Jie Song1, Jianguo Lu2, Erhui Wang3, Mengxue Lu4, Zhen An5, Yue Liu6, Xiang Zeng5, Wen Li5, Huijun Li5, Dongqun Xu6, Sanqiao Yao5, Weidong Wu5. 1. School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, Xinxiang 453003, China. Electronic address: songjie231@126.com. 2. The First Affiliated Hospital of Xinxiang Medical University, Xinxiang 453100, China. 3. School of Public Health, Xinxiang Medical University, Xinxiang 453003, China. 4. Xinxiang Medical University, Xinxiang 453003, China. 5. School of Public Health, Xinxiang Medical University, Xinxiang 453003, China; Henan International Collaborative Laboratory for Air Pollution Health Effects and Intervention, Xinxiang 453003, China. 6. National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing 100021, China.
Abstract
BACKGROUND: Studies on the effects of extreme ambient temperature on the risk of adverse birth outcomes are limited, and the results are inconsistent. In this study, we evaluated the short-term effects of daily mean temperature on the risk of premature rupture of membranes (PROM) in Xinxiang, China. METHODS: Daily hospitalization data for PROM, daily meteorological data, and ambient pollution data in Xinxiang from January 1, 2015 to December 31, 2017 were collected. A quasi-Poisson generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was applied to assess the short-term impact of temperature on PROM. The model was adjusted for relative humidity, air pollution, time trend, day of the week, and public holidays. RESULTS: The number of daily hospitalizations for PROM during the study period was 3255. With a reference median temperature of 17 °C, there were significant associations between the temperature deviation from the threshold temperature (2 °C, 12th percentile; 29 °C, 91st percentile) and PROM hospitalization at lag 0-2 days. Exposure to extreme cold (-2 °C, 1st percentile) or extreme heat (32 °C, 99th percentile) were associated with 0.528 (95% confidence interval [CI]: 0.278-0.986) and 2.161 (95% CI: 1.240-3.764) increased risks of PROM, respectively. Younger mothers with age <35 years were more sensitive to the impact of extreme temperature. CONCLUSIONS: These findings suggest that heat temperature is associated with higher PROM risk, while cold temperature might be a protective factor against PROM in Xinxiang, China. Given the adverse consequences of PROM and concerns over global climate change, pregnant women should take special precautions in summer when there are sudden increases in temperature.
BACKGROUND: Studies on the effects of extreme ambient temperature on the risk of adverse birth outcomes are limited, and the results are inconsistent. In this study, we evaluated the short-term effects of daily mean temperature on the risk of premature rupture of membranes (PROM) in Xinxiang, China. METHODS: Daily hospitalization data for PROM, daily meteorological data, and ambient pollution data in Xinxiang from January 1, 2015 to December 31, 2017 were collected. A quasi-Poisson generalized additive model (GAM) combined with a distributed lag non-linear model (DLNM) was applied to assess the short-term impact of temperature on PROM. The model was adjusted for relative humidity, air pollution, time trend, day of the week, and public holidays. RESULTS: The number of daily hospitalizations for PROM during the study period was 3255. With a reference median temperature of 17 °C, there were significant associations between the temperature deviation from the threshold temperature (2 °C, 12th percentile; 29 °C, 91st percentile) and PROM hospitalization at lag 0-2 days. Exposure to extreme cold (-2 °C, 1st percentile) or extreme heat (32 °C, 99th percentile) were associated with 0.528 (95% confidence interval [CI]: 0.278-0.986) and 2.161 (95% CI: 1.240-3.764) increased risks of PROM, respectively. Younger mothers with age <35 years were more sensitive to the impact of extreme temperature. CONCLUSIONS: These findings suggest that heat temperature is associated with higher PROM risk, while cold temperature might be a protective factor against PROM in Xinxiang, China. Given the adverse consequences of PROM and concerns over global climate change, pregnant women should take special precautions in summer when there are sudden increases in temperature.
Authors: Maayan Yitshak-Sade; Itai Kloog; Joel D Schwartz; Victor Novack; Offer Erez; Allan C Just Journal: Environ Int Date: 2021-04-30 Impact factor: 13.352
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