Institute of Medical Information, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Department of Environmental and Occupational Health, Joe C. Wen School of Population & Public Health, University of California, Irvine, California, USA.
Environ Health Perspect. 2024 Nov;132(11):117004. doi: 10.1289/EHP14783. Epub 2024 Nov 27.
Postpartum depression (PPD) has been associated with biological, emotional, social, and environmental factors. However, evidence regarding the effect of temperature on PPD is extremely limited.
We aimed to examine the associations between postpartum temperature exposure and PPD.
We conducted a retrospective cohort study using data from Kaiser Permanente Southern California electronic health records from 1 January 2008 through 31 December 2018. PPD was first assessed using the Edinburgh Postnatal Depression Scale (score ) during the first year of the postpartum period and further identified by using both diagnostic codes and prescription medications. Historical daily ambient temperatures were obtained from the resolution gridMET dataset (https://www.climatologylab.org/gridmet.html) and linked to participants' residential addresses at delivery. Postpartum temperature exposures were measured by calculating various temperature metrics during the period from delivery to PPD diagnosis date. A time-to-event approach with a discrete-time logistic regression was applied to estimate the association between temperature exposure and time to PPD. Effect modification by maternal characteristics and other environmental factors was examined.
There were 46,114 (10.73%) PPD cases among 429,839 pregnancies ( age y). Increased PPD risks were positively associated with exposure to higher mean temperature [adjusted odds ratio (aOR) per interquartile range increment: 1.07; 95% confidence interval (CI): 1.05, 1.09] and diurnal temperature range (; 95% CI: 1.06, 1.10); the associations were stronger for maximum temperature compared with minimum temperature. The temperature-related PPD risks were greater among African American, Asian, and Hispanic mothers and among mothers years of age compared with their counterparts. We also observed higher effects of temperature on PPD among mothers exposed to higher air pollution or lower green space levels and among mothers with lower air conditioning penetration rates.
Maternal exposure to higher temperature and diurnal temperature variability during the postpartum period was associated with an increased risk of PPD. Effect modification by maternal age, race/ethnicity, air pollution, green space, and air conditioning penetration was identified. https://doi.org/10.1289/EHP14783.
产后抑郁症（PPD）与生物、情绪、社会和环境因素有关。然而，关于温度对 PPD 影响的证据极其有限。
我们旨在研究产后体温暴露与 PPD 之间的关系。
我们使用 Kaiser Permanente Southern California 电子健康记录的数据进行了回顾性队列研究，数据时间范围为 2008 年 1 月 1 日至 2018 年 12 月 31 日。在产后第一年，使用爱丁堡产后抑郁量表（得分 ）首次评估 PPD，通过诊断代码和处方药物进一步确定 PPD。从分辨率格梅特数据集（https://www.climatologylab.org/gridmet.html）获取历史每日环境温度，并与分娩时参与者的居住地址相关联。在从分娩到 PPD 诊断日期的时间段内，通过计算各种温度指标来测量产后体温暴露。采用时间事件方法和离散时间逻辑回归来估计温度暴露与 PPD 发生时间之间的关系。检验了母体特征和其他环境因素的效应修饰作用。
在 429839 例妊娠中（年龄 y），有 46114 例（10.73%）患有 PPD。与暴露于较高平均温度（每四分位距增加的调整比值比：1.07；95%置信区间（CI）：1.05，1.09）和日较差（；95%CI：1.06，1.10）相比，PPD 风险呈正相关；与最低温度相比，最高温度的相关性更强。与年龄相仿的母亲相比，非裔美国人、亚洲人和西班牙裔母亲以及年龄较大的母亲，温度相关的 PPD 风险更高。我们还发现，在暴露于较高空气污染或较低绿地水平的母亲以及空调渗透率较低的母亲中，温度对 PPD 的影响更大。
产后期间母体暴露于较高温度和日较差与 PPD 风险增加有关。鉴定了母体年龄、种族/民族、空气污染、绿地和空调渗透率的效应修饰作用。https://doi.org/10.1289/EHP14783.
