Association of Ambient Temperature at Delivery with Selected Adverse Pregnancy and Neonatal Outcomes: A Hospital-Based Cross-Sectional Study from Western India

Abstract

Background:
Pregnancy-related physiological changes may increase vulnerability to environmental stressors, including extremes of ambient temperature. Short-term thermal exposure around delivery has been associated with adverse birth outcomes, but evidence from western India remains limited.

Methods:
A hospital-based cross-sectional study was conducted among 1,346 institutional deliveries at a tertiary care center in Gujarat, India. Ambient mean temperature on the day of delivery was obtained from official meteorological records and categorized as <25°C, 25–30°C, and >30°C. Maternal and neonatal data were extracted from hospital records. Outcomes assessed included preterm birth, low birth weight, stillbirth, intrauterine fetal death (IUFD), congenital anomalies, and neonatal intensive care unit (NICU) admission. Associations were assessed using the chi-square test. Multivariable logistic regression was performed to evaluate the independent association between ambient temperature and preterm birth. A p-value <0.05 was considered statistically significant.

Results:
A total of 1,346 deliveries were analyzed. Preterm birth occurred in 20.3% of cases and showed a significant association with increasing ambient temperature. The highest rates of preterm birth, stillbirth, intrauterine death, and NICU admission were observed at temperatures >30°C (p < 0.05). Multivariable analysis demonstrated that higher ambient temperature was independently associated with increased odds of preterm birth, while maternal age, residence, antenatal care visits, and maternal complications were not significantly associated.

Conclusion:
Higher ambient temperature at delivery, particularly above 30°C, was associated with adverse pregnancy and neonatal outcomes, especially preterm birth and NICU admission. These findings highlight the importance of temperature-sensitive peripartum care in regions experiencing high ambient temperatures.