暴露于环境热量与自然流产的风险:病例交叉研究。

IF 4.7 2区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Epidemiology Pub Date : 2024-11-01 Epub Date: 2024-07-26 DOI:10.1097/EDE.0000000000001774
Amelia K Wesselink, Emma L Gause, Keith D Spangler, Perry Hystad, Kipruto Kirwa, Mary D Willis, Gregory A Wellenius, Lauren A Wise
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引用次数: 0

摘要

背景:很少有流行病学研究探讨环境温度与自然流产的关系,而自然流产是一种常见的破坏性妊娠结局:我们在孕前队列研究(2013-2022 年)"在线妊娠研究 "中嵌套进行了一项病例交叉研究。我们纳入了所有报告自然流产的参与者(n=1,524)。我们将病例窗口定义为事件发生前的 7 天,并使用时间分层参照物选择来选择与日历月份和星期相匹配的对照窗口。在每个为期 7 天的病例窗口和对照窗口内,我们测量了每日室外最高气温的平均值、最高值和最低值。我们对全年的非线性关系进行了样条拟合,并通过条件逻辑回归估算了暖季(5 月至 9 月)气温升高和冷季(11 月至 3 月)气温降低时自然流产的几率比(OR)和 95% CI:结果:根据全年数据,我们发现室外气温与自然流产风险之间存在 U 型关系。如果仅限于暖季事件(n=657),0-6滞后日最高气温平均值每增加10个百分点的OR值为1.1(95% CI:0.96,1.2),最高值为1.1(95% CI:0.99,1.2)。与前一周任何极端高温日(>95th 县特定百分位数)相关的 OR 值为 1.2(95% CI:0.95, 1.5)。在凉季事件(n=615)中,较低气温与自然流产风险之间没有明显关联:我们的研究提供了室外高温与自然流产发生率之间存在关联的证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Exposure to Ambient Heat and Risk of Spontaneous Abortion: A Case-Crossover Study.

Background: Few epidemiologic studies have examined the association of ambient heat with spontaneous abortion, a common and devastating pregnancy outcome.

Methods: We conducted a case-crossover study nested within Pregnancy Study Online, a preconception cohort study (2013-2022). We included all participants reporting spontaneous abortion (N = 1,524). We defined the case window as the 7 days preceding the event and used time-stratified referent selection to select control windows matched on calendar month and day of week. Within each 7-day case and control window, we measured the mean, maximum, and minimum of daily maximum outdoor air temperatures. We fit splines to examine nonlinear relationships across the entire year and conditional logistic regression to estimate odds ratios (ORs) and 95% confidence interval (CI) of spontaneous abortion with increases in temperature during the warm season (May-September) and decreases during the cool season (November-March).

Results: We found evidence of a U-shaped association between outdoor air temperature and spontaneous abortion risk based on year-round data. When restricting to warm season events (n = 657), the OR for a 10-percentile increase in the mean of lag 0-6 daily maximum temperatures was 1.1 (95% CI: 0.96, 1.2) and, for the maximum, 1.1 (95% CI: 0.99, 1.2). The OR associated with any extreme heat days (>95th county-specific percentile) in the preceding week was 1.2 (95% CI: 0.95, 1.5). Among cool season events (n = 615), there was no appreciable association between lower temperatures and spontaneous abortion risk.

Conclusion: Our study provides evidence of an association between high outdoor temperatures and the incidence of spontaneous abortion.

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来源期刊
Epidemiology
Epidemiology 医学-公共卫生、环境卫生与职业卫生
CiteScore
6.70
自引率
3.70%
发文量
177
审稿时长
6-12 weeks
期刊介绍: Epidemiology publishes original research from all fields of epidemiology. The journal also welcomes review articles and meta-analyses, novel hypotheses, descriptions and applications of new methods, and discussions of research theory or public health policy. We give special consideration to papers from developing countries.
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