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Less clear are the effects of cold and the joint effects of air pollution and temperature.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Using a Cox proportional hazard regression model, we assessed the risk of independent and combined short-term exposure to ambient daily mean temperature and PM<jats:sub>2.5<\/jats:sub> associated with sPTB in the last week before delivery on overall sPTB (weeks 23\u201336) and three subtypes: extremely sPTB, very sPTB, and moderate-to-late sPTB for a birth cohort of 1,318,570 births from Australia (Jan 2001\u2013Dec 2019), while controlling for chronic exposure (i.e., throughout pregnancy except the last week before delivery) to PM<jats:sub>2.5<\/jats:sub> and temperature. The temperature was modeled as a natural cubic spline, PM<jats:sub>2.5<\/jats:sub> as a linear term, and the interaction effect was estimated using a multiplicative term. For short-term exposure to temperature hazard ratios reported are relative to the median temperature (18.1\u00b0C).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Hazard ratios at low temperature [5th percentile(11.5\u00b0C)] were 0.95 (95% CI: 0.90, 1.00), 1.08 (95% CI: 0.84, 1.4), 0.87 (95% CI: 0.71, 1.06), and 1.00 (95% CI: 0.94, 1.06) and greater for high temperature [95th percentile (24.5\u00b0C)]: 1.22 (95% CI: 1.16, 1.28), 1.27 (95% CI: 1.03, 1.57), and 1.26 (95% CI: 1.05, 1.5) and 1.05 (1.00, 1.11), respectively, for overall, extremely, very, and moderate-to-late sPTBs. While chronic exposure to PM<jats:sub>2.5<\/jats:sub> had adverse effects on sPTB, short-term exposure to PM<jats:sub>2.5<\/jats:sub> appeared to have a negative association with all types of sPTB, with hazard ratios ranging from 0.86 (95th CI: 0.80, 0.94) to 0.98 (95th CI: 0.97, 1.00) per 5 \u03bcg\/m<jats:sup>3<\/jats:sup> increase in PM<jats:sub>2.5<\/jats:sub>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Discussion<\/jats:title><jats:p>The risk of sPTB was found to increase following acute exposure to hot and cold ambient temperatures. Earlier sPTB subtypes seemed to be the most vulnerable. This study adds to the evidence that short-term exposure to ambient cold and heat and longer term gestational exposure to ambient PM<jats:sub>2.5<\/jats:sub> are associated with an elevated risk of sPTB.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fpubh.2023.1220797","type":"journal-article","created":{"date-parts":[[2023,12,1]],"date-time":"2023-12-01T09:37:35Z","timestamp":1701423455000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":18,"title":["Acute air pollution and temperature exposure as independent and joint triggers of spontaneous preterm birth in New South Wales, Australia: a time-to-event analysis"],"prefix":"10.3389","volume":"11","author":[{"given":"Tanya","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Jalaludin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shakoor","family":"Hajat","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey G.","family":"Morgan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrin","family":"Meissner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Kaldor","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Donna","family":"Green","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Jegasothy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2023,11,30]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"m3811","DOI":"10.1136\/bmj.m3811","article-title":"Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis","volume":"371","author":"Chersich","year":"2020","journal-title":"BMJ."},{"key":"B2","doi-asserted-by":"publisher","first-page":"144","DOI":"10.1016\/j.envres.2018.07.008","article-title":"Ambient air pollution and pregnancy outcomes: a comprehensive review and identification of environmental public health challenges","volume":"167","author":"Klepac","year":"2018","journal-title":"Environ Res."},{"key":"B3","doi-asserted-by":"publisher","first-page":"573","DOI":"10.1136\/oemed-2015-103086","article-title":"Prenatal ambient air pollution exposure and the risk of stillbirth: systematic review and meta-analysis of the empirical evidence","volume":"73","author":"Siddika","year":"2016","journal-title":"Occup Environ Med."},{"key":"B4","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.envres.2012.05.007","article-title":"Ambient air pollution, birth weight and preterm birth: a systematic review and meta-analysis","volume":"117","author":"Stieb","year":"2012","journal-title":"Environ Res."},{"key":"B5","doi-asserted-by":"publisher","first-page":"300","DOI":"10.1186\/s12884-015-0738-2","article-title":"The association between fine particulate matter exposure during pregnancy and preterm birth: a meta-analysis","volume":"15","author":"Sun","year":"2015","journal-title":"BMC Pregn Childbirth."},{"key":"B6","doi-asserted-by":"publisher","first-page":"700","DOI":"10.1016\/j.envpol.2017.02.066","article-title":"Temperature exposure during pregnancy and birth outcomes: an updated systematic review of epidemiological evidence","volume":"225","author":"Zhang","year":"2017","journal-title":"Environ Pollut."},{"key":"B7","doi-asserted-by":"publisher","first-page":"e37","DOI":"10.1016\/S2214-109X(18)30451-0","article-title":"Global, regional, and national estimates of levels of preterm birth in 2014: a systematic review and modelling analysis","volume":"7","author":"Chawanpaiboon","year":"2019","journal-title":"Lancet Global Health."},{"key":"B8","doi-asserted-by":"publisher","first-page":"2162","DOI":"10.1016\/S0140-6736(12)60820-4","article-title":"National, regional, and worldwide estimates of preterm birth rates in the year 2010 with time trends since 1990 for selected countries: a systematic analysis and implications","volume":"379","author":"Blencowe","year":"2012","journal-title":"Lancet."},{"key":"B9","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1046\/j.1471-0528.2003.00013.x","article-title":"Economic consequences of preterm birth and low birthweight","volume":"110","author":"Petrou","year":"2003","journal-title":"BJOG."},{"key":"B10","doi-asserted-by":"publisher","first-page":"247","DOI":"10.3109\/00016347709162009","article-title":"WHO: recommended definitions, terminology and format for statistical tables related to the per-inatal period and use of a new certificate for cause of perinatal deaths. 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