Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study.
Maternal exposure to Wenchuan earthquake and prolonged risk of offspring birth outcomes: a natural experiment study.
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DOI：
10.1186/s12884-020-03206-1
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发表时间：
2020-09-22
影响因子：
3.1
通讯作者：
Zhang L
中科院分区：
文献类型：
--
作者：
Lian Q;Ni J;Zhang J;Little J;Luo S;Zhang L
灾害对幸存者生育结果的长期影响研究较少，研究结果也不一致。我们研究了孕前几年母体暴露于2008年汶川地震与不良分娩结局的关系。我们选取了2015/16年度中国劳动与分娩调查中在24个省区96家医院分娩的73493名产妇。我们基于粗精确匹配（CEM）体重和调查体重的组合对多变量logistic模型进行加权，并进行性别分层分析，以检验产妇地震暴露与不良分娩结局（死胎、早产[PTB]、低出生体重[LBW]和胎龄小[SGA]）的关联是否因性别而异。双变量模型显示，暴露组各不良出生结局的加权发生率均高于未暴露组：死胎（2.00% vs. 1.33%）、PTB （14.14% vs. 7.32%）、LBW （10.82% vs. 5.76%）和SGA （11.32% vs. 9.52%）。多变量模型显示，在所有分娩中，母亲地震暴露仅与后代患肺结核的高风险显著相关(校正风险比[aRR]（95%CI):1.25(1.06-1.48), P = 0.010）。性别分层分析显示，该相关性在男婴中显著(aRR (95%CI): 1.40(1.12-1.75),P = 0.002)，但在女婴中不显著。敏感性分析报告了类似的结果。2008年汶川地震对肺结核有长期影响。产妇急性暴露于灾害中可能是长期生殖结果的主要监测指标。应更多地注意与灾害有关的不良出生结果的主要原因。
The prolonged effects of disasters on reproductive outcomes among the survivors are less studied, and the findings are inconsistent. We examined the associations of maternal exposure to the 2008 Wenchuan earthquake years before conception with adverse birth outcomes. We included 73,493 women who delivered in 96 hospitals in 24 provinces and autonomous regions from the 2015/16 China Labor and Delivery Survey. We weighted the multivariable logistic models based on the combination of coarsened exact matching (CEM) weight and survey weight, and performed sex-stratified analysis to test whether associations of maternal earthquake exposure with adverse birth outcomes (Stillbirth, preterm birth [PTB], low birthweight [LBW], and small for gestational age [SGA]) varied by sex. The bivariate models showed that the weighted incidence of each adverse birth outcome was higher in exposed group than unexposed group: stillbirth (2.00% vs. 1.33%), PTB (14.14% vs. 7.32%), LBW (10.82% vs. 5.76%), and SGA (11.32% vs. 9.52%). The multivariable models showed maternal earthquake exposure was only associated significantly with a higher risk of PTB in offspring among all births (adjusted risk ratio [aRR](95%CI):1.25(1.06–1.48), P = 0.010). The sex-stratified analysis showed the association was significant among male births (aRR (95%CI): 1.40(1.12–1.75),P = 0.002),but unsignificant among female births. The sensitivity analysis reported similar findings. The 2008 Wenchuan earthquake exposure has a long-term effect on PTB. Maternal acute exposure to disasters could be a major monitor for long-term reproductive outcomes. More attention should be paid to the underlining reasons for disaster-related adverse birth outcomes.
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影响因子：
20.8
作者：
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通讯作者：
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DOI：
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发表时间：
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影响因子：
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影响因子：
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