环境温度对不良妊娠结局的影响：中国福州的一项出生队列研究。

Impact of ambient temperature on adverse pregnancy outcomes: a birth cohort study in Fuzhou, China.

机构信息

Fujian Center for Prevention and Control of Occupational Diseases and Chemical Poisoning, Fuzhou, Fujian, China.

Department of Preventive Medicine, School of Public Health, Fujian Medical University, Fuzhou, Fujian, China.

出版信息

Front Public Health. 2023 Jul 6;11:1183129. doi: 10.3389/fpubh.2023.1183129. eCollection 2023.

DOI:10.3389/fpubh.2023.1183129

PMID:37483924

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10359494/

Abstract

BACKGROUND

Previous studies have identified a series of specific adverse pregnancy outcomes (APOs) linked with temperature extremes. Most of them focus on preterm birth, low birth weight, and stillbirth. Other possible adverse outcomes were under-researched. This study aimed to investigate the impact of ambient temperature on maternal complications, white blood cell count (WBC), newborn hearing, and neonatal jaundice.

METHODS

A total of 418 participants were recruited from Fuzhou Maternity & Child Healthcare Hospital in 2016. Participants were invited to fill out a structured questionnaire. The gridded near-surface air temperatures at a resolution of 0.1°* 0.1° for Fuzhou were extracted from a published dataset. Meteorological data and PM were extracted based on participants' residential addresses using R packages "ncdf4" and "raster." Multivariate logistic regression models were used to quantify the effects of ambient temperature on APOs after controlling for confounders.

RESULTS

Overall, there were 107 APOs, accounting for 25.6% of all participants. Every 1°C increase in mean temperature was associated with a 10.0% increase in APOs (aOR = 1.100, 95%CI 1.006-1.203) during the period of early pregnancy. However, negative associations were observed in the middle pregnancy period, and a 1°C increase in mean temperature was associated 8.8% decrease in APOs (aOR = 0.912, 95%CI 0.846-0.982). Diurnal temperature variation had a significant impact on APOs in the third trimester. Infant jaundice was negatively associated with temperature exposure in the middle and late pregnancy periods. The risk of neonatal jaundice increased at lag weeks 2-9 in the first trimester, with the greatest lagged effect (aOR = 1.201, 95%CI 1.020-1.413) observed at lag week 3. A 1°C increase in mean temperature led to a 29.6% (aOR = 1.296, 95%CI 1.019-1.649) increase in high WBC. A 1°C increase in temperature variation was associated with more than two times (aOR = 2.469, 95%CI 1.001-6.089) increase of high WBC in the first trimester and about five times (aOR = 4.724, 95%CI 1.548-14.409) increase in the third trimester.

CONCLUSION

Ambient temperature affects neonatal jaundice, newborn hearing loss, and infections during pregnancy. In addition to the identified epidemiologic link and susceptible exposure windows, there is a need to understand the underlying biological mechanisms for better recommendations for climate change adaptation policies.

摘要

背景

先前的研究已经确定了一系列与极端温度相关的特定不良妊娠结局 (APO)。其中大多数都集中在早产、低出生体重和死胎上。其他可能的不良结局研究较少。本研究旨在调查环境温度对产妇并发症、白细胞计数 (WBC)、新生儿听力和新生儿黄疸的影响。

方法

2016 年，共从福州妇幼保健院招募了 418 名参与者。邀请参与者填写一份结构化问卷。从已发表的数据集中提取了分辨率为 0.1°* 0.1°的福州近地表空气温度网格数据。使用 R 包“ncdf4”和“raster”，根据参与者的居住地址提取气象数据和 PM。在控制混杂因素后，使用多变量逻辑回归模型来量化环境温度对 APO 的影响。

结果

总体而言，有 107 例 APO，占所有参与者的 25.6%。在妊娠早期，平均温度每升高 1°C，APO 增加 10.0%（aOR=1.100，95%CI 1.006-1.203）。然而，在妊娠中期观察到负相关，平均温度升高 1°C，APO 减少 8.8%（aOR=0.912，95%CI 0.846-0.982）。日温差对妊娠晚期的 APO 有显著影响。婴儿黄疸与妊娠中期和晚期的温度暴露呈负相关。在妊娠早期，第 2-9 周的滞后周数与新生儿黄疸的风险增加有关，第 3 周的滞后效应最大（aOR=1.201，95%CI 1.020-1.413）。平均温度升高 1°C，WBC 升高 29.6%（aOR=1.296，95%CI 1.019-1.649）。温度变化增加 1°C，与妊娠早期 WBC 升高超过两倍（aOR=2.469，95%CI 1.001-6.089）和妊娠晚期升高约五倍（aOR=4.724，95%CI 1.548-14.409）有关。