{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T23:35:13Z","timestamp":1794353713939,"version":"4.9.0"},"reference-count":29,"publisher":"Wiley","issue":"S3","license":[{"start":{"date-parts":[[2023,8,15]],"date-time":"2023-08-15T00:00:00Z","timestamp":1692057600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100009633","name":"Eunice Kennedy Shriver National Institute of Child Health and Human Development","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100009633","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["BJOG"],"published-print":{"date-parts":[[2023,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Growing evidence suggests that environmental heat stress negatively influences fetal growth and pregnancy outcomes. However, few studies have examined the impact of heat stress on pregnancy outcomes in low\u2010resource settings. We combined data from a large multi\u2010country maternal\u2013child health registry and meteorological data to assess the impacts of heat stress.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Three sites based in south Asia as part of the Global Network for Women's and Children's Health research in India (Belagavi and Nagpur) and Pakistan (Thatta).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Population or Sample<\/jats:title>\n                    <jats:p>Data from women enrolled between 2014 and 2020 in the Global Network's Maternal Newborn Health Registry (MNHR), a prospective, population\u2010based registry of pregnancies, were used.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 126\u2009273 pregnant women were included in this analysis. Daily maximal air temperatures (\n                      <jats:italic>T<\/jats:italic>\n                      <jats:sub>max<\/jats:sub>\n                      ) were acquired from local meteorological records. Associations between averages of daily maximal temperatures for each trimester and main outcomes were analysed using a modified Poisson regression approach.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcomes measures<\/jats:title>\n                    <jats:p>Incidence of stillbirth, preterm birth, low birthweight (&lt;2500\u2009g) or evidence of pregnancy hypertension or pre\u2010eclampsia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the overall cohort, risk of preterm birth was positively associated with greater temperature in the second trimester (relative risk [RR] 1.05, 95% CI 1.02\u20131.07,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0002). Among individual sites, the risk of preterm birth was greatest in Nagpur (RR 1.07, 95% CI 1.03\u20131.11,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.0005) and associated with second\u2010trimester temperature. The overall risk of low birthweight was associated with ambient temperature in second trimester (RR 1.02, 95% CI 1.01\u20131.04,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.01). The risk for LBW was associated with first\u2010trimester heat in Thatta and with second\u2010trimester heat in Nagpur. Finally, the overall risk of gestational hypertensive disease was associated with greater temperature in the third trimester among all sites (RR 1.07, 95% CI 1.02\u20131.12,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.005) and was particularly significant for Nagpur (RR 1.13, 95% CI 1.05\u20131.23,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002). These findings highlight the increased risk of detrimental obstetric and neonatal outcomes with greater temperature.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In a multi\u2010country, community\u2010based study, greater risk of adverse outcomes was observed with increasing temperature. The study highlights the need for deeper understanding of covarying factors and intervention strategies, especially in regions where high temperatures are common.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1471-0528.17616","type":"journal-article","created":{"date-parts":[[2023,8,18]],"date-time":"2023-08-18T13:00:20Z","timestamp":1692363620000},"page":"124-133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Associations between ambient temperature and pregnancy outcomes from three south Asian sites of the Global Network Maternal Newborn Health Registry: A retrospective cohort study"],"prefix":"10.1111","volume":"130","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7964-9026","authenticated-orcid":false,"given":"Kartik","family":"Shankar","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Section of Nutrition University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kay","family":"Hwang","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie L.","family":"Westcott","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Nutrition University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarah","family":"Saleem","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumera A.","family":"Ali","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saleem","family":"Jessani","sequence":"additional","affiliation":[{"name":"Aga Khan University  Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2558-7421","authenticated-orcid":false,"given":"Archana","family":"Patel","sequence":"additional","affiliation":[{"name":"Lata Medical Research Foundation  Nagpur India"},{"name":"Datta Meghe Institute of Medical Sciences  Wardha India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2176-4697","authenticated-orcid":false,"given":"Avinash","family":"Kavi","sequence":"additional","affiliation":[{"name":"KLE Academy Higher Education and Research, J N Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8871-5072","authenticated-orcid":false,"given":"Manjunath S.","family":"Somannavar","sequence":"additional","affiliation":[{"name":"KLE Academy Higher Education and Research, J N Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shivaprasad S.","family":"Goudar","sequence":"additional","affiliation":[{"name":"KLE Academy Higher Education and Research, J N Medical College  Belagavi Karnataka India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia L.","family":"Hibberd","sequence":"additional","affiliation":[{"name":"Boston University  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard J.","family":"Derman","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Hoffman","sequence":"additional","affiliation":[{"name":"Thomas Jefferson University  Philadelphia Pennsylvania USA"},{"name":"Christiana Care Health System  Newark Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Blair J.","family":"Wylie","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert L.","family":"Goldenberg","sequence":"additional","affiliation":[{"name":"Department of Obstetrics and Gynecology Columbia University  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vanessa R.","family":"Thorsten","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8659-5444","authenticated-orcid":false,"given":"Elizabeth M.","family":"McClure","sequence":"additional","affiliation":[{"name":"RTI International  Durham North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5652-7547","authenticated-orcid":false,"given":"Nancy F.","family":"Krebs","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Section of Nutrition University of Colorado School of Medicine  Aurora Colorado USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,8,15]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1029\/2019GH000234"},{"key":"e_1_2_11_3_1","unstructured":"NOAA.Global climate report January 2023. 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