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热浪和早产:通过个人和区域层面的因素探索脆弱性

A Fitch¹, M Huang¹, M J Strickland¹

¹Department of Epidemiology, Biostatistics, and Environmental Health School of Public Health University of Nevada, Reno Reno NV USA.

|April 24, 2025

概括

极端的高温会增加过早分娩的风险,尤其对处境不利的母亲来说. 过早分娩的风险也在增加,但脆弱性模式在社会经济群体之间有所不同.

科学领域:

环境健康环境健康
生殖流行病学生殖流行病学
围产期健康围产期健康

背景情况:

极端高温事件越来越常见,并与不利的健康结果有关.
以前的研究表明,暴露于热量和不良分娩结果之间存在联系,包括早产.
了解与高温相关的分娩风险的差异对于公共卫生干预至关重要.

研究的目的:

调查急性热浪暴露与早产 (PTB) 和早产 (ETB) 风险之间的联系.
检查个人层面 (母亲的年龄,教育) 和区域层面 (社会贫困,土地覆盖) 的因素如何改变这些风险.
确定在怀孕期间因暴露于热量而面临更高风险的脆弱子组.

主要方法:

利用了时间分层的案例交叉设计,使用来自多个美国州 (1990-2017) 的重要记录.
在出生前的四天曝光窗口期间,在邮政编码表格区 (ZCTAs) 内的每日平均温度的97.5百分点基础上定义的热浪.
根据母体和区域级特征进行分层分析,使用反变量加权将结果汇总起来.

主要成果:

热浪与早产风险 (ETB) 的增加有关,特别是在年轻的母亲 (<25岁),低教育程度 (≤高中) 的母亲,以及在社会贫困程度高,土地覆盖不透的地区的母亲中.
在这些子组中,早产 (PTB) 的风险也较高,但在更有利的群体中也观察到.
在所有子组和结果中,与高温相关的分娩率增加的幅度从0%到7.9%不等.

结论:

与热量相关的早产风险在社会经济弱势群体中不成比例地高.
虽然早产风险也随着暴露于热量而增加,但不同社会经济层面的脆弱性模式不太一致.
这些发现凸显了针对性公共卫生战略的必要性,以减轻怀孕期间与热有关的风险,特别是对弱势群体的风险.

关键词:

出生后的结果.早产期的出生早期的出生热浪热浪的热浪热浪是一种热浪.土地覆盖面土地覆盖面过早出生过早出生社会剥夺,社会剥夺.

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