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

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 () and Wei Huang ()
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Xinghou He: Peking University
Mengyao Li: Peking University
Hongbing Xu: Peking University
Bin Zhang: Peking University
Xinyi Lv: National Research Institute for Family Planning
Long Wang: Lanzhou University
Chuanyu Zhao: National Research Institute for Family Planning
Xuyang Shan: Peking University
Yuan He: National Research Institute for Family Planning
Yan Fang: Peking University
Yuanyuan Wang: National Research Institute for Family Planning
Huiying Xu: Peking University
Jihong Xu: National Research Institute for Family Planning
Xiaoming Song: Peking University
Ya Zhang: National Research Institute for Family Planning
Hongguang Zhang: National Research Institute for Family Planning
Ying Yang: National Research Institute for Family Planning
Xu Ma: National Research Institute for Family Planning
Wei Huang: Peking University

Nature Communications, 2025, vol. 16, issue 1, 1-12

Abstract: 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 (

Date: 2025
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DOI: 10.1038/s41467-025-64410-1

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