Association Between High Ambient Temperature and Risk of Stillbirth in California
Association Between High Ambient Temperature and Risk of Stillbirth in California
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DOI：
10.1093/aje/kwv295
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发表时间：
2016-05-15
影响因子：
5
通讯作者：
Malig, Brian J.
中科院分区：
文献类型：
--
作者：
Basu, Rupa;Sarovar, Varada;Malig, Brian J.
最近的研究表明，表观温度升高与不良的出生结果有关，如早产，但其他出生结果尚未得到很好的研究。我们检查了8，510例胎儿死亡（每千日元20周妊娠的一部分），以估计其与1999年至2009年加州暖季（5月至10月）的平均表观温度（温度和湿度的组合）的关系。其中包括居住地邮政编码在气象监测器10公里范围内的母亲。气象数据由加州灌溉管理信息系统、美国环境保护署和国家气候数据中心提供，而加州公共卫生部提供死胎数据。使用时间分层病例交叉研究设计，我们发现表观温度每增加10A华氏度（5.6A摄氏度）死产风险变化10.4%（95%置信区间：4.4，16.8）（滞后2-6天的累积平均值）。风险因母亲的种族/民族而异，年轻母亲、受教育程度较低的母亲和男性胎儿的风险更大。在妊娠20-25周和31-33周观察到最高风险。在寒冷的季节（11月至4月）没有发现任何关联，所观察到的关联是独立的空气污染物。这项研究增加了越来越多的文献确定孕妇和胎儿作为亚组容易受到热暴露。
Recent studies have linked elevated apparent temperatures with adverse birth outcomes, such as preterm delivery, but other birth outcomes have not been well studied. We examined 8,510 fetal deaths (a parts per thousand yen20 weeks' gestation) to estimate their association with mean apparent temperature, a combination of temperature and humidity, during the warm season in California (May-October) from 1999 to 2009. Mothers whose residential zip codes were within 10 km of a meteorological monitor were included. Meteorological data were provided by the California Irrigation Management Information System, the US Environmental Protection Agency, and the National Climatic Data Center, while the California Department of Public Health provided stillbirth data. Using a time-stratified case-crossover study design, we found a 10.4% change (95% confidence interval: 4.4, 16.8) in risk of stillbirth for every 10A degrees F (5.6A degrees C) increase in apparent temperature (cumulative average of lags 2-6 days). Risk varied by maternal race/ethnicity and was greater for younger mothers, less educated mothers, and male fetuses. The highest risks were observed during gestational weeks 20-25 and 31-33. No associations were found during the cold season (November-April), and the observed associations were independent of air pollutants. This study adds to the growing body of literature identifying pregnant women and their fetuses as subgroups vulnerable to heat exposure.