A systematic review and meta-analysis of heat exposure impacts on maternal, fetal and neonatal health

IF 58.7 1区 医学 Q1 BIOCHEMISTRY & MOLECULAR BIOLOGY Nature Medicine Pub Date : 2024-11-05 DOI:10.1038/s41591-024-03395-8
Darshnika P. Lakhoo, Nicholas Brink, Lebohang Radebe, Marlies H. Craig, Minh Duc Pham, Marjan M. Haghighi, Amy Wise, Ijeoma Solarin, Stanley Luchters, Gloria Maimela, Matthew F. Chersich
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Abstract

Climate Change has severe and wide-ranging health impacts, especially for vulnerable groups. Despite growing evidence of heat-associated adverse maternal and neonatal health outcomes, there remains a lack of synthesis quantifying associations and identifying specific risk periods. We systematically reviewed the literature on heat impacts on maternal, fetal, and neonatal health, and quantified impacts through meta-analyses. We found 198 studies across66 countries, predominantly high income (63.3%) and temperature climate zones (40.1%), and 23 outcomes. Results showed increased odds of preterm birth of 1.04 (95%CI = 1.03, 1.06; n = 12) per 1°C increase in heat exposure and 1.26 (95%CI = 1.08, 1.47; n = 10) during heatwaves. Similarly high heat exposure increased the risk for stillbirths (OR = 1.13 (95%CI=0.95, 1.34; n = 9)), congenital anomalies (OR=1.48 (95%CI = 1.16, 1.88; n = 6)), and gestational diabetes mellitus (OR = 1.28 (95%CI = 1.05, 1.74; n = 4)). The odds of any obstetric complication increased by 1.25 (95%CI = 1.09, 1.42; n = 11) during heatwaves. Patterns in susceptibility windows varied by condition. The findings were limited by heterogeneity in exposure metrics and study designs. The systematic review demonstrated that escalating heat exposure poses a major threat to maternal and neonatal health, highlighting research priorities, guiding the selection and monitoring of heat-health indicators, and emphasising the need to prioritise maternal and neonatal health in national climate-health programmes.

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热暴露对孕产妇、胎儿和新生儿健康影响的系统回顾和荟萃分析
气候变化会对健康产生严重而广泛的影响,尤其是对弱势群体。尽管有越来越多的证据表明,高温会对孕产妇和新生儿的健康造成不利影响,但目前仍缺乏量化相关性和确定特定风险期的综述。我们系统回顾了有关高温对孕产妇、胎儿和新生儿健康影响的文献,并通过荟萃分析对影响进行了量化。我们发现了 198 项研究,涉及 66 个国家,主要是高收入国家(63.3%)和温度气候带国家(40.1%),以及 23 种结果。结果显示,热暴露温度每升高 1°C,早产几率增加 1.04(95%CI = 1.03,1.06;n = 12),热浪期间增加 1.26(95%CI = 1.08,1.47;n = 10)。同样,高温也会增加死胎(OR = 1.13 (95%CI = 0.95, 1.34; n = 9))、先天性畸形(OR = 1.48 (95%CI = 1.16, 1.88; n = 6))和妊娠糖尿病(OR = 1.28 (95%CI = 1.05, 1.74; n = 4))的风险。任何产科并发症的几率在热浪期间增加了 1.25(95%CI = 1.09,1.42;n = 11)。易感窗口的模式因条件而异。研究结果受到暴露指标和研究设计异质性的限制。该系统综述表明,不断升级的热暴露对孕产妇和新生儿健康构成重大威胁,突出了研究重点,为选择和监测热健康指标提供了指导,并强调了在国家气候健康计划中优先考虑孕产妇和新生儿健康的必要性。
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来源期刊
Nature Medicine
Nature Medicine 医学-生化与分子生物学
CiteScore
100.90
自引率
0.70%
发文量
525
审稿时长
1 months
期刊介绍: Nature Medicine is a monthly journal publishing original peer-reviewed research in all areas of medicine. The publication focuses on originality, timeliness, interdisciplinary interest, and the impact on improving human health. In addition to research articles, Nature Medicine also publishes commissioned content such as News, Reviews, and Perspectives. This content aims to provide context for the latest advances in translational and clinical research, reaching a wide audience of M.D. and Ph.D. readers. All editorial decisions for the journal are made by a team of full-time professional editors. Nature Medicine consider all types of clinical research, including: -Case-reports and small case series -Clinical trials, whether phase 1, 2, 3 or 4 -Observational studies -Meta-analyses -Biomarker studies -Public and global health studies Nature Medicine is also committed to facilitating communication between translational and clinical researchers. As such, we consider “hybrid” studies with preclinical and translational findings reported alongside data from clinical studies.
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