave (relative risk\u2009=\u20092.14, 95% confidence interval: 1.46 to 3.13), compared to non\u2010exposed cohorts. Sensitivity analyses excluding July and September months or restricting to summer months yielded consistent findings.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Evidence from the \u201cnatural experiment\u201d of an extreme climate event suggests an elevated risk of NTDs following exposure to prolonged extreme heat during the periconceptional period.<\/jats:p><\/jats:sec>","DOI":"10.1002\/bdr2.2397","type":"journal-article","created":{"date-parts":[[2024,8,31]],"date-time":"2024-08-31T05:05:26Z","timestamp":1725080726000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Climate Change and Congenital Anomalies: A Population\u2010Based Study of the Effect of Prolonged Extreme Heat Exposure on the Risk of Neural Tube Defects in France"],"prefix":"10.1002","volume":"116","author":[{"given":"Tim\u00a0A.","family":"Bruckner","sequence":"first","affiliation":[{"name":"Program in Public Health University of California  Irvine California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nhung\u00a0T.\u00a0H.","family":"Trinh","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Epidemiology and Statistics Research Center \u2013 CRESS INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team  Paris France"},{"name":"PharmacoEpidemiology and Drug Safety Research Group, Department of Pharmacy University of Oslo  Norway"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathalie","family":"Lelong","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Epidemiology and Statistics Research Center \u2013 CRESS INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team  Paris France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaveh","family":"Madani","sequence":"additional","affiliation":[{"name":"United Nations University Institute for Water Environment and Health (UNU\u2010INWEH)  Richmond Hill Ontario Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R\u00e9my","family":"Slama","sequence":"additional","affiliation":[{"name":"University Grenoble Alpes, Inserm, CNRS, Team of Environmental Epidemiology Applied to Reproduction and Respiratory Health, Institute for Advanced Biosciences  Grenoble France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanne","family":"Given","sequence":"additional","affiliation":[{"name":"Institute of Nursing and Health Research Ulster University  Belfast UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Khoshnood","sequence":"additional","affiliation":[{"name":"Universit\u00e9 de Paris, Epidemiology and Statistics Research Center \u2013 CRESS INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team  Paris 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