Ambient biothermal stress, preconceptional thyrotropin abnormalities, and the risk of preterm birth: a nationwide Chinese cohort study.

IF 15.7 1区综合性期刊 Q1 MULTIDISCIPLINARY SCIENCES

Nature Communications Pub Date : 2025-10-23 DOI:10.1038/s41467-025-64410-1

Xinghou He,Mengyao Li,Hongbing Xu,Bin Zhang,Xinyi Lv,Long Wang,Chuanyu Zhao,Xuyang Shan,Yuan He,Yan Fang,Yuanyuan Wang,Huiying Xu,Jihong Xu,Xiaoming Song,Ya Zhang,Hongguang Zhang,Ying Yang,Xu Ma,Wei Huang

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Abstract

Epidemiologic evidence on thermal stress and preterm birth (PTB) is based on ambient temperature rather than a biothermal metric. Thyrotropin abnormalities have been associated with PTB and may increase thermal vulnerability. However, it remains unknown whether thermal stress and thyrotropin abnormalities synergistically contribute to increased risk of PTB. Here we conducted a nationwide cohort study among 6,218,131 singleton live births in China. Biothermal stress was measured using the Universal Thermal Climate Index. We found that both heat stress and cold stress during each trimester were associated with increased risks of PTB, with hazard ratios ranging from 1.06 (95% confidence interval [CI]: 1.05, 1.07) to 2.33 (95% CI: 2.30, 2.35) and from 1.08 (95% CI: 1.07, 1.09) to 1.68 (95% CI:1.67, 1.70), respectively. Participants with subnormal (<0.37 mIU/L) or supranormal thyrotropin levels (≥4.88 mIU/L) and biothermal stress had higher risks of PTB, compared with those with normal thyrotropin levels and non-thermal stress. Additive interactions were also identified between biothermal stress and thyrotropin abnormalities. We estimated that up to 13.52% of PTB were attributable to biothermal stress and thyrotropin abnormalities. Our study showed a synergistic effect of biothermal stress and preconceptional thyrotropin abnormalities, highlighting the importance of climate adaption measures and thyroid management toward pregnant women under climate change scenario.

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环境热应激、孕前促甲状腺激素异常和早产风险：一项中国全国队列研究

热应激和早产（PTB）的流行病学证据是基于环境温度而不是生物热测量。促甲状腺激素异常与PTB有关，并可能增加热易感性。然而，尚不清楚热应激和促甲状腺激素异常是否会协同增加PTB的风险。在这里，我们对中国6218131名单胎活产婴儿进行了一项全国性的队列研究。采用通用热气候指数测量生物热应力。我们发现，每个孕期的热应激和冷应激都与PTB的风险增加有关，风险比分别为1.06（95%可信区间[CI]: 1.05, 1.07）至2.33 （95% CI: 2.30, 2.35）和1.08 （95% CI: 1.07, 1.09）至1.68 （95% CI:1.67, 1.70）。与正常促甲状腺素水平和非热应激的参与者相比，低于正常（<0.37 mIU/L）或异常促甲状腺素水平（≥4.88 mIU/L）和双热应激的参与者患PTB的风险更高。还确定了热应激和促甲状腺激素异常之间的相互作用。我们估计高达13.52%的PTB可归因于热应激和促甲状腺激素异常。我们的研究显示了生物热应激和孕前促甲状腺激素异常的协同效应，强调了气候变化情景下孕妇气候适应措施和甲状腺管理的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature Communications Biological Science Disciplines-

CiteScore

24.90

自引率

2.40%

发文量

6928

审稿时长

3.7 months

期刊介绍： Nature Communications, an open-access journal, publishes high-quality research spanning all areas of the natural sciences. Papers featured in the journal showcase significant advances relevant to specialists in each respective field. With a 2-year impact factor of 16.6 (2022) and a median time of 8 days from submission to the first editorial decision, Nature Communications is committed to rapid dissemination of research findings. As a multidisciplinary journal, it welcomes contributions from biological, health, physical, chemical, Earth, social, mathematical, applied, and engineering sciences, aiming to highlight important breakthroughs within each domain.