Short-term effects of ambient temperature on the risk of preeclampsia in Nanjing, China: a time-series analysis

Abstract

ObjectivesPrevious studies on the association between temperature and preeclampsia mainly considered temperature on a monthly or seasonal time scale. The objective of this study was to assess the preeclampsia risk associated with short-term temperature exposure using daily data.Study designDaily preeclampsia hospitalization data, daily meteorological data and daily air pollutant data from Nanjing were collected from 2016 to 2017. Both the T test and distributed lag nonlinear model (DLNM) were applied to assess the short-term effect of temperature on preeclampsia risk. Three kinds of daily temperature, including the daily mean temperature, daily minimum temperature and daily maximum temperature, were analysed.ResultsWhen the daily number of preeclampsia hospital admissions was divided into two subgroups based on temperature, it was significantly larger on cold days than on hot days. Regarding the mean temperature, a very low level of mean temperature (4.5 °C, lag = 0–20) and a low level of mean temperature (9.1 °C, lag = 0–20) increased the cumulative relative risk of preeclampsia by more than 60%. At the same time, a very high level of mean temperature (28.7 °C, lags = 0–10, 0–15, 0–20) and a high level of mean temperature (24.1 °C, lags = 0–10, 0–15) decreased the cumulative relative risk of preeclampsia by more than 35%. At a minimum temperature, a very low level of minimum temperature (0.9 °C, lag 0–5) and a low level of minimum temperature (5.6 °C, lag 0–5) increased the cumulative relative risk of preeclampsia by more than 55%. At the same time, a high level of mean temperature (20.9 °C, lags = 0, 0–5) decreased the cumulative relative risk of preeclampsia by more than 20%. The maximum temperature result was similar to the mean temperature result.ConclusionsBoth direct and lag effects of low temperature on preeclampsia were demonstrated to be significant risk factors. These results could be used to help pregnant women and the government reduce preeclampsia risk.