Prenatal cold duration and childhood cognitive performance: Evidence from a multifaceted assessment of temperature...

Prenatal environmental stressors are critical determinants of later cognitive-related performance, yet the impact of multifaceted temperature anomalies remains under-explored.

Leveraging a quasi-experimental framework, this study investigated the associations between prenatal temperature exposure (frequency, variability, and intensity) and school-age cognitive performance using a nationally representative sample of 2219 children from the China Family Panel Studies (CFPS). We employed high-dimensional fixed-effects (HDFE) models to leverage within-region temporal variation in prenatal temperature anomalies while accounting for time-invariant regional characteristics and shared temporal shocks.

Among the examined temperature metrics, cold duration was the only metric significantly associated with mathematics scores; a 1-standard deviation (SD) (equal to 6.5 days) increase was associated with a 0.053 SD decrease in mathematics scores (P = 0.020), whereas no significant association was found for word-recognition scores. Furthermore, the pregnancy-window analysis suggested late pregnancy as a potentially sensitive developmental window. Sensitivity analyses, including comparisons with postnatal exposure windows, generally supported the prenatal specificity of the observed association.

Our findings support prenatal cold duration as a potentially overlooked environmental contributor to lower school-age mathematics performance, with late pregnancy appearing to be a potentially sensitive developmental window. These findings highlight maternal thermal protection during prolonged cold events as a relevant public health consideration.