气候变化领域集成服务门户(CCPortal): Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology

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DOI	10.1016/j.scitotenv.2024.172730
	Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology
	Wang, Liyun; Zhang, Chunying; Di, Jiangli; Wang, Qiong; Ren, Meng; Huang, Aiqun; Chen, Sidi; Zhao, Wei; Hu, Huanqing; Wang, Ailing; Di, Qian; Ji, John S.; Liang, Wannian; Huang, Cunrui
发表日期	2024
ISSN	0048-9697
EISSN	1879-1026
起始页码	931
卷号	931
英文摘要	Background: Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. Objective: In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. Methods: We assigned heat exposure to a multi -center birth cohort in China during 2015 - 2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio -weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. Findings: Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. Conclusions: This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.
英文关键词	Climate change; Heat exposure; Preterm birth; Fetal heart rate; Mediation effect
语种	英语
WOS研究方向	Environmental Sciences & Ecology
WOS类目	Environmental Sciences
WOS记录号	WOS:001238474400001
来源期刊	SCIENCE OF THE TOTAL ENVIRONMENT
文献类型	期刊论文
条目标识符	http://gcip.llas.ac.cn/handle/2XKMVOVA/304899
作者单位	Sun Yat Sen University; Chinese Center for Disease Control & Prevention; National Center for Women & Children's Health, Chinese Center for Disease Control & Prevention; Tsinghua University; Tsinghua University
推荐引用方式 GB/T 7714	Wang, Liyun,Zhang, Chunying,Di, Jiangli,et al. Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology[J],2024,931.
APA	Wang, Liyun.,Zhang, Chunying.,Di, Jiangli.,Wang, Qiong.,Ren, Meng.,...&Huang, Cunrui.(2024).Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology.SCIENCE OF THE TOTAL ENVIRONMENT,931.
MLA	Wang, Liyun,et al."Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology".SCIENCE OF THE TOTAL ENVIRONMENT 931(2024).