孕期母体环境温度暴露与胎盘重量、体积和胎盘灌注分数的关系：中国广州的一项出生队列研究。
Associations of maternal ambient temperature exposures during pregnancy with the placental weight, volume and PFR: A birth cohort study in Guangzhou, China.
机构信息
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China.
Gynecology Department, Guangdong Women and Children Hospital, Guangzhou 511442, China.
出版信息
Environ Int. 2020 Jun;139:105682. doi: 10.1016/j.envint.2020.105682. Epub 2020 Apr 2.
BACKGROUND
The placenta performs crucial functions to ensure normal fetal development. Experimental studies have indicated associations between exposure to elevated temperatures during pregnancy and reduction in placental weight and volume. However, epidemiological studies in humans are lacking.
OBJECTIVE
To estimate the associations between prenatal exposure to ambient temperature with placental weight, volume, and the placental weight to birth weight ratio (PFR).
METHODS
We conducted a prospective birth cohort study using the Prenatal Environment and Offspring Health Cohort (PEOH Cohort) beginning in 2016 in Guangzhou, China. Women in early pregnancy were recruited and followed up during their hospitalization for childbirth. An inverse distance-weighted method was employed to estimate the average temperature exposure of every 4 weeks as well as the trimester-specific average temperature exposure at the individual's residential address. A generalized linear model was applied to estimate the effects of temperature exposure during pregnancy on the placental weight, volume, and PFR.
RESULTS
A total of 4051 pregnant women were enrolled. Compared with the reference temperature of 20 °C, maternal exposure to 29 °C (95th centile) during late pregnancy was associated with an average of -6.03 g (95% confidence interval [CI]: -11.28 g, -0.78 g) in placental weight, -16.15 cm (95% CI: -26.24 cm, -6.07 cm) in placental volume, and 0.26 (95% CI: 0.07, 0.45) in PFR. The peak effects of high temperatures on placental weight, volume, and PFR were found from 29 to 32 weeks (β = -3.79 g, 95% CI: -8.39 g, 0.82 g), 37 to 40 weeks (β = -19.34 cm, 95% CI: -30.99 cm, -7.69 cm), and 25 to 28 weeks (β = 0.35, 95% CI: 0.04, 0.66), respectively.
CONCLUSIONS
Maternal exposure to elevated temperatures was associated with a decrease in placental weight and volume and an increase in PFR. The associations were stronger when exposures occurred during late pregnancy.
背景
胎盘在确保胎儿正常发育方面发挥着至关重要的作用。实验研究表明，孕妇在怀孕期间暴露于高温与胎盘重量和体积减少之间存在关联。然而，人类的流行病学研究尚缺乏。
目的
估计产前暴露于环境温度与胎盘重量、体积以及胎盘重量与出生体重比（PFR）之间的关联。
方法
我们于 2016 年在中国广州开展了一项前瞻性出生队列研究，即产前环境与后代健康队列（PEOH 队列）。在孕早期招募了女性，并在其住院分娩期间对其进行随访。采用逆距离加权法估算每 4 周的平均温度暴露以及个体住址的妊娠特定时期的平均温度暴露。应用广义线性模型估计怀孕期间的温度暴露对胎盘重量、体积和 PFR 的影响。
结果
共纳入了 4051 名孕妇。与 20°C 的参考温度相比，孕妇在妊娠晚期暴露于 29°C（第 95 百分位数）时，胎盘重量平均减少 6.03g（95%置信区间[CI]：-11.28g，-0.78g），胎盘体积平均减少 16.15cm（95%CI：-26.24cm，-6.07cm），PFR 增加 0.26（95%CI：0.07，0.45）。在妊娠 29 至 32 周（β=-3.79g，95%CI：-8.39g，0.82g）、妊娠 37 至 40 周（β=-19.34cm，95%CI：-30.99cm，-7.69cm）和妊娠 25 至 28 周（β=0.35，95%CI：0.04，0.66）时，高温对胎盘重量、体积和 PFR 的峰值效应最大。
结论
孕妇暴露于高温与胎盘重量和体积减少以及 PFR 增加有关。当暴露发生在妊娠晚期时，关联更强。
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