Zhu Zhenghong, Zhang Tuantuan, Benmarhnia Tarik, Chen Xin, Wang Huailin, Wulayin Maimaitiminjiang, Knibbs Luke D, Yang Song, Xu Lianlian, Huang Cunrui, Wang Qiong
School of Public Health, Sun Yat-sen University, Guangzhou, China.
School of Atmospheric Sciences, Sun Yat-sen University, Guangzhou, China; Southern Marine Science and Engineering Guangdong Laboratory, Zhuhai, China.
Lancet Planet Health. 2024 Dec;8(12):e997-e1009. doi: 10.1016/S2542-5196(24)00242-0.
Pregnant individuals are particularly susceptible to non-optimal temperatures due to their physiological status. Moreover, pregnancy is a crucial period for programming fetal health. Quantifying the impact of non-optimal temperature exposure and the contribution of anthropogenic climate change is crucial for mitigating and adapting to climate-related health risks. However, this has not been thoroughly studied in pregnant individuals in low-income and middle-income countries (LMICs).
Using data from 511 449 births across 31 LMICs from 1990 to 2018, we linked climate simulations (with and without anthropogenic forcing) to spatiotemporally resolved temperature data and birthweight records. We assessed the association between heat and cold exposure (ie, >90th and <10th percentile of temperature by region) during pregnancy and birthweight across different regions. We then used temperature simulations from both historically forced and natural-only forced climate models to estimate changes in exposure due to anthropogenic climate change and to quantify the burden of temperature-related low birthweight (ie, a birthweight <2500 g) attributable to anthropogenic climate change.
Heat exposure during pregnancy, compared with the optimal temperature range, was associated with an increased risk of low birthweight in several regions: southern Asia (odds ratio 1·41, 95% CI 1·34-1·48), western Africa (1·12, 1·02-1·24), and eastern Africa (1·40, 1·27-1·55). Cold exposure increased the risk of low birthweight in central Africa (1·31, 1·10-1·56), southern Africa (1·18, 1·02-1·36), and eastern Africa (1·14, 1·02-1·26). Anthropogenic climate change contributed to approximately 59·2% (95% CI 16·6-94·3), 89·0% (51·0-100·0), and 77·3% (27·0-100·0) of heat-related low birthweight cases in southern Asia, western Africa, and eastern Africa, respectively. Conversely, in regions where cold exposure was predominant, anthropogenic climate change reduced the burden of low birthweight.
Our study provides quantitative estimates of the contribution of anthropogenic climate change to the low birthweight burden in LMICs. These findings can inform strategies for climate mitigation and adaptation in LMICs and help reduce global health inequalities.
National Natural Science Foundation of China.
由于生理状态，孕妇特别容易受到非适宜温度的影响。此外，孕期是胎儿健康编程的关键时期。量化非适宜温度暴露的影响以及人为气候变化的作用对于减轻和适应与气候相关的健康风险至关重要。然而，在低收入和中等收入国家（LMICs）的孕妇中，这方面尚未得到充分研究。
利用1990年至2018年31个LMICs中511449例出生的数据，我们将气候模拟（有和无人为强迫）与时空分辨的温度数据及出生体重记录相联系。我们评估了孕期热暴露和冷暴露（即按地区划分温度的第90百分位数以上和第10百分位数以下）与不同地区出生体重之间的关联。然后，我们使用历史强迫和仅自然强迫气候模型的温度模拟，来估计由于人为气候变化导致的暴露变化，并量化人为气候变化导致的与温度相关的低出生体重（即出生体重<2500g）的负担。
与最佳温度范围相比，孕期热暴露在几个地区与低出生体重风险增加相关：南亚（优势比1.41，95%CI 1.34 - 1.48）、西非（1.12，1.02 - 1.24）和东非（1.40，1.27 - 1.55）。冷暴露在中非（1.31，1.10 - 1.56）、南非（1.18，1.02 - 1.36）和东非（1.14，1.02 - 1.26）增加了低出生体重风险。人为气候变化分别导致南亚、西非和东非与热相关的低出生体重病例的约59.2%（95%CI 16.6 - 94.3）、89.0%（51.0 - 100.0）和77.3%（27.0 - 100.0）。相反，在以冷暴露为主的地区，人为气候变化减轻了低出生体重的负担。
我们的研究提供了人为气候变化对LMICs低出生体重负担贡献的定量估计。这些发现可为LMICs的气候缓解和适应策略提供参考，并有助于减少全球健康不平等。
中国国家自然科学基金。
