Shah Aashna Pranav, Achilleos Souzana, Wang Veronica A, Leung Michael, Weisskopf Marc G, Kyprianou Theopisti, Koutrakis Petros, Papatheodorou Stefania
Department of Environmental Health, Harvard T.H. Chan School of Public Health, 677 Huntington Ave, Boston, MA, 02115, USA.
Department of Primary Care and Population Health, University of Nicosia Medical School, 93 Agiou Nikolaou Street, Engomi, 2408, Nicosia, Cyprus.
J Expo Sci Environ Epidemiol. 2025 May 22. doi: 10.1038/s41370-025-00781-3.
While ambient climatic factors are linked to adverse pregnancy outcomes, only a few studies examine the risk of pregnancy loss.
This study aims to examine the effects of climatic factors on pregnancy loss in Nicosia, Cyprus, an area that is highly affected by climate change.
Birth registry data obtained from maternity units in Nicosia from 2014-2019 were linked with daily meteorological and traffic pollution data (minimum and maximum temperature, °C; relative humidity [RH], %; and nitrogen dioxide [NO], μg/m). We also estimated other climatic factors from the obtained data (mean weekly temperature, standard deviation of weekly temperature and RH [temperature and RH variability], and heat index [HI]). We used a novel variation of time-series design and distributed lag models adjusting for secular trends and air pollution to explore the association between climatic factors and weekly live-birth identified conceptions (LBICs), to indirectly estimate pregnancy losses.
There were 26,382 live births over the study period, with an average weekly LBICs of 84.7( ± 12.2). We found an association between exposure to higher temperature between gestation weeks 0-9 and pregnancy loss, with the strongest association in weeks 0-1. Specifically, for a 5°C increase in mean week 0-1 temperature, 3.17 (95% Confidence Interval [CI]: 1.06-5.28) additional conceptions would result in pregnancy losses. A similar effect during early pregnancy was found for exposure to minimum and maximum temperature, HI, and RH. Furthermore, we found that temperature variability may have an impact in later weeks during pregnancy, with the strongest estimate in week 26 (6.70 [95% CI: 0.78-13.21] losses per 5 °C increase in standard deviation of weekly temperature). Similar results were observed for RH variability.
This research investigates the link between climatic factors and pregnancy loss in Nicosia, Cyprus, a region experiencing rising temperatures and humidity levels. By analyzing live birth data using a novel time-series approach, the study finds that higher temperatures and humidity levels are associated with increased pregnancy loss, particularly in early gestation. These findings underscore the need for targeted public health interventions, such as heat warning systems, to mitigate the impact of climate change on vulnerable populations. As climate change escalates, understanding these associations is crucial for developing effective strategies to protect maternal and fetal health.
虽然环境气候因素与不良妊娠结局有关，但仅有少数研究探讨了妊娠丢失的风险。
本研究旨在考察气候因素对塞浦路斯尼科西亚妊娠丢失的影响，该地区受到气候变化的严重影响。
将2014年至2019年从尼科西亚产科单位获得的出生登记数据与每日气象和交通污染数据（最低和最高温度，°C；相对湿度[RH]，%；以及二氧化氮[NO]，μg/m）相链接。我们还从获得的数据中估算了其他气候因素（每周平均温度、每周温度和RH的标准差[温度和RH变异性]以及热指数[HI]）。我们使用了一种时间序列设计的新颖变体和分布滞后模型，对长期趋势和空气污染进行调整，以探讨气候因素与每周活产确认妊娠（LBICs）之间的关联，从而间接估算妊娠丢失情况。
在研究期间共有26382例活产，平均每周LBICs为84.7（±12.2）。我们发现妊娠0至9周期间暴露于较高温度与妊娠丢失之间存在关联，在第0至1周关联最强。具体而言，第0至1周平均温度每升高5°C，会导致3.17（95%置信区间[CI]：1.06 - 5.28）例额外妊娠发生妊娠丢失。在妊娠早期，暴露于最低和最高温度、HI及RH时也发现了类似效应。此外，我们发现温度变异性可能在妊娠后期几周产生影响，在第26周估计效应最强（每周温度标准差每增加5°C，有6.70 [95% CI：0.78 - 13.21]例丢失）。对于RH变异性也观察到了类似结果。
本研究调查了塞浦路斯尼科西亚气候因素与妊娠丢失之间的联系，该地区气温和湿度水平不断上升。通过使用新颖的时间序列方法分析活产数据，研究发现较高的温度和湿度水平与妊娠丢失增加有关，尤其是在妊娠早期。这些发现强调了有针对性的公共卫生干预措施的必要性，如高温预警系统，以减轻气候变化对脆弱人群的影响。随着气候变化加剧，了解这些关联对于制定保护母婴健康的有效策略至关重要。
