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目的研究广州地区气象因素与早产的关系。方法采用时间序列方法,利用广州市白云、越秀、番禺三区2004—2010年早产、气象与空气污染物资料,应用分布滞后非线性模型研究气象因素与早产的关联。结果广州市白云、越秀、番禺三区2004—2010年共活产分娩438 021例,早产儿29973例,早产率为6.84%(95%CI:6.77%~6.92%);日均出生早产儿(11.72±5.63)例,气温均值为(23.41±6.38)℃,相对湿度均值为(67.34±13.84)%,气压均值为(1012.94±6.88)h Pa;风速均值为(6.99±3.70)m/s。气象因素在不同滞后日与早产的关联呈非线性,总体上各气象因素与早产的风险效应呈正向关联。气温、相对湿度、气压和风速分别达到最大值(34℃、100%、1 032.2 h Pa、26 m/s)时,在滞后期(0~26、0~1、0~25、0~24 d)内总体风险效应达到最高,RR值分别为2.01(95%CI:1.28~3.16),1.25(95%CI:1.08~1.45),1.67(95%CI:1.03~2.71)和4.91(95%CI:0.63~38.11)。累积热效应在滞后期0~26 d内最高,RR值为1.47(95%CI:1.16~1.86);累积潮湿风险效应在滞后0 d时最高,RR值为1.12(95%CI:1.05~1.19);累积高气压效应在滞后期0~25 d内最高,RR值为1.34(95%CI:1.01~1.78)。首次怀孕、首次分娩、男婴及孕33~36周的早产亚组对气象因素较为易感,特别是对高温因素。结论广州地区的气温、相对湿度、风速和气压等气象因素可能是早产的重要影响因素。
Objective To study the relationship between meteorological factors and preterm labor in Guangzhou. Methods Time series method was used to study the relationship between meteorological factors and preterm birth by using the non-linear model of distribution lag using the data of premature birth, meteorological and air pollutants from 2004 to 2010 in Baiyun, Yuexiu and Panyu districts of Guangzhou. Results A total of 438 021 live births and 29973 premature infants were born in Baiyun, Yuexiu and Panyu districts from 2004 to 2010. The preterm birth rate was 6.84% (95% CI: 6.77% ~ 6.92% 11.72 ± 5.63). The average temperature was (23.41 ± 6.38) ℃, the average relative humidity was (67.34 ± 13.84)%, the mean pressure was (1012.94 ± 6.88) hPa, and the average wind speed was (6.99 ± 3.70) m / s. The association of meteorological factors with premature labor on different lag days is nonlinear. Generally speaking, the meteorological factors are positively correlated with the risk effects of preterm birth. When the temperature, relative humidity, air pressure and wind speed reach the maximum (34 ℃, 100%, 1032.2 hPa, 26 m / s) (95% CI: 1.28-3.16), 1.25 (95% CI: 1.08-1.45), 1.67 (95% CI: 1.03-2.71) and 4.91 (95% CI: CI: 0.63 to 38.11). The cumulative thermal effect was the highest in 0-26 days of lag period, and the RR was 1.47 (95% CI: 1.16-1.86). The cumulative wet risk effect was the highest at 0 days, with a RR of 1.12 (95% CI: 1.05-1.19) The cumulative high pressure effect was the highest in 0-25 days of lag period, and the RR was 1.34 (95% CI: 1.01-1.78). First-time pregnancies, first-time deliveries, baby boys, and preterm birth subgroups 33-36 weeks of pregnancy are more susceptible to meteorological factors, especially to high temperature. Conclusion The meteorological factors such as temperature, relative humidity, wind speed and air pressure in Guangzhou area may be the important influencing factors of preterm birth.