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目的了解广州市炎热指数对早产的滞后效应。方法以广州市白云区、越秀区2004年1月1日至2011年12月31日间分娩的产妇为研究对象,符合纳入标准的共293 849人,其中发生早产者22 702例。收集该时期产妇分娩数据、气象资料和空气污染物数据。采用分布滞后非线性模型,以广州市年均炎热指数为参照,建立炎热指数在滞后0~20 d内对逐日早产例数的回归模型,分析产妇暴露于不同炎热指数后0~20 d内发生早产的相对危险度。结果研究期间广州市白云区、越秀区的早产发生率为7.70%;炎热指数波动区间为45~136℉,年均炎热指数为(101±20)℉,以炎热指数101℉为参照,炎热指数升高20℉时,滞后第5~7日的早产发生危险性升高,其中第6日风险最高(RR=1.014,95%CI:1.005~1.023);第10~12日、19日的早产发生危险性降低,其中第19日风险最低(RR=0.985,95%CI:0.974~0.997)。炎热指数降低20℉时,滞后第5~7日的早产发生危险性降低,其中第6日风险最低(RR=0.986,95%CI:0.978~0.995);第10~12日、19日的早产发生危险性升高,其中第19日风险最高(RR=1.015,95%CI:1.003~1.027)。结论广州市炎热指数对早产的发生呈非线性滞后影响。炎热指数升高时,早产相对危险度先增加后降低;炎热指数降低时,早产相对危险度先降低后增加。
Objective To understand the lagging effect of heat index on preterm labor in Guangzhou. Methods A total of 293 849 pregnant women who gave birth between January 1, 2004 and December 31, 2011 in Baiyun District and Yuexiu District of Guangzhou City were enrolled. Among them, 22 702 premature births occurred. Data on maternal delivery, meteorological data and air pollutants during this period were collected. By using the lagged nonlinear model and taking the annual average heat index of Guangzhou as a reference, a regression model of the index of daily average number of premature infants within 0 ~ 20 days of lag was established. The maternal exposure occurred to 0 ~ 20 days after exposure to different heat index The relative risk of premature delivery. Results During the study period, the prevalence of preterm birth was 7.70% in Baiyun District and Yuexiu District of Guangzhou City. The index of heat index fluctuated in the range of 45-136 ℉ with an average annual temperature of (101 ± 20) ℉. The thermal index was 101 ℉, At 20 ° F, the risk of premature labor increased from day 5 to day 7, with the highest risk on day 6 (RR = 1.014, 95% CI: 1.005 to 1.023); premature birth on days 10 to 12 and 19 Risk reduction occurred, of which the lowest risk on the 19th (RR = 0.985, 95% CI: 0.974 ~ 0.997). At 20 ° F, the risk of premature labor was reduced from days 5 to 7, with the lowest risk on day 6 (RR = 0.986, 95% CI: 0.978 to 0.995); premature birth on days 10 to 12 and 19 The risk increased, of which the highest risk on the 19th (RR = 1.015, 95% CI: 1.003 ~ 1.027). Conclusion The heat index in Guangzhou shows a nonlinear lag effect on the occurrence of prematurity. When the index of fever increased, the relative risk of premature labor increased first and then decreased; when the index of heat decreased, the relative risk of premature labor decreased first and then increased.