摘要
目的分析温州市早产儿出生情况,探讨不同孕期温度暴露对早产儿发生的影响。方法收集温州市2012—2016年9月围生期保健和分娩监测系统的新生儿资料和环境温度资料,采用基于限制三次样条基函数的Logistic回归模型,在控制性别、出生年份、出生季节和登记住址等混杂因素后,分析孕期温度暴露与早产儿发生的关联性。结果纳入研究491 854名新生儿,2012—2016年早产儿平均发生率为4.56%,早产儿发生率呈逐年上升趋势(P<0.05),平均胎龄、平均出生体重呈逐年下降趋势(P<0.05)。夏季和冬季早产儿发生率较高,分别为4.69%和4.75%。孕早期温度暴露与早产儿发生风险呈现"U"型关系,相对于中位温度20℃,孕早期暴露在极端寒冷(7.5℃)和极端炎热温度(30.5℃)下,早产儿发生风险分别增加26.5%(95%CI:18.2%~35.6%)和15.1%(95%CI:7.9%~29.1%)。孕晚期暴露在极端炎热温度(30.5℃)下,早产儿发生风险增加11.9%(95%CI:7.3%~17.0%)。结论温州市早产儿发生率逐年上升,孕期极端温度暴露可增加早产儿发生风险,尤其是孕早期和孕晚期。
引文
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