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[背景]高热虽然已经是一种公认导致动物畸形的原因,产妇发烧也与人类出生缺陷相关,但是有关环境温度升高与出生缺陷之间关系的资料尚有限。[目的]为了确定孕期是否更加容易受到气候变化时出现的极端天气的影响,评估极端夏季高温与婴儿出生缺陷之间的关系。[方法]以人群为基础的病例对照研究,将1992—2006年间纽约州先天性畸形登记表与出生联系起来,从活产婴儿中随机抽样,选出10%无畸形婴儿作为对照。作者基于孕妇在生产时居住环境的气象数据进行分组,汇总贯穿整个胚胎发育关键期的普遍体感温度(universal apparent temperature,UAT,℃),进行多变量logistic回归分析,估计调整后的比值比(ORa)和95%可信区间(CI),控制与出生相关的干扰因素。[结果]在至少共享了夏季中1周关键期的6422病例和59328例正常对照中,平均日最低UAT增加5℃与先天性白内障相关(ORa=1.51,95%CI:1.14～1.99)。先天性白内障与所有环境温度指标均相关:热浪、热浪数和超过第90百分位以上的天数等。观察发现肾脏发育不全(正向关联)与无眼(小眼)畸形和腹裂畸形(负向关联)与温度指标亚组间的关联不一致。[结论]在发育相关的窗口期,多个高温指标与先天性白内障具有正相关和一致性。该研究尚需要其他来源的资料加以证实。
BACKGROUND [0002] Although hyperthermia is a recognized cause of animal malformations and maternal fever is also associated with human birth defects, there is limited information on the relationship between elevated ambient temperature and birth defects. [Objective] To assess the relationship between extreme summer heat and infant birth defects in order to determine whether the pregnancy is more susceptible to extreme weather during climate change. [Methods] A population-based case-control study that linked the New York State Congenital Anomalies Registry to births between 1992 and 2006, randomly selected from live infants, and selected 10% unformed infants as controls. The authors grouped the meteorological data of pregnant women at the time of production and summarized the universal apparent temperature (UAT, ° C) throughout the critical period of embryo development. Multivariate logistic regression analysis was performed to estimate the adjusted odds ratio (ORa ) And a 95% confidence interval (CI) to control birth-related disturbances. [Results] In 6422 cases and 59328 normal controls that shared at least 1 week in summer, the mean daily minimum UAT increase of 5 ° C was associated with congenital cataract (ORa = 1.51, 95% CI: 1.14-1.99). Congenital cataracts are related to all ambient temperature indicators: heat waves, heat waves and days beyond the 90th percentile. Observation found that renal hypoplasia (positive correlation) and no eye (small eye) deformity and gastroschisis (negative correlation) and temperature indicators of the association between subgroups inconsistent. [Conclusion] There are positive correlation and consistency between multiple hyperthermia indexes and congenital cataract during the developmental window period. The study still needs information from other sources to confirm.