Basu Rupa, Chen Hong, Li De-Kun, Avalos Lyndsay A
California Office of Environmental Health Hazard Assessment, Air and Climate Epidemiology Section, Oakland, CA, United States.
Kaiser Permanente Northern California, Division of Research, Oakland, CA, United States.
Environ Res. 2017 Apr;154:109-114. doi: 10.1016/j.envres.2016.12.017. Epub 2017 Jan 3.
Few studies have examined maternal modifiers of temperature and adverse birth outcomes because of lack of data. We assessed the relationship between apparent temperature, preterm delivery (PTD) and maternal demographics, medical and mental health conditions, and behaviors.
A time-stratified case-crossover analysis was conducted using 14,466 women who had a PTD (20 to less than 37 gestational weeks) from 1995 to 2009 using medical records from a large health maintenance organization in Northern California. Effect modifiers considered by stratification included several maternal factors: age, race/ethnicity, depression, hypertension, diabetes, smoking, alcohol use, pre-pregnancy body mass index, and Medicaid status. Apparent temperature data for women who had a monitor located within 20km of their residential zip codes were included. All analyses were stratified by warm (May 1 through October 31) and cold (November 1 through April 30) seasons.
For every 10°F (5.6°C) increase in average cumulative weekly apparent temperature (lag06), a greater risk was observed for births occurring during the warm season (11.63%; 95% CI: 4.08, 19.72%) compared to the cold season (6.18%; -2.96, 16.18%), especially for mothers who were younger, Black, Hispanic, underweight, smoked or consumed alcohol during pregnancy, or had pre-existing /gestational hypertension, diabetes, or pre-eclampsia.
Our findings suggest that warmer apparent temperatures exacerbate the risk of PTD, particularly for subgroups of more vulnerable women.
由于缺乏数据，很少有研究探讨温度的母体调节因素与不良出生结局之间的关系。我们评估了体感温度、早产（PTD）与孕产妇人口统计学特征、医疗和心理健康状况以及行为之间的关系。
采用时间分层病例交叉分析，利用加利福尼亚北部一个大型健康维护组织的医疗记录，对1995年至2009年期间14466例早产（妊娠20至不足37周）的女性进行研究。分层考虑的效应修饰因素包括几个母体因素：年龄、种族/族裔、抑郁症、高血压、糖尿病、吸烟、饮酒、孕前体重指数和医疗补助状态。纳入居住邮政编码20公里范围内安装了监测器的女性的体感温度数据。所有分析按暖季（5月1日至10月31日）和冷季（11月1日至4月30日）分层。
平均每周累积体感温度每升高10°F（5.6°C）（滞后06），与冷季（6.18%；-2.96，16.18%）相比，暖季出生的风险更高（11.63%；95%CI：4.08，19.72%），尤其是年龄较小、黑人、西班牙裔、体重过轻、孕期吸烟或饮酒、或患有慢性/妊娠期高血压、糖尿病或先兆子痫的母亲。
我们的研究结果表明，较高的体感温度会增加早产风险，尤其是对更脆弱的女性亚组。
