宁波市日均气温与孕妇早产关系的时间序列研究

舒铭铭; 周旭平; 谷少华; 张百蕾; 潘兴强

doi:10.11836/JEOM21433

宁波市日均气温与孕妇早产关系的时间序列研究

Association between daily average temperature and premature birth in Ningbo City: A time-series analysis

摘要

摘要:
背景有关环境气温与孕妇早产关联的研究越来越受到关注，但是既往文献结论尚不一致。

目的探索宁波市环境气温暴露对孕妇早产的影响。

方法通过宁波市妇女儿童医院的电子病历系统收集该院2016年1月—2020年9月的分娩信息、早产资料和孕妇年龄等信息；通过宁波市气象局获取同期的气象资料，包括日均气温、日均相对湿度、日均气压；通过宁波市环境保护局网站的“空气质量实时发布系统”收集SO₂、NO₂、PM₁₀的每日质量浓度（简称浓度）资料。采用分布滞后非线性模型，按孕妇年龄、生产方式分层，分析环境气温对早产的影响。

结果 2016—2020年宁波市早产发生率为5.91%。环境温度与早产的暴露-反应曲线呈“U”型。以22.5 ℃为参考，31 ℃（第95百分位数）和32 ℃（第99百分位数）与早产的滞后21 d累积效应有统计学意义，其RR（95%CI）分别为1.67（1.05~2.65）和1.85（1.09~3.14）。分层分析结果显示，在≥30岁的孕妇中，31 ℃和32 ℃与早产的滞后21 d累积效应有统计学意义，其RR（95%CI）分别为2.09（1.08~4.05）和2.36（1.11~5.03）；在自然分娩的孕妇中，32 ℃与早产的滞后21 d累积效应有统计学意义，其RR（95%CI）为1.95（1.02~3.74)。

结论孕妇妊娠期间暴露于高温环境可能会增加早产发生的风险，存在滞后累积效应。

Abstract:
Background Research on the relationship between ambient temperature and preterm birth has received increasing attention, but the conclusions of the previous literature are inconsistent.

Objective To explore the impact of environmental temperature exposure in Ningbo on premature delivery of pregnant women.

Methods The birth information, preterm birth data, and age of pregnant women from January 2016 to September 2020 were collected by the electronic medical record system of Ningbo Women’s and Children’s Hospital. Meteorological data for the same period were obtained through Ningbo Meteorological Bureau, including daily average temperature, daily average relative humidity, and daily average air pressure. Daily concentrations of SO₂, NO₂, and PM₁₀ were derived through the air quality real-time release system on the website of Ningbo Environmental Protection Bureau. A distributed lag nonlinear model was used to analyze the impact of environmental temperature on preterm birth by stratifying pregnant women’s age and birth delivery mode.

Results The incidence rate of preterm birth in Ningbo from 2016 to 2020 was 5.91%. The exposure-response curve between environmental temperature and preterm birth presented a “U” shape. Taking 22.5 ℃ as a reference, the cumulative effect of 31 ℃ (the 95th percentile) and 32 ℃ (the 99th percentile) over a 21-day lag on preterm delivery was statistically significant, and the related RR (95%CI) values were 1.67 (1.05-2.65) and 1.85 (1.09-3.14) respectively. The results of stratified analysis showed that among pregnant women ≥30 years old, the 21-day cumulative effects of 31 ℃ and 32 ℃ on preterm delivery were statistically significant, and the related RR (95%CI) values were 2.09 (1.08-4.05) and 2.36 (1.11-5.03) respectively; among pregnant women with natural delivery, the 21-day cumulative effect of 32 ℃ on preterm delivery was statistically significant, and theRR (95%CI) was 1.95 (1.02-3.74).

Conclusion Exposure of pregnant women to high temperature during pregnancy could increase the risk of preterm birth, and there is a delayed cumulative effect.

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