Projecting future disease and economic burdens of heatwave-related preterm birth in China under different climate...

The increasing frequency of heatwaves poses significant risks for preterm birth (PTB). However, the extent of the disease and economic burdens attributable to heatwave-related PTB in China remains uncertain.

We defined a heatwave event as two or more consecutive days in which the daily maximum temperature exceeded the 90th percentile during 1995-2014, and estimated the burdens of heatwave-related PTB under different Shared Socioeconomic Pathway (SSP) scenarios, including cases, deaths, disability-adjusted life years (DALY), and the value of a statistical life (VSL) from 2015 to 2100, at the city level in China.

The number of heatwave-related PTBs showed a fluctuating upward trend from 2015 to 2100 under three SSP scenarios. By the 2090 s, heatwave-related PTB cases per million births are estimated at 2,314.64 (95 %CI: 1,112.30, 3,518.23), 4,335.15 (95 %CI: 2,651.81, 6,020.31) and 5,217.16 (95 %CI: 3,606.26, 6,829.17) under SSP126, SSP370 and SSP585 scenarios, respectively. From the 2020 s to 2090 s, the number of attributable deaths in infants under 1 year is projected to decrease from 19.91 (95 % CI: 11.37, 28.32) to 6.58 (95 % CI: 4.61, 8.51) thousand under SSP585 scenario. Attributable DALY rate is projected to increase after 2023, with DALY mainly in the Sichuan Basin and the Beijing-Tianjin-Hebei Urban Agglomeration. Population-adjusted attributable VSL is projected to increase before the 2040s and then stabilize under SSP126 and SSP370, while showing a sustainedly increasing trend during the 2000s-2090s under SSP585.

Heatwaves would impose a significant disease burden from PTB and translate into substantial economic burden, particularly under higher emission scenarios.