Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States
Projected Changes in Maternal Heat Exposure During Early Pregnancy and the Associated Congenital Heart Defect Burden in the United States
复制标题
美国孕早期孕妇受热情况的预计变化以及相关先天性心脏缺陷负担
DOI：
10.1161/jaha.118.010995
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发表时间：
2019-02-05
影响因子：
5.4
通讯作者：
Botto, Lorenzo
中科院分区：
文献类型：
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作者：
Zhang, Wangjian;Spero, Tanya L.;Botto, Lorenzo
由于气候变化，预计美国将出现更强烈、更持久的高温事件。本研究的目的是项目的潜在变化，在怀孕早期（3-8周后的概念）和相关的负担，先天性心脏病（CHD）在future.Methods和Results-This研究扩大了以前的全国范围内的病例对照研究，评估CHD和母亲在夏季和春季怀孕早期的热暴露之间的关联。我们定义了热暴露的多个指标，并将基线（1995-2005）匹配季节获得的已发表比值比应用于预测期（2025 - 2035），以估计美国CHD负担的潜在变化。预计美国各地的母亲热暴露增加，夏季更大。中西部的夏季母亲暴露于酷热天气（3.42; 95% CI，每次妊娠2.99-3.88）、热事件频率（0.52; 95% CI，0.44-0.60）和热事件持续时间（1.73; 95% CI，1.49-1.97）的增加可能最高。我们还发现，在春季，特定的CHD亚型大幅增加，其中包括34.0%，（95% CI，4.9%-70.8%）南部圆锥动脉干CHD增加，（95%可信区间，9.9%-75.1%）增加。结论-在美国的某些季节和地区，预计母亲热暴露的增加可能导致CHD负担增加。
Background-More intense and longer-lasting heat events are expected in the United States as a consequence of climate change. This study aimed to project the potential changes in maternal heat exposure during early pregnancy (3-8 weeks post conception) and the associated burden of congenital heart defects (CHDs) in the future.Methods and Results-This study expanded on a prior nationwide case-control study that evaluated the association between CHDs and maternal heat exposure during early pregnancy in summer and spring. We defined multiple indicators of heat exposure, and applied published odds ratios obtained for the matching season of the baseline (1995-2005) into the projection period (20252035) to estimate potential changes in CHD burden throughout the United States. Increases in maternal heat exposure were projected across the United States and to be larger in the summer. The Midwest will potentially have the highest increase in summer maternal exposure to excessively hot days (3.42; 95% CI, 2.99-3.88 per pregnancy), heat event frequency (0.52; 95% CI, 0.44-0.60) and heat event duration (1.73; 95% CI, 1.49-1.97). We also found large increases in specific CHD subtypes during spring, including a 34.0% (95% CI, 4.9%-70.8%) increase in conotruncal CHD in the South and a 38.6% (95% CI, 9.9%-75.1%) increase in atrial septal defect in the Northeast.Conclusions-Projected increases in maternal heat exposure could result in an increased CHD burden in certain seasons and regions of the United States.