{"title":"大气压力下降和随后的日产生量波动:一项病例交叉研究。","authors":"Shuhei Terada, Hisaaki Nishimura, Naoyuki Miyasaka, Takeo Fujiwara","doi":"10.1111/ppe.70012","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Fluctuations in daily delivery volume impact obstetricians' workload and maternal-fetal complications. While sudden drops in atmospheric pressure (e.g. due to typhoons or hurricanes) may be associated with an increase in daily delivery volume in the following days, few studies have explored these associations by gestational week while considering lagged effects.</p><p><strong>Objectives: </strong>To investigate whether drops in atmospheric pressure are associated with fluctuations in the daily volume of deliveries with spontaneous onset of labour.</p><p><strong>Methods: </strong>We employed a time-stratified case-crossover design. Data on the daily volume of spontaneous-onset deliveries from 47 prefectures between 2011 and 2020 were obtained from the Japan Perinatal Registry Network database. Quasi-Poisson regression models with distributed lag nonlinear models were used to examine the association between pressure drops (e.g. -13.8 hectopascal (hPa), representing the 1st percentile) and daily delivery volume in each prefecture, with lag periods of up to 14 days. Prefectural estimates were combined using random-effects meta-analysis. Stratified analyses were conducted by the gestational week, categorised as < 37, 37, 38, 39, 40 and 41+ weeks.</p><p><strong>Results: </strong>A total of 1,074,380 spontaneous-onset deliveries were recorded. The lag-cumulative relative risk of spontaneous-onset deliveries peaked with a lag period of 0-4 days and became negligible beyond 1 week, likely due to harvesting effects. The associations were most pronounced among women with a gestational age between 38 and 40 weeks. Specifically, for a PCN of -13.8 hPa, the 0-4 day lag-cumulative relative risk was as follows: at 38 weeks, 1.07 (95% confidence interval [CI] 1.00, 1.14); at 39 weeks, 1.08 (95% CI 1.02, 1.14); and at 40 weeks, 1.10 (95% CI 1.03, 1.19), compared to no pressure change.</p><p><strong>Conclusions: </strong>Pressure drops were associated with a modestly larger volume of spontaneous-onset deliveries over the following few days, especially at full-term gestation.</p>","PeriodicalId":19698,"journal":{"name":"Paediatric and perinatal epidemiology","volume":" ","pages":"325-333"},"PeriodicalIF":2.7000,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Drops in Atmospheric Pressure and Subsequent Fluctuations in Daily Delivery Volume: A Case-Crossover Study.\",\"authors\":\"Shuhei Terada, Hisaaki Nishimura, Naoyuki Miyasaka, Takeo Fujiwara\",\"doi\":\"10.1111/ppe.70012\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Fluctuations in daily delivery volume impact obstetricians' workload and maternal-fetal complications. While sudden drops in atmospheric pressure (e.g. due to typhoons or hurricanes) may be associated with an increase in daily delivery volume in the following days, few studies have explored these associations by gestational week while considering lagged effects.</p><p><strong>Objectives: </strong>To investigate whether drops in atmospheric pressure are associated with fluctuations in the daily volume of deliveries with spontaneous onset of labour.</p><p><strong>Methods: </strong>We employed a time-stratified case-crossover design. Data on the daily volume of spontaneous-onset deliveries from 47 prefectures between 2011 and 2020 were obtained from the Japan Perinatal Registry Network database. Quasi-Poisson regression models with distributed lag nonlinear models were used to examine the association between pressure drops (e.g. -13.8 hectopascal (hPa), representing the 1st percentile) and daily delivery volume in each prefecture, with lag periods of up to 14 days. Prefectural estimates were combined using random-effects meta-analysis. Stratified analyses were conducted by the gestational week, categorised as < 37, 37, 38, 39, 40 and 41+ weeks.</p><p><strong>Results: </strong>A total of 1,074,380 spontaneous-onset deliveries were recorded. The lag-cumulative relative risk of spontaneous-onset deliveries peaked with a lag period of 0-4 days and became negligible beyond 1 week, likely due to harvesting effects. The associations were most pronounced among women with a gestational age between 38 and 40 weeks. Specifically, for a PCN of -13.8 hPa, the 0-4 day lag-cumulative relative risk was as follows: at 38 weeks, 1.07 (95% confidence interval [CI] 1.00, 1.14); at 39 weeks, 1.08 (95% CI 1.02, 1.14); and at 40 weeks, 1.10 (95% CI 1.03, 1.19), compared to no pressure change.</p><p><strong>Conclusions: </strong>Pressure drops were associated with a modestly larger volume of spontaneous-onset deliveries over the following few days, especially at full-term gestation.</p>\",\"PeriodicalId\":19698,\"journal\":{\"name\":\"Paediatric and perinatal epidemiology\",\"volume\":\" \",\"pages\":\"325-333\"},\"PeriodicalIF\":2.7000,\"publicationDate\":\"2025-05-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Paediatric and perinatal epidemiology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1111/ppe.70012\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/3/27 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Paediatric and perinatal epidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/ppe.70012","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/3/27 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景:日产生量的波动影响产科医生的工作量和母胎并发症。虽然大气压力的突然下降(例如,由于台风或飓风)可能与随后几天每日产生量的增加有关,但很少有研究在考虑滞后效应的同时,按妊娠周探讨这些关联。目的:探讨大气压力下降是否与自然分娩时的日产生量波动有关。方法:采用时间分层病例交叉设计。2011年至2020年期间,日本47个县的每日自发性分娩量数据来自日本围产期登记网络数据库。使用分布滞后非线性模型的准泊松回归模型来检验每个州的压力降(例如-13.8百帕斯卡(hPa),代表第一个百分位数)与日交付量之间的关系,滞后期长达14天。使用随机效应荟萃分析合并各县的估计。按妊娠周进行分层分析,分类为结果:记录了1,074,380例自发性分娩。自发性分娩的滞后累积相对风险在滞后期为0-4天时达到峰值,超过1周后可以忽略不计,可能是由于收获效应。这种关联在孕龄在38到40周之间的女性中最为明显。具体来说,对于-13.8 hPa的PCN, 0-4天的滞后累积相对风险如下:在38周时,1.07(95%可信区间[CI] 1.00, 1.14);39周时,1.08 (95% CI 1.02, 1.14);与无压力变化相比,40周时为1.10 (95% CI 1.03, 1.19)。结论:在接下来的几天里,压降与自发性分娩的体积稍大有关,特别是在足月妊娠期间。
Drops in Atmospheric Pressure and Subsequent Fluctuations in Daily Delivery Volume: A Case-Crossover Study.
Background: Fluctuations in daily delivery volume impact obstetricians' workload and maternal-fetal complications. While sudden drops in atmospheric pressure (e.g. due to typhoons or hurricanes) may be associated with an increase in daily delivery volume in the following days, few studies have explored these associations by gestational week while considering lagged effects.
Objectives: To investigate whether drops in atmospheric pressure are associated with fluctuations in the daily volume of deliveries with spontaneous onset of labour.
Methods: We employed a time-stratified case-crossover design. Data on the daily volume of spontaneous-onset deliveries from 47 prefectures between 2011 and 2020 were obtained from the Japan Perinatal Registry Network database. Quasi-Poisson regression models with distributed lag nonlinear models were used to examine the association between pressure drops (e.g. -13.8 hectopascal (hPa), representing the 1st percentile) and daily delivery volume in each prefecture, with lag periods of up to 14 days. Prefectural estimates were combined using random-effects meta-analysis. Stratified analyses were conducted by the gestational week, categorised as < 37, 37, 38, 39, 40 and 41+ weeks.
Results: A total of 1,074,380 spontaneous-onset deliveries were recorded. The lag-cumulative relative risk of spontaneous-onset deliveries peaked with a lag period of 0-4 days and became negligible beyond 1 week, likely due to harvesting effects. The associations were most pronounced among women with a gestational age between 38 and 40 weeks. Specifically, for a PCN of -13.8 hPa, the 0-4 day lag-cumulative relative risk was as follows: at 38 weeks, 1.07 (95% confidence interval [CI] 1.00, 1.14); at 39 weeks, 1.08 (95% CI 1.02, 1.14); and at 40 weeks, 1.10 (95% CI 1.03, 1.19), compared to no pressure change.
Conclusions: Pressure drops were associated with a modestly larger volume of spontaneous-onset deliveries over the following few days, especially at full-term gestation.
期刊介绍:
Paediatric and Perinatal Epidemiology crosses the boundaries between the epidemiologist and the paediatrician, obstetrician or specialist in child health, ensuring that important paediatric and perinatal studies reach those clinicians for whom the results are especially relevant. In addition to original research articles, the Journal also includes commentaries, book reviews and annotations.