Background: Although future climate is predicted to have more extreme heat conditions, the available evidence on the impact of these conditions on pregnancy length is very scarce and inconclusive.

Objectives: We investigated the impact of maternal short-term exposure to extreme ambient heat on the length of pregnancy.

Methods: This study was based on a cohort of births that occurred in a major university hospital in Barcelona during 2001–2005. Three indicators of extreme heat conditions based on 1-day exposure to an unusually high heat–humidity index were applied. Each mother was assigned the measures made by the meteorological station closest to maternal residential postcodes. A two-stage analysis was developed to quantify the change in pregnancy length after maternal exposure to extreme heat conditions adjusted for a range of covariates. The second step was repeated for lags 0 (delivery date) to 6 days.

Results: We included data from 7,585 pregnant women in our analysis. We estimated a 5-day reduction in average gestational age at delivery after an unusually high heat–humidity index on the day before delivery.

Conclusion: Extreme heat was associated with a reduction in the average gestational age of children delivered the next day, suggesting an immediate effect of this exposure on pregnant women. Further studies are required to confirm our findings in different settings.