孕期高温暴露导致早产的机制研究进展
Research progress on potential mechanisms of preterm birth after maternal heat exposure
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摘要:
早产及其并发症是导致新生儿死亡的主要原因，也是造成全球疾病负担的围产难题。近年来，多项关联性研究发现孕期高温暴露会增加早产的发生风险，但目前学术界对于高温如何影响早产的生物学机制尚不清楚。基于此，本文对既往文献进行了系统梳理，回顾了孕期高温暴露导致早产过程中的孕妇个体脆弱性因素和环境区域修饰性因素，总结了孕期高温暴露导致早产风险的潜在生物学机制，发现孕期高温会通过氧化应激、炎症反应、生殖和泌尿系统感染、神经内分泌改变以及妊娠期合并症等机制路径，导致早产风险。基于此提出高温暴露导致早产风险机制研究中存的在问题及未来研究方向，建议今后应基于前瞻性队列研究和动物实验研究，阐明高温对不同类型早产的不良健康效应和机制，为高温天气时保障母婴健康，开展临床早产预防提供科学依据。
Abstract: Preterm birth and its complications are the leading cause of neonatal death, and also a perinatal problem that contributes to the global burden of disease. Recently, the association between maternal heat exposure and elevated risk of preterm birth has been found in lots of studies. But the potential mechanisms of how heat exposure increase the incidence of preterm birth are still unclear. Thus, we reviewed maternal vulnerability factors and territorial moderators associated with preterm birth due to heat exposure during pregnancy, and summarized potential mechanisms between heat exposure and risk of preterm birth based on previous studies. We found that heat exposure during pregnancy may involve various mechanisms to increase the risk of preterm birth, such as oxidative stress, inflammation, reproductive and urinary infections, neuroendocrine changes, and complications during pregnancy. Prospective cohort studies and animal experiments should be conducted to clarify the adverse health effects of heat exposure on different types of preterm birth from three facets of "exposure-mechanism-effect", aiming to provide a scientific basis for the protection of maternal and infant health through conducing clinical preventive interventions against preterm birth in scorching weather.
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