The modifying role of residential greenness on the association between heat waves and adverse birth outcomes: Results from the ELEFANT project

IF 7.7 2区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environmental Research Pub Date : 2025-02-12 DOI:10.1016/j.envres.2025.121118

Yuxuan Ma , Yuanyuan Yu , Lei Zhao , Qisijing Liu , Jiayan Ni , Zi Lin , Bin Chen , Weixia Li , Huishu Lin , Yuhong He , Shuhao Shi , Jianqiong Zheng , Hongping Zhang , Chen Li , Furong Deng , Shike Hou , Tailang Yin , Yan Zhou , Liqiong Guo

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引用次数: 0

Abstract

Background

The impact of heat waves on perinatal outcomes has become a focus of attention. However, the association between heat waves and preterm birth (PTB), low birth weight (LBW), small for gestational age (SGA) and large for gestational age (LGA) remains controversial. Furthermore, whether residential greenness can mitigate the adverse effects of heat waves on birth outcomes still unclear.

Methods

This study employed a retrospective cohort design based on data from the ELEFANT project, conducted in Tianjin, China, spanning from 2011 to 2019. We assessed heat waves exposure by creating 12 definitions of extreme heat with varying relative temperatures (90th, 95th, 97.5th and 99th percentiles) and durations (at least 2, 3, or 4 consecutive days). Residential greenness levels were evaluated using the MODIS Normalized Difference Vegetation Index (NDVI). Cox proportional hazards regression models were fitted to estimate the risks of PTB, LBW, SGA and LGA in relation to heatwaves exposure and the multiplicative and additive interactions of heat waves and greenness on adverse birth outcomes across different pregnancy periods, including pre-pregnancy.

Results

Our findings indicate that heatwaves significantly increase the risks of PTB by 2.4%–15.6%, LBW by 7.6%–18 %, SGA by 3.6%–88.4%, and LGA by 2%–3.4%. The lack of residential greenness exhibited a synergistic interaction with heatwaves on PTB, SGA and LGA (RERI >0), especially during milder heat events during entire pregnancy. For LBW, interactions between greenness and heatwaves were limited. Furthermore, we identified that heatwave was significantly associated with high risk of adverse birth outcomes among mothers living in rural areas.

Conclusions

Prioritizing greenspace can help mitigate the effects of heatwaves, offering a viable and cost-effective approach to protecting maternal and fetal health.

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背景：热浪对围产期结果的影响已成为人们关注的焦点。然而，热浪与早产（PTB）、低出生体重（LBW）、胎龄小（SGA）和胎龄大（LGA）之间的关系仍存在争议。此外，住宅绿化是否能减轻热浪对出生结果的不利影响仍不清楚：本研究采用回顾性队列设计，基于 2011 年至 2019 年在中国天津开展的 ELEFANT 项目的数据。我们通过创建 12 个不同相对温度（第 90、95、97.5 和 99 百分位数）和持续时间（至少连续 2、3 或 4 天）的极端高温定义来评估热浪暴露。利用 MODIS 归一化差异植被指数 (NDVI) 评估住宅区绿化水平。我们采用 Cox 比例危险回归模型来估算不同孕期（包括孕前）的新生儿畸形率、低体重儿、SGA 和 LGA 风险与热浪暴露的关系，以及热浪和绿化对不良出生结果的乘法和加法交互作用：结果：我们的研究结果表明，热浪会使婴儿患先天性巨结肠的风险大幅增加 2.4% 至 15.6%，低体重儿的风险增加 7.6% 至 18%，SGA 的风险增加 3.6% 至 88.4%，LGA 的风险增加 2% 至 3.4%。住宅绿化不足与热浪对 PTB、SGA 和 LGA 的影响具有协同作用（RERI > 0），尤其是在整个孕期较温和的热浪期间。对于低体重儿而言，绿化与热浪之间的相互作用是有限的。此外，我们还发现，热浪与居住在农村地区的母亲出现不良出生结果的高风险显著相关：结论：优先考虑绿地有助于减轻热浪的影响，为保护孕产妇和胎儿健康提供了一种可行且具有成本效益的方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environmental Research 环境科学-公共卫生、环境卫生与职业卫生

CiteScore

12.60

自引率

8.40%

发文量

2480

审稿时长

4.7 months

期刊介绍： The Environmental Research journal presents a broad range of interdisciplinary research, focused on addressing worldwide environmental concerns and featuring innovative findings. Our publication strives to explore relevant anthropogenic issues across various environmental sectors, showcasing practical applications in real-life settings.