Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case–crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0–6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval (CI) 1.01–1.78)). The estimates for stillbirths were similarly positive, but CIs included unity: OR = 1.29 (95% CI 0.95–1.77) for all stillbirths, OR = 1.18 (95% CI 0.71–1.95) for antepartum stillbirths and OR = 1.64 (95% CI 0.74–3.63) for intrapartum stillbirths. The cumulative exposure–response curve suggested that the steepest slopes for heat for intrapartum stillbirths and associations were stronger during the hottest seasons. We conclude that short-term heat exposure may increase mortality risks, particularly for intrapartum stillbirths, raising the importance of improved intrapartum care.

越来越多的证据表明，极端高温事件会影响孕妇及其婴儿，但很少有来自撒哈拉以南非洲的研究。使用来自贝宁、马拉维、坦桑尼亚和乌干达 138,015 家医院 16 例单胎分娩的数据，我们调查了极端高温与早期围产期死亡（包括产前和产时死产）以及出生后 24 小时内死亡之间的关联使用时间分层病例交叉设计。我们观察到分娩前 1 周平均温度从第 75 个百分位数增加到第 99 个百分位数（滞后 0-6 d）与围产期死亡率之间存在关联 （比值比 （OR） = 1.34 （95% 置信区间 （CI） 1.01-1.78））。死产的估计值同样为阳性，但置信区间包括一致性：所有死产的 OR = 1.29 （95% CI 0.95-1.77），产前死产的 OR = 1.18 （95% CI 0.71-1.95），产时死产的 OR = 1.64 （95% CI 0.74-3.63）。累积暴露-反应曲线表明，在最热的季节，产时死产和关联热的最陡斜率更强。我们得出结论，短期热暴露可能会增加死亡风险，尤其是产时死产，从而提高了改善产时护理的重要性。