Preterm birth (PTB) is the leading cause of infant mortality worldwide. Changes in PTB rates, ranging from −90% to +30%, were reported in many countries following early COVID-19 pandemic response measures (‘lockdowns’). It is unclear whether this variation reflects real differences in lockdown impacts, or perhaps differences in stillbirth rates and/or study designs. Here we present interrupted time series and meta-analyses using harmonized data from 52 million births in 26 countries, 18 of which had representative population-based data, with overall PTB rates ranging from 6% to 12% and stillbirth ranging from 2.5 to 10.5 per 1,000 births. We show small reductions in PTB in the first (odds ratio 0.96, 95% confidence interval 0.95–0.98, P value <0.0001), second (0.96, 0.92–0.99, 0.03) and third (0.97, 0.94–1.00, 0.09) months of lockdown, but not in the fourth month of lockdown (0.99, 0.96–1.01, 0.34), although there were some between-country differences after the first month. For high-income countries in this study, we did not observe an association between lockdown and stillbirths in the second (1.00, 0.88–1.14, 0.98), third (0.99, 0.88–1.12, 0.89) and fourth (1.01, 0.87–1.18, 0.86) months of lockdown, although we have imprecise estimates due to stillbirths being a relatively rare event. We did, however, find evidence of increased risk of stillbirth in the first month of lockdown in high-income countries (1.14, 1.02–1.29, 0.02) and, in Brazil, we found evidence for an association between lockdown and stillbirth in the second (1.09, 1.03–1.15, 0.002), third (1.10, 1.03–1.17, 0.003) and fourth (1.12, 1.05–1.19, <0.001) months of lockdown. With an estimated 14.8 million PTB annually worldwide, the modest reductions observed during early pandemic lockdowns translate into large numbers of PTB averted globally and warrant further research into causal pathways.

The climate-violence relationship has been debated for decades, and yet most of the supportive evidence came from ecological or cross-sectional analyses with very limited long-term exposure data. We conducted an individual-level, longitudinal study to investigate the association between ambient temperature and externalizing behaviors of urban-dwelling adolescents. Participants (n = 1,287) of the Risk Factors for Antisocial Behavior Study were examined in 2000–2012 (aged 9–18 years) with repeated assessments of their externalizing behaviors (aggression; delinquency). Ambient temperature data were obtained from the local Meteorological Information System. In adjusted multi-level models, aggressive behaviors significantly increased with rising average temperatures (per 1°C-increment) in preceding 1–3 years (β = 0.23, 95% CI: 0.00, 0.46; β = 0.35, 95% CI: 0.06, 0.63; β = 0.41, 95% CI: 0.08, 0.74; respectively), equivalent to 1.5–3 years of delay in age-related behavioral maturation. These associations were slightly stronger among girls and families of lower socioeconomic status, but greatly diminished in neighborhoods with higher greenspace. No significant associations were found with delinquency. Our study provides the first individual-level epidemiologic evidence supporting the adverse association of long-term ambient temperature and aggression. Similar approaches to studying meteorology and violent crimes may further inform scientific debates on climate change and collective violence.