{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:47:46Z","timestamp":1784868466966,"version":"3.55.0"},"reference-count":67,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T00:00:00Z","timestamp":1731024000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"funder":[{"name":"Australia National Health and Medical Research Council","award":["#1099655 and #1173991; G.P."],"award-info":[{"award-number":["#1099655 and #1173991; G.P."]}]},{"name":"Australia National Health and Medical Research Council","award":["#1195716"],"award-info":[{"award-number":["#1195716"]}]},{"name":"Curtin International Postgraduate Research Scholarship, Curtin University, Perth, Australia"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,9,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>A few studies investigated critical periods of temperature and the risks of stillbirth and preterm birth. This study aimed to identify critical periods of composite biothermal stress (Universal Thermal Climate Index, UTCI) for stillbirth and spontaneous preterm birth (sPTB). From the Midwives Notification System, 415\u2009271 singleton births between January 1, 2000, and December 31, 2015, were linked to spatiotemporal UTCI in Western Australia. Covariate-adjusted weekly and monthly distributed lag nonlinear Cox regression from 12 weeks before conception to birth was performed. Relative to median exposure (14.2 \u00b0C), extreme UTCI levels (1st-10th and 90th-99th centiles) were associated with higher hazards of stillbirth and sPTB, especially stronger at lower than higher exposures. Critical susceptible periods at 1st centile (10.2 \u00b0C) exposure were found during gestational weeks 21 to 42, with the strongest hazard of 1.14 (95% CI, 1.03-1.27) in the 42nd week for stillbirth, and during gestational weeks 26 to 36, with the strongest hazard of 1.09 (95% CI, 1.06-1.12) in the 36th week for sPTB. Monthly exposure showed a similar pattern but with greater magnitude. Mid to late gestation showed critical susceptible periods of biothermal stress on the birth outcomes, suggesting further studies and timely climate-related health care interventions.<\/jats:p>","DOI":"10.1093\/aje\/kwae431","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T23:27:24Z","timestamp":1730935644000},"page":"2580-2589","source":"Crossref","is-referenced-by-count":5,"title":["Identifying critical periods of susceptibility for maternal exposure to biothermal stress and the risks of stillbirth and spontaneous preterm birth in Western Australia"],"prefix":"10.1093","volume":"194","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6233-0262","authenticated-orcid":false,"given":"Sylvester Dodzi","family":"Nyadanu","sequence":"first","affiliation":[{"name":"Curtin School of Population Health, Curtin University , Perth, Bentley, Western Australia 6102 ,","place":["Australia"]},{"name":"Education, Culture, and Health Opportunities (ECHO) Ghana, ECHO Research Group International , Aflao , VZ 1042,","place":["Ghana"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-8151","authenticated-orcid":false,"given":"Gizachew A","family":"Tessema","sequence":"additional","affiliation":[{"name":"Curtin School of Population Health, Curtin University , Perth, Bentley, Western Australia 6102 ,","place":["Australia"]},{"name":"School of Public Health, University of Adelaide , Adelaide, SA 5000 ,","place":["Australia"]},{"name":"enAble Institute, Curtin University , Perth, Kent Street, Bentley, WA 6102 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6722-1073","authenticated-orcid":false,"given":"Ben","family":"Mullins","sequence":"additional","affiliation":[{"name":"Curtin School of Population Health, Curtin University , Perth, Bentley, Western Australia 6102 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2271-3568","authenticated-orcid":false,"given":"Antonio","family":"Gasparrini","sequence":"additional","affiliation":[{"name":"Department of Social and Environmental Health Research, London School of Hygiene and Tropical Medicine , London , Keppel Street, WC1E 7HT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3740-8117","authenticated-orcid":false,"given":"Gavin","family":"Pereira","sequence":"additional","affiliation":[{"name":"Curtin School of Population Health, Curtin University , Perth, Bentley, Western Australia 6102 ,","place":["Australia"]},{"name":"enAble Institute, Curtin University , Perth, Kent Street, Bentley, WA 6102 ,","place":["Australia"]},{"name":"WHO Collaborating Centre for Climate Change and Health Impact Assessment, Faculty of Health Science, Curtin University , Bentley, Western Australia 6102 ,","place":["Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,11,8]]},"reference":[{"issue":"10409","key":"2026011400525320600_ref1","doi-asserted-by":"publisher","first-page":"1261","DOI":"10.1016\/S0140-6736(23)00878-4","article-title":"National, regional, and global estimates of preterm birth in 2020, with trends from 2010: a systematic analysis","volume":"402","author":"Ohuma","year":"2023","journal-title":"Lancet."},{"issue":"10302","key":"2026011400525320600_ref2","doi-asserted-by":"publisher","first-page":"772","DOI":"10.1016\/S0140-6736(21)01112-0","article-title":"Global, regional, and national estimates and trends in stillbirths from 2000 to 2019: a systematic assessment","volume":"398","author":"Hug","year":"2021","journal-title":"Lancet."},{"issue":"3","key":"2026011400525320600_ref3","doi-asserted-by":"publisher","first-page":"321","DOI":"10.1111\/ajo.13171","article-title":"The Australian Preterm Birth Prevention Alliance","volume":"60","author":"Morris","year":"2020","journal-title":"Aust N Z J Obstet Gynaecol."},{"issue":"6","key":"2026011400525320600_ref4","doi-asserted-by":"publisher","first-page":"506","DOI":"10.1016\/j.wombi.2020.09.005","article-title":"Stillbirth in Australia 1: the road to now: two decades of stillbirth research and advocacy in Australia. 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