Ambient Temperature and Early Delivery of Singleton Pregnancies.
Ambient Temperature and Early Delivery of Singleton Pregnancies.
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DOI：
10.1289/ehp97
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发表时间：
2017-03
影响因子：
10.4
通讯作者：
Mendola P
中科院分区：
文献类型：
--
作者：
Ha S;Liu D;Zhu Y;Kim SS;Sherman S;Mendola P
极端温度与不良出生结果有关，但尚不清楚它是否会增加早产风险。我们的目的是确定环境温度和早期分娩之间的关系。来自美国12个地点的223，375例单胎分娩的医疗记录与当地环境温度有关。使用特定于地点和特定于窗户的温度分布，定义了怀孕前3个月、前两个孕期的7周、分娩前1周和整个孕期的热（>第90百分位数）或冷（<第10百分位数）暴露。怀孕。Poisson回归和广义估计方程计算了与冷热暴露相关的早产的相对危险度（RR）和95%置信区间，校正了受孕月份、湿度、地点、性别、产妇人口统计学、产次、保险、孕前体重指数、妊娠并发症和妊娠期间吸烟或饮酒。急性温度协会估计分别为温暖的季节（5月至9月）和寒冷的季节（3月至4月）的情况下，交叉分析，使用条件logistic回归。与温和的温度相比（第10- 90百分位数），第1-7周暴露于高温或低温会增加早期早产的风险（< 34周）[RR热：1.11（95% CI：1.01，1.21）; RR冷：1.20（95% CI：1.11，1.30）]，晚期早产（34-36周）[RR冷：1.09（95% CI：1.04，1.15）]和早期（37-38周）[RR热：1.04（95% CI：1.02，1.07）; RR冷：1.03（95% CI：1.00，1.05）]分娩。在第15-21周期间，热暴露的结果相似。从第23周到第38周每周检查分娩情况，整个妊娠期的热暴露在第34周和第36-38周增加了6-21%的分娩风险。在病例交叉分析中，分娩前一周内5°F的升高分别与温暖季节和寒冷季节提前分娩风险的12-16%和4-5%降低相关。急性和慢性环境温度极端都可能影响早产风险。Ha S，Liu D，Zhu Y，Kim SS，谢尔曼S，Mendola P. 2017.环境温度与单胎妊娠早期分娩。环境健康展望125：453-459; http：dx.doi.org/10.1289/EHP97Citation：Ha S，Liu D，Zhu Y，Kim SS，谢尔曼S，Mendola P. 2017。 环境温度与单胎妊娠早期分娩。环境健康展望125：453-459; http：dx.doi.org/10.1289/EHP97
Extreme temperature is associated with adverse birth outcomes but it is unclear whether it increases early delivery risk. We aimed to determine the association between ambient temperature and early delivery. Medical records from 223,375 singleton deliveries from 12 U.S. sites were linked to local ambient temperature. Exposure to hot (> 90th percentile) or cold (< 10th percentile) using site-specific and window-specific temperature distributions were defined for 3-months preconception, 7-week periods during the first two trimesters, 1 week preceding delivery, and whole pregnancy. Poisson regression with generalized estimating equations calculated the relative risk (RR) and 95% confidence interval for early deliveries associated with hot/cold exposures, adjusting for conception month, humidity, site, sex, maternal demographics, parity, insurance, prepregnancy body mass index, pregnancy complications, and smoking or drinking during pregnancy. Acute temperature associations were estimated separately for warm (May–September) and cold season (October–April) in a case-crossover analysis using conditional logistic regression. Compared with mild temperature (10–90th percentile), exposure to hot or cold during weeks 1–7 increased risk for early preterm (< 34 weeks) [RRhot: 1.11 (95% CI: 1.01, 1.21); RRcold: 1.20 (95% CI: 1.11, 1.30)], late preterm (34–36 weeks) [RRcold: 1.09 (95% CI: 1.04, 1.15)], and early term (37–38 weeks) [RRhot: 1.04 (95% CI: 1.02, 1.07); RRcold: 1.03 (95% CI: 1.00, 1.05)] delivery. Findings were similar for hot exposures during weeks 15–21. Examining deliveries at each week from 23 through 38, whole-pregnancy hot exposures increased delivery risk by 6–21% at weeks 34 and 36–38. In the case-crossover analysis, a 5°F increase during the week preceding delivery was associated with 12–16% higher and 4–5% lower early delivery risk during warm and cold season, respectively. Both acute and chronic ambient temperature extremes may affect early delivery risk. Ha S, Liu D, Zhu Y, Kim SS, Sherman S, Mendola P. 2017. Ambient temperature and early delivery of singleton pregnancies. Environ Health Perspect 125:453–459; http://dx.doi.org/10.1289/EHP97Citation: Ha S, Liu D, Zhu Y, Kim SS, Sherman S, Mendola P. 2017. Ambient temperature and early delivery of singleton pregnancies. Environ Health Perspect 125:453–459; http://dx.doi.org/10.1289/EHP97