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Elevated ambient temperatures and risk of neural tube defects
  1. Nathalie Auger1,2,
  2. William D Fraser3,
  3. Laura Arbour4,
  4. Marianne Bilodeau-Bertrand2,
  5. Tom Kosatsky5
  1. 1University of Montreal Hospital Research Centre, Montreal, Quebec, Canada
  2. 2Institut national de santé publique du Québec, Montreal, Quebec, Canada
  3. 3University of Sherbrooke Hospital Research Centre, Sherbrooke, Quebec, Canada
  4. 4Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
  5. 5National Collaborating Centre for Environmental Health, British Columbia Centre for Disease Control, Vancouver, British Columbia, Canada
  1. Correspondence to Dr Nathalie Auger, 190 Cremazie Boulevard East, Montreal, Quebec, Canada H2P 1E2; nathalie.auger{at}


Objectives The association between ambient heat and neural tube defects has received limited attention, despite imminent climate warming this century. We sought to determine the relationship between elevated outdoor temperatures during neurogenesis and risk of neural tube defects.

Methods We carried out a retrospective cohort study of 887 710 fetuses between 3 and 4 weeks postconception from the months of April through September for 1988–2012 in Quebec, Canada. The exposure was maximum daily temperature and the outcome presence of neural tube defects at delivery. We estimated prevalence ratios (PR) and 95% CIs for the association between maximum temperature and neural tube defects in log-binomial regression models adjusted for maternal characteristics.

Results Relative to 20°C, exposure to temperatures of 30°C was associated with risk of neural tube defects on day 5 (PR 1.56, 95% CI 1.04 to 2.35) and day 6 (PR 1.49, 95% CI 1.00 to 2.21) of the 4th week postconception, during the time of neural tube closure. The trend was apparent for spina bifida and anencephalus/encephalocoele, the main subtypes of neural tube defects. Temperature during the 3rd week postconception was not associated with neural tube defects.

Conclusions Elevated ambient temperatures may be weakly associated with risk of neural tube defects during tube closure.

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  • Contributors NA, MB-B and TK designed the study. NA and MB-B executed the study and analysed the data. All authors helped interpret the results. NA and MB-B drafted the first version of the manuscript. All authors revised the manuscript for critical intellectual content and discussion. NA, WDF and TK secured funding for the study, and NA is the guarantor.

  • Funding This work was supported by the Canadian Institutes of Health Research (grant number MOP-142277) and the Fonds de recherche du Québec-Santé (career award number 25128). The study sponsors were not involved in study conception, design, acquisition of data, analysis, interpretation of results, preparation of the manuscript or the decision to submit the paper for publication.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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