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受孕季节与孕产妇及围产期健康之间的关联:一项前瞻性出生队列研究。

Associations between season of conception and maternal and perinatal health: a prospective birth cohort study.

作者信息

Li Qingxiu, Miao Yecheng, Chen Jiayi, Zhang Qian, Sun Bin, Wu Zhengqin, Liu Junwei, Shi Huimin, Gao Haiyan, Li Wei, Liu Wenjuan, Zhu Yibing, Li Haibo

机构信息

Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, China.

Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China.

出版信息

J Glob Health. 2025 Sep 1;15:04243. doi: 10.7189/jogh.15.04243.

Abstract

BACKGROUND

Global maternal health progress stagnated during the Sustainable Development Goal era, while the impact of meteorological conditions on maternal-infant outcomes remains contentious. We aimed to investigate the relationship between the season of conception and adverse perinatal outcomes.

METHODS

We conducted a prospective cohort study, collecting basic demographic characteristics of pregnant women and estimating the season of conception based on the date of the last menstrual period. We did a follow-up until delivery to monitor pregnancy health issues, such as gestational diabetes mellitus (GDM), gestational hypertension (GH), premature rupture of membranes (PROM), and postpartum haemorrhage (PPH), as well as neonatal health indicators such as birth weight and other relevant outcomes.

RESULTS

We included data from 26 341 pregnant women in our analysis. The average age of pregnant women was 30.3 years (standard deviation (SD) = 4.0), and 60.9% were primiparas. Compared to conception in spring (reference group), conception in summer was associated with a 15% reduction in GDM risk (odds ratio (OR) = 0.85; 95% confidence interval (CI) = 0.77-0.94) and a 10% lower PROM risk (OR = 0.90; 95% CI = 0.82-0.99), but a 46% increased PPH risk (OR = 1.46; 95% CI = 1.07-1.99). Conceptions in autumn and winter demonstrated even more pronounced protective effects, with the former showing a GDM risk reduction of 23% (OR = 0.77; 95% CI = 0.70-0.85) and 26% lower GH risk (OR = 0.74; 95% CI = 0.61-0.90), and the latter a 14% GDM risk reduction (OR = 0.86; 95% CI = 0.79-0.94) and 20% lower GH risk (OR = 0.80; 95% CI = 0.68-0.96).

CONCLUSIONS

We found that conception in spring was associated with an increased risk of GDM, GH, and PROM, while conception in summer was linked to a higher risk of PPH. However, the preliminary nature of our findings suggests that further research is needed to confirm causality and assess the feasibility of any potential interventions.

摘要

背景

在可持续发展目标时代,全球孕产妇健康进展停滞不前,而气象条件对母婴结局的影响仍存在争议。我们旨在研究受孕季节与不良围产期结局之间的关系。

方法

我们进行了一项前瞻性队列研究,收集孕妇的基本人口统计学特征,并根据末次月经日期估算受孕季节。我们进行随访直至分娩,以监测妊娠健康问题,如妊娠期糖尿病(GDM)、妊娠期高血压(GH)、胎膜早破(PROM)和产后出血(PPH),以及新生儿健康指标,如出生体重和其他相关结局。

结果

我们在分析中纳入了26341名孕妇的数据。孕妇的平均年龄为30.3岁(标准差(SD)=4.0),60.9%为初产妇。与春季受孕(参照组)相比,夏季受孕与GDM风险降低15%(优势比(OR)=0.85;95%置信区间(CI)=0.77-0.94)和PROM风险降低10%(OR=0.90;95%CI=0.82-0.99)相关,但PPH风险增加46%(OR=1.46;95%CI=1.07-1.99)。秋季和冬季受孕显示出更明显的保护作用,前者GDM风险降低23%(OR=0.77;95%CI=0.70-0.85),GH风险降低26%(OR=0.74;95%CI=0.61-0.90),后者GDM风险降低14%(OR=0.86;95%CI=0.79-0.94),GH风险降低20%(OR=0.80;95%CI=0.68-0.96)。

结论

我们发现春季受孕与GDM、GH和PROM风险增加相关,而夏季受孕与PPH风险较高相关。然而,我们研究结果的初步性质表明,需要进一步研究以确认因果关系并评估任何潜在干预措施的可行性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c0fc/12400889/3a26c990f893/jogh-15-04243-F1.jpg

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