Curtin School of Population Health, Curtin University, Perth, Bentley, Western Australia, Australia.
Education, Culture, and Health Opportunities (ECHO) Ghana, ECHO Research Group International, Aflao, Ghana.
Environ Health Perspect. 2023 Dec;131(12):127017. doi: 10.1289/EHP12660. Epub 2023 Dec 27.
There is limited and inconsistent evidence on the risk of ambient temperature on small for gestational age (SGA) and there are no known related studies for large for gestational age (LGA). In addition, previous studies used temperature rather than a biothermal metric.
Our aim was to examine the associations and critical susceptible windows of maternal exposure to a biothermal metric [Universal Thermal Climate Index (UTCI)] and the hazards of SGA and LGA.
We linked 385,337 singleton term births between 1 January 2000 and 31 December 2015 in Western Australia to daily spatiotemporal UTCI. Distributed lag nonlinear models with Cox regression and multiple models were used to investigate maternal exposure to UTCI from 12 weeks preconception to birth and the adjusted hazard ratios (HRs) of SGA and LGA.
Relative to the median exposure, weekly and monthly specific exposures showed potential critical windows of susceptibility for SGA and LGA at extreme exposures, especially during late gestational periods. Monthly exposure showed strong positive associations from the 6th to the 10th gestational months with the highest hazard of 13% for SGA (; 95% CI: 1.10, 1.14) and 7% for LGA (; 95% CI: 1.03, 1.11) at the 10th month for the 1st UTCI centile. Entire pregnancy exposures showed the strongest hazards of 11% for SGA (; 95% CI: 1.04, 1.18) and 3% for LGA (; 95% CI: 0.95, 1.11) at the 99th UTCI centile. By trimesters, the highest hazards were found during the second and first trimesters for SGA and LGA, respectively, at the 99th UTCI centile. Based on estimated interaction effects, male births, mothers who were non-Caucasian, smokers, years of age, and rural residents were most vulnerable.
Both weekly and monthly specific extreme biothermal stress exposures showed potential critical susceptible windows of SGA and LGA during late gestational periods with disproportionate sociodemographic vulnerabilities. https://doi.org/10.1289/EHP12660.
关于环境温度对小于胎龄儿（SGA）的风险，目前的证据有限且不一致，而且对于大于胎龄儿（LGA），目前尚无相关研究。此外，之前的研究使用的是温度而不是生物热指标。
我们旨在检查母体暴露于生物热指标（通用热气候指数（UTCI））与 SGA 和 LGA 危险之间的关联和关键易感窗口。
我们将 2000 年 1 月 1 日至 2015 年 12 月 31 日期间西澳大利亚州的 385337 例单胎足月出生与每日时空 UTCI 相关联。使用 Cox 回归和多模型分布滞后非线性模型来研究从受孕前 12 周至出生期间母体暴露于 UTCI 的情况，以及 SGA 和 LGA 的调整后的危害比（HRs）。
与中位数暴露相比，每周和每月的特定暴露在极端暴露下显示出 SGA 和 LGA 的潜在关键易感窗口，尤其是在妊娠后期。从第六个月到第十个月，每月暴露与 SGA 的最高危险度为 13%（95%CI：1.10，1.14）和 LGA 的最高危险度为 7%（95%CI：1.03，1.11）有关，在第十个月时，第 1 UTCI 百分位数的危险度最高。整个孕期暴露的 SGA 最高危险度为 11%（95%CI：1.04，1.18）和 LGA 的最高危险度为 3%（95%CI：0.95，1.11），这两个指标均处于第 99 UTCI 百分位数。按三个月期划分，在第 99 UTCI 百分位数时，SGA 和 LGA 的最高危险度分别出现在第二个和第一个三个月期。基于估计的交互效应，男性出生、非白种人母亲、吸烟者、岁和农村居民的脆弱性最大。
每周和每月特定的极端生物热应激暴露都显示出在妊娠后期 SGA 和 LGA 的潜在关键易感窗口，且具有不成比例的社会人口学脆弱性。https://doi.org/10.1289/EHP12660.
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