孕期环境温度对新生儿出生体重的影响——基于武汉市一家医院
Effects of ambient temperature during pregnancy on birth weight of newborns-Based on a hospital in Wuhan
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摘要:
背景 已开展的孕期空气温度变化对新生儿出生体重影响的研究提示，环境温度的改变可能是新生儿低出生体重的潜在影响因素。
目的 评价孕期环境温度是否会影响新生儿出生体重以及低出生体重发生风险。
方法 选取2011年1月1日-2014年5月31日间，于武汉大学人民医院分娩的5 533例单胎活产儿作为研究对象，获取产妇社会人口学和分娩资料。从中国气象数据中心和中国环境监测总站收集2010年3月20日-2013年10月18日的环境温度、湿度数据和空气质量指数数据。分别构建广义线性模型和logistc回归模型，评价不同孕期环境温度变化对新生儿出生体重以及低出生体重发生风险的影响。通过在广义线性模型中对环境平均温度和相对湿度使用自由度为3的自然立方样条函数，拟合不同孕期环境平均温度与出生体重的暴露-效应曲线。
结果 研究对象平均出生体重为（3 201.8±563.5）g，低出生体重儿的发生率为9.0%（498/5 533）。研究期间产妇孕早期、孕中期和孕晚期环境温度分别为（17.5±8.6）℃、（16.4±7.8）℃、（16.0±8.6）℃。控制产妇社会人口学因素和空气质量的影响后，孕早期和孕中期的环境平均温度每升高1℃，新生儿出生体重分别上升1.984 g（95% CI：0.240~3.729）和2.742g（95% CI：0.868~4.615）；未发现孕期环境温度与低出生体重的发生风险之间存在关联。孕晚期环境温度与新生儿出生体重的暴露-效应曲线呈倒"U"型，孕早期和孕中期呈线性。
结论 本研究提示孕早期和孕中期的环境温度升高可能与新生儿出生体重的增加有关，尚未发现温度变化与低出生体重的发生风险之间存在有统计学意义的关联。
Abstract:Background Many studies suggest that ambient temperature change is a potental risk factor of low birth weight of newborns.
Objectve The current study evaluates whether ambient temperature change during pregnancy would affect the birth weight of newborns and the risk of low birth weight.
Methods Study subjects were 5 533 single live newborns delivered in the Renmin Hospital of Wuhan University from January 1, 2011 to May 31, 2014. Their maternal sociodemographic data and delivery data were collected. The meteorological data (such as ambient temperature and humidity) and air quality index (AQI) from March 20, 2010 to October 18, 2013 were retrieved from the National Meteorological Information Center and the China National Environmental Monitoring Centre, respectively. A generalized linear model and a logistic regression model were conducted respectively to evaluate the effects of ambient temperature during different trimesters on the birth weight of newborns and the risk of low birth weight. A generalized linear model was fted using natural cubic spline with 3 degrees of freedom for ambient temperature and relatve humidity, and the relatonships between average temperature during different trimesters and birth weight were explored by plotng the exposure-response curve.
Results The average birth weight of newborns was (3201.8±563.5) g, and the incidence rate of low-birth-weight infants was 9.0% (498/5 533) during the observed tme period. The daily mean values of ambient temperature during the frst, second, and third trimesters of the partcipants were (17.5±8.6), (16.4±7.8), and (16.0±8.6)℃, respectvely. By controlling maternal sociodemographic factors and AQI, the increases of birth weight associated with per 1℃ increase of mean ambient temperature were 1.984 g (95%CI:0.240-3.729) and 2.742 g (95%CI:0.868-4.615) for the first trimester and the second trimester, respectively. However, no apparent evidence showed an association between ambient temperature and the risk of low birth weight. The exposure-response curve illustratng the relatonship between mean temperature in the third trimester and birth weight was inverted "U" shaped, and the curve illustratng the relatonship between mean temperature in the frst or second trimester and birth weight was linear.
Conclusion The study findings suggest that the increased birth weight of newborns may be associated with the increased ambient temperature during the frst and second trimesters. No signifcant associaton between ambient temperature change and the low birth weight of newborns is found in this study.
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