Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis.
Associations between high temperatures in pregnancy and risk of preterm birth, low birth weight, and stillbirths: systematic review and meta-analysis.
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怀孕中的高温与早产，低出生体重和死胎的风险之间的关联：系统评价和荟萃分析。
DOI：
10.1136/bmj.m3811
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发表时间：
2020-11-04
期刊：
影响因子：
--
通讯作者：
Climate Change and Heat-Health Study Group
中科院分区：
文献类型：
--
作者：
Chersich MF;Pham MD;Areal A;Haghighi MM;Manyuchi A;Swift CP;Wernecke B;Robinson M;Hetem R;Boeckmann M;Hajat S;Climate Change and Heat-Health Study Group
评估怀孕期间暴露在高温下是否与早产、低出生体重和死产的风险增加有关。系统综述和随机效应荟萃分析。Medline和Web of Science的搜索截止到2018年9月，更新于2019年8月。环境温度升高与早产、出生体重和死产之间关系的临床研究。共筛选出14篇 880条记录和175篇全文。这项研究包括了27个国家的70项研究，其中7个是低收入或中等收入国家。在47项研究中，有40项在较高温度下早产比较低温度下早产更常见。暴露分为热波、1摄氏度增量和温度阈值截止点。在随机效应荟萃分析中，气温每升高1摄氏度，早产几率增加1.05倍(95%可信区间1.03至1.07)，热浪期间早产几率增加1.16倍(1.10至1.23)。在28项研究中，有18项研究表明，较高的温度与出生体重降低有关，具有相当大的统计学异质性。八项关于死胎的研究都表明了温度和死胎之间的关系，气温每升高1摄氏度，死胎就会增加1.05倍(1.01到1.08)。在较低社会经济群体和年龄极端的女性中，体温和结果之间的关联最大。多个温度指标和滞后分析限制了研究和设置之间的比较。尽管综合效应的规模相对较小，但热暴露是常见的，其结果是人口健康的重要决定因素。社会经济地位和研究结果之间的联系表明，低收入和中等收入国家的风险可能最大。全球变暖导致的气温上升可能会对儿童健康产生重大影响。PROSPERO CRD 42019140136和CRD 42018118113。
To assess whether exposure to high temperatures in pregnancy is associated with increased risk for preterm birth, low birth weight, and stillbirth. Systematic review and random effects meta-analysis. Medline and Web of Science searched up to September 2018, updated in August 2019. Clinical studies on associations between high environmental temperatures, and preterm birth, birth weight, and stillbirths. 14 880 records and 175 full text articles were screened. 70 studies were included, set in 27 countries, seven of which were countries with low or middle income. In 40 of 47 studies, preterm births were more common at higher than lower temperatures. Exposures were classified as heatwaves, 1°C increments, and temperature threshold cutoff points. In random effects meta-analysis, odds of a preterm birth rose 1.05-fold (95% confidence interval 1.03 to 1.07) per 1°C increase in temperature and 1.16-fold (1.10 to 1.23) during heatwaves. Higher temperature was associated with reduced birth weight in 18 of 28 studies, with considerable statistical heterogeneity. Eight studies on stillbirths all showed associations between temperature and stillbirth, with stillbirths increasing 1.05-fold (1.01 to 1.08) per 1°C rise in temperature. Associations between temperature and outcomes were largest among women in lower socioeconomic groups and at age extremes. The multiple temperature metrics and lag analyses limited comparison between studies and settings. Although summary effect sizes are relatively small, heat exposures are common and the outcomes are important determinants of population health. Linkages between socioeconomic status and study outcomes suggest that risks might be largest in low and middle income countries. Temperature rises with global warming could have major implications for child health. PROSPERO CRD 42019140136 and CRD 42018118113.
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