Department of Environmental Health & Environment and Health Innovation Team, School of Public Health, Zhengzhou University, Zhengzhou, Henan, 450001, PR China.
National Health Commission Key Laboratory of Birth Defects Prevention, Henan Key Laboratory of Population Defects Prevention, Henan Institute of Reproduction Health Science and Technology, Zhengzhou, Henan, 450002, PR China.
Environ Res. 2021 Oct;201:111545. doi: 10.1016/j.envres.2021.111545. Epub 2021 Jun 24.
A number of studies have explored the association between ambient temperature and preterm birth (PTB), but rarely among adolescent mothers.
To estimate the effects of ambient temperature on the risk of PTB and gestational age of newborns delivered by adolescent mothers in rural areas of Henan province.
We obtained 5394 medical records of adolescent mothers with results of pre-pregnancy physical examination and pregnancy outcomes from the National Free Preconception Health Examination Project (NFPHEP) in Henan province. Meteorological information was obtained from the China Meteorological Data Sharing Service System. Individual exposure levels were evaluated with an inverse distance-weighted model. A multiple logistic regression model and multiple linear regression model were used to estimate the effects of ambient temperature on the risk of PTB and gestational age, respectively. Stratified and interaction analyses were also performed.
Of newborns in this study, 3.45% (186/5394) were PTB. Mean, maximum and minimum temperature during the entire pregnancy, especially the last 1-4 weeks of pregnancy, were positively associated with the risk of PTB and negatively associated with gestational age (P < 0.05). Nevertheless, a masking effect was observed that gestational age was positively associated with ambient temperature during the first trimester of pregnancy, due to the strongly inverse correlation between ambient temperature during the early and late stages of pregnancy. Stratified analyses showed that increasing temperature during the last 1-4 weeks of pregnancy increased the risk of PTB and decreased gestational age in newborns born in the cold season (P < 0.05). Furthermore, interaction analyses showed that birth season modified the effects of temperature on the gestational age (P < 0.10).
Elevated ambient temperature can decrease gestational age and increase the risk of PTB in offspring of adolescent mothers in rural areas. The birth season may modify the effects of temperature on gestational age.
已有多项研究探讨了环境温度与早产（PTB）之间的关联，但很少涉及青少年母亲。
评估环境温度对河南省农村地区青少年母亲分娩的早产儿（PTB）风险和新生儿胎龄的影响。
我们从河南省国家免费孕前健康检查项目（NFPHEP）中获取了 5394 名青少年母亲的孕前体检结果和妊娠结局的医疗记录。气象信息来自中国气象数据共享服务系统。采用反距离加权模型评估个体暴露水平。采用多因素逻辑回归模型和多元线性回归模型分别估计环境温度对 PTB 风险和胎龄的影响，并进行分层和交互作用分析。
在本研究中，新生儿的早产率为 3.45%（186/5394）。整个孕期、尤其是妊娠最后 1-4 周的平均、最高和最低温度与 PTB 风险呈正相关，与胎龄呈负相关（P<0.05）。然而，由于妊娠早期和晚期环境温度之间存在强烈的负相关关系，妊娠早期环境温度与胎龄呈正相关，因此存在掩蔽效应。分层分析显示，妊娠最后 1-4 周内温度升高会增加寒冷季节新生儿 PTB 风险并降低其胎龄（P<0.05）。此外，交互作用分析表明，出生季节会改变温度对胎龄的影响（P<0.10）。
环境温度升高会降低农村地区青少年母亲后代的胎龄并增加其 PTB 风险。出生季节可能会改变温度对胎龄的影响。
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