文章基本信息

标题：Ambient Temperature and Stillbirth: A Multi-Center Retrospective Cohort Study
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作者：Sandie Ha ; Danping Liu ; Yeyi Zhu 等
期刊名称：Environmental Health Perspectives
印刷版ISSN：0091-6765
电子版ISSN：1552-9924
出版年度：2017
卷号：125
期号：6
页码：067011
DOI：10.1289/EHP945
语种：English
出版社：OCR Subscription Services Inc
摘要：Background: Climate change is expected to have adverse health effects, but the association between extreme ambient temperatures and stillbirth is unclear. Objectives: We investigated acute and chronic associations between extreme ambient temperatures and stillbirth risk, and estimated the attributable risk associated with local temperature extremes in the United States. Methods: We linked 223,375 singleton births ≥ 23 weeks of gestation (2002–2008) from 12 U.S. sites to local temperature. Chronic exposure to hot ( > 90th percentile), cold ( < 10th percentile), or mild (10th–90th percentile) temperatures was defined using window- and site-specific temperature distributions for three-months preconception, first and second trimester, and whole-pregnancy averages. For acute exposure, average temperature for the week preceding delivery was compared to two alternative control weeks in a case-crossover analysis. Results: In comparison with mild, whole-pregnancy exposure to cold [adjusted odds ratio (aOR) = 4.75; 95% confidence interval (CI): 3.95, 5.71] and hot (aOR = 3.71; 95% CI: 3.07, 4.47) were associated with stillbirth risk, and preconception and first and second trimester exposures were not. Approximately 17–19% of stillbirth cases were potentially attributable to chronic whole-pregnancy exposures to local temperature extremes. This is equivalent to ∼ 1,116 cold - related and ∼ 1,019 hot - related excess cases in the United States annually. In the case-crossover analysis, a 1°C increase during the week preceding delivery was associated with a 6% (3–9%) increase in stillbirth risk during the warm season (May–September). This incidence translates to ∼ 4 (2–6) additional stillbirths per 10,000 births for each 1°C increase. Conclusions: Extremes of local ambient temperature may have chronic and acute effects on stillbirth risk, even in temperate zones. Temperature-related effects on pregnancy outcomes merit additional investigation. https://doi.org/10.1289/EHP945