妊娠期间环境温度低与不良出生结局的关联：系统评价和荟萃分析。
Association between low ambient temperature during pregnancy and adverse birth outcomes: A systematic review and meta-analysis.
机构信息
Department of Pediatrics, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610041, China.
Key Laboratory of Obstetrics and Gynecologic and Pediatric Diseases and Birth Defects of the Ministry of Education, Sichuan University, Chengdu, Sichuan 610041, China.
出版信息
Chin Med J (Engl). 2023 Oct 5;136(19):2307-2315. doi: 10.1097/CM9.0000000000002361.
BACKGROUND
Extreme temperature events, including extreme cold, are becoming more frequent worldwide, which might be harmful to pregnant women and cause adverse birth outcomes. We aimed to investigate the association between exposure to low ambient temperature in pregnant women and adverse birth outcomes, such as preterm birth, low birth weight, and stillbirth, and to summarize the evidence herein.
METHODS
Relevant studies were searched in PubMed, Cochrane, and Embase electronic databases until November 2021. Studies involving low ambient temperature, preterm birth, birth weight, and stillbirth were included. The guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses were followed to conduct this study risk of bias and methods for data synthesis.
RESULTS
A total of 34 studies were included. First, pregnant women exposed to low ambient temperature had an increased risk of preterm birth (risk ratio [RR] 1.08; 95% confidence interval [CI] 1.04-1.13). Subgroup analyses revealed that exposure during late pregnancy was more likely to induce preterm birth. In addition, only pregnant women exposed to <1st percentile of the mean temperature suffered increased risk of preterm birth. Moreover, pregnant women living in medium or hot areas were more prone to have preterm births than those in cold areas when exposed to low ambient temperatures. Asians and Blacks were more susceptible to low ambient temperatures than Caucasians. Second, pregnant women exposed to low ambient temperature had an increased risk of low birth weight (RR 1.07; 95% CI 1.03-1.12). Third, pregnant women had an increased risk of stillbirth while exposed to low ambient temperature during the entire pregnancy (RR 4.63; 95% CI 3.99-5.38).
CONCLUSIONS
Exposure to low ambient temperature during pregnancy increases the risk of adverse birth outcomes. Pregnant women should avoid exposure to extremely low ambient temperature (<1st percentile of the mean temperature), especially in their late pregnancy. This study could provide clues for preventing adverse outcomes from meteorological factors.
REGISTRATION
No. CRD42021259776 at PROSPERO ( https://www.crd.york.ac.uk/PROSPERO/ ).
背景
极冷等极端温度事件在全球范围内变得更加频繁，这可能对孕妇有害，并导致不良的出生结局。我们旨在研究孕妇暴露于低环境温度与早产、低出生体重和死产等不良出生结局之间的关联，并在此总结相关证据。
方法
在 PubMed、Cochrane 和 Embase 电子数据库中检索到 2021 年 11 月前的相关研究。纳入研究包括低环境温度、早产、出生体重和死产。本研究遵循系统评价和荟萃分析的首选报告项目指南进行了风险偏倚评估和数据综合方法。
结果
共纳入 34 项研究。首先，暴露于低环境温度的孕妇早产风险增加（风险比 [RR] 1.08；95%置信区间 [CI] 1.04-1.13）。亚组分析显示，妊娠晚期暴露更可能导致早产。此外，只有暴露于平均温度的第 1 百分位数以下的孕妇早产风险增加。此外，当暴露于低环境温度时，居住在中热地区的孕妇比居住在寒冷地区的孕妇更容易早产。与白种人相比，亚洲人和黑种人更容易受到低环境温度的影响。其次，暴露于低环境温度的孕妇低出生体重风险增加（RR 1.07；95% CI 1.03-1.12）。第三，孕妇在整个妊娠期间暴露于低环境温度时，死产风险增加（RR 4.63；95% CI 3.99-5.38）。
结论
妊娠期间暴露于低环境温度会增加不良出生结局的风险。孕妇应避免暴露于极低的环境温度（平均温度的第 1 百分位以下），尤其是在妊娠晚期。本研究可为预防气象因素所致不良结局提供线索。
注册
无。在 PROSPERO（https://www.crd.york.ac.uk/PROSPERO/ ）登记号为 CRD42021259776。
Zotero 插件