Associations of ambient temperature exposure during pregnancy with the risk of miscarriage and the modification effects of greenness in Guangdong, China
Associations of ambient temperature exposure during pregnancy with the risk of miscarriage and the modification effects of greenness in Guangdong, China
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中国广东省妊娠期环境温度暴露与流产风险的关系及绿化的改变效应
DOI：
10.1016/j.scitotenv.2019.134988
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发表时间：
2020
影响因子：
9.8
通讯作者：
Liu Tao
中科院分区：
文献类型：
--
作者：
Sun Xiaoli;Luo Xiping;Cao Ganxiang;Zhao Chunmei;Xiao Jianpeng;Liu Xin;Dong Moran;Wang Jiaqi;Zeng Weilin;Guo Lingchuan;Wan Donghua;Ma Wenjun;Liu Tao
流产是最常见的妊娠并发症之一。虽然以前的研究表明，环境因素是流产的重要原因，但证据仍然不足。在这里，我们研究了母亲暴露于温度与流产风险的关系，并进一步评估了周围住宅绿化的修饰作用。在中国广州的一家大型医院进行了病例对照研究。所有参与者的信息都是从医院记录中提取的。采用距离加权反比法估算各居民点的温度暴露量，并利用归一化植被指数（NDVI）计算各居民点的绿度。应用逻辑回归模型估计温度暴露与流产风险的关联。本研究共纳入2044例流产病例和2285例对照。我们观察到温度暴露与流产风险之间存在非线性正相关关系。在住院前两个月，高温与低温的影响比其他时期更明显。住院前第一个月内29.4 ℃（第95百分位数）与15 ℃相比的比值比（OR）为1.480（95%CI：1.021-2.145）。与那些绿色较少的参与者相比，温度对环境绿色适度的参与者流产风险的影响较小。我们的结论是，母亲在怀孕期间暴露于中等高温可能会增加流产的风险，但绿色对这些协会的修改效果需要在未来的研究中进一步测试。(C)2019 Elsevier B. V.版权所有。
Miscarriage is one of the commonest complications of pregnancy. Although previous studies suggested that environmental factors were important causes of miscarriage, evidence is still inadequate. Here, we examined the association of maternal exposure to temperature with the risk of miscarriage and further assessed the modifying effects of surrounding residential greenness. A case-control study was conducted at a large hospital in Guangzhou, China. All participants' information was extracted from hospital records. An inverse distance weighted method was used to estimate the temperature exposure at each residential address, where the greenness was measured by Normalized Difference Vegetation Index (NDVI). A logistic regression model was applied to estimate the association of temperature exposure with the risk of miscarriage. A total of 2044 cases of miscarriage and 2285 controls were included in the present study. We observed a generally non-linear positive relationship between temperature exposure and the risk of miscarriage. More pronounced effects of high temperatures vs. low temperatures were found during the two months prior to hospitalization than in other periods. The odds ratio (OR) of 29.4 degrees C (95th centile) compared with 15 degrees C during the first month prior to hospitalization was 1.480 (95% CI: 1.021-2.145). Smaller effects of temperatures were seen on the risk of miscarriage among participants with moderately great surrounding greenness compared with those with less greenness. We concluded that maternal exposure to moderately high temperature during pregnancy may increase the risk of miscarriage, but the modifying effects of greenness on these associations need to be further tested in future studies. (C) 2019 Elsevier B.V. All rights reserved.