The impact of maternal factors on the association between temperature and preterm delivery.
The impact of maternal factors on the association between temperature and preterm delivery.
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DOI：
10.1016/j.envres.2016.12.017
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发表时间：
2017-04
影响因子：
8.3
通讯作者：
Avalos LA
中科院分区：
文献类型：
--
作者：
Basu R;Chen H;Li DK;Avalos LA
由于缺乏数据，很少有研究考察母亲对温度和不良分娩结果的影响因素。我们评估了表观体温、早产(PTD)和母亲人口统计学、医疗条件和行为之间的关系。使用北加州一家大型健康维护组织的医疗记录，对1995至2009年间患有PTD(孕周20至37周)的14,466名妇女进行了时间分层的病例交叉分析。分层考虑的影响因素包括几个母亲因素：年龄、种族/民族、抑郁症、高血压、糖尿病、吸烟、饮酒、孕前体重指数和医疗补助状况。婴儿性别的差异也被考虑在内。数据还包括那些在住处邮政编码20公里范围内安装了监测仪的女性的表观温度数据。所有分析都按温暖季节(5月1日至10月31日)和寒冷季节(11月1日至4月30日)进行了分层。每周平均累积表观温度每升高10°F(5.6°C)，在暖季分娩的风险(11.63%；95%CI：4.08，19.72%)高于冷季(6.18%；−2.96，16.18%)，特别是对于年轻、黑人、西班牙裔、体重过轻、分娩前有医疗补助、或有既往存在或妊娠高血压或糖尿病的母亲。我们的发现表明，较暖的表观温度可能会加剧PTD的风险，特别是对于风险较高的女性亚群。
Few studies have examined maternal modifiers of temperature and adverse birth outcomes because of lack of data. We assessed the relationship between apparent temperature, preterm delivery (PTD) and maternal demographics, medical conditions, and behaviors. A time-stratified case-crossover analysis was conducted using for 14,466 women who had a PTD (20 to less than 37 gestational weeks) from 1995 to 2009 using medical records from a large health maintenance organization in Northern California. Effect modifiers considered by stratification included several maternal factors: age, race/ethnicity, depression, hypertension, diabetes, smoking, alcohol use, pre-pregnancy body mass index, and Medicaid status. Difference by infant sex were also considered. Apparent temperature data for women who had a monitor located within 20 kilometers of their residential zip codes were included. All analyses were stratified by warm (May 1 through October 31) and cold (November 1 through April 30) seasons. Every 10°F (5.6°C) increase in average cumulatively weekly apparent temperature (lag06), a greater risk was observed for births occurring during the warm season (11.63%; 95% CI: 4.08, 19.72%) compared to the cold season (6.18%; −2.96, 16.18%), especially for mothers who were younger, Black, Hispanic, underweight, had Medicaid prior to giving birth, or had pre-existing or gestational hypertension or diabetes. Our findings suggest that warmer apparent temperatures may exacerbate the risk of PTD, particularly for subgroups of women at higher risk.