Division of Pulmonary Medicine, Department of Pediatrics, The University of Texas Health Science Center, McGovern Medical School, Houston, Texas, USA.
Curr Opin Pediatr. 2023 Jun 1;35(3):344-349. doi: 10.1097/MOP.0000000000001241. Epub 2023 Mar 28.
To date, there is no evidence that humanity will implement appropriate mitigation measures to avoid the catastrophic impact of climate change on the planet and human health. Vulnerable populations such as pregnant women and children will be the most affected. This review highlights epidemiologic data on climate change-related prenatal environmental exposures affecting the fetus and children's respiratory health.
Research on outcomes of prenatal exposure to climate change-related environmental changes and pediatric pulmonary health is limited. In addition to adverse pregnancy outcomes known to affect lung development, changes in lung function, increased prevalence of wheezing, atopy, and respiratory infections have been associated with prenatal exposure to increased temperatures, air pollution, and maternal stress. The mechanisms behind these changes are ill-defined, although oxidative stress, impaired placental functioning, and epigenetic modifications have been observed. However, the long-term impact of these changes remains unknown.
The detrimental impact of the climate crisis on pediatric respiratory health begins before birth, highlighting the inherent vulnerability of pregnant women and children. Research and advocacy, along with mitigation and adaptation measures, must be implemented to protect pregnant women and children, the most affected but the least responsible for the climate crisis.
综述目的:迄今为止,尚无证据表明人类将采取适当的缓解措施来避免气候变化对地球和人类健康造成的灾难性影响。孕妇和儿童等弱势群体将受到最严重的影响。本综述重点介绍了与气候变化相关的产前环境暴露对胎儿和儿童呼吸道健康影响的流行病学数据。
最近的发现:与产前暴露于气候变化相关的环境变化和儿科肺部健康相关的研究结果有限。除了已知会影响肺部发育的不良妊娠结局外,还发现与气温升高、空气污染和母体压力有关的肺功能变化、喘息增加、特应性和呼吸道感染与产前暴露有关。尽管已经观察到氧化应激、胎盘功能障碍和表观遗传修饰等,但这些变化背后的机制仍不清楚。然而,这些变化的长期影响仍不清楚。
总结:气候危机对儿科呼吸道健康的有害影响始于出生前,突出了孕妇和儿童固有的脆弱性。必须开展研究和宣传工作,并采取缓解和适应措施,以保护孕妇和儿童,他们是受影响最严重但对气候危机最不负责的人群。