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Impacts of high temperature on adverse birth outcomes in Seoul, Korea: Disparities by individual- and community-level characteristics

机译:高温对韩国首尔不利分娩结果的影响:按个人和社区水平特征的差异

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Background: Few studies have examined temperature's effect on adverse birth outcomes and relevant effect modifiers.Objectives: We investigated associations between heat and adverse birth outcomes and how individual and community characteristics affect these associations for Seoul, Korea, 2004-2012.Methods: We applied logistic regression to estimate associations between heat index during pregnancy, 4 weeks before delivery, and 1 week before delivery and risk of preterm birth and term low birth weight. We investigated effect modification by individual (infant's sex, mother's age, and mother's educational level) and community characteristics (socioeconomic status (SES) and percentage of green areas near residence at the gu level, which is similar to borough in Western countries). We also evaluated associations by combinations of individual- and community-level SES.Results: Heat exposure during whole pregnancy was significantly associated with risk of preterm birth. An interquartile (IQR) increase (5.5 degrees C) in heat index during whole pregnancy was associated with an odds ratio (OR) of 1.033 (95% CI 1.005, 1.061) with NO2 adjustment, and 1.028 (95% CI 0.998, 1.059) with PM10 adjustment, for preterm birth. We also found significant associations with heat exposure during 4 weeks before delivery and 1 week before delivery on preterm birth. We did not observe significant associations with term low birth weight. Higher risk of heat on preterm birth was associated with some individual characteristics such as infants with younger or older mothers and lower community-level SES. For combinations of individual- and community-level SES, the highest and most significant estimated effect was found for infants with low educated mothers living in low SES communities, with suggestions of effects of both individual-and community-level SES.Conclusions: Our findings have implications for evaluating impacts of high temperatures on birth outcomes, estimating health impacts of climate change, and identifying which subpopulations and factors are most relevant for disparities in this association.
机译:背景:很少有研究检查温度对不良出生结局的影响及其相关的影响因素目的:我们调查了韩国首尔市2004-2012年温度与不良出生结局之间的关联以及个人和社区特征如何影响这些关联的研究。进行逻辑回归分析以估计怀孕期间,分娩前4周和分娩前1周的热量指数与早产风险和足月低出生体重的关系。我们研究了按个人(婴儿的性别,母亲的年龄和母亲的教育水平)和社区特征(社会经济地位(SES)以及在居所级别附近居住的绿地百分比,与西方国家的自治区相似)进行的效果修正。我们还通过个体和社区水平的SES组合评估了相关性。结果:整个妊娠期间的热暴露与早产风险显着相关。整个妊娠期间热量指数的四分位数(IQR)升高(5.5摄氏度)与经调整NO2的比值比(OR)为1.033(95%CI 1.005,1.061)和1.028(95%CI 0.998,1.059)相关调整PM10,用于早产。我们还发现早产前4周和分娩前1周与热暴露显着相关。我们没有发现与足月出生低体重的显着相关性。早产时高热风险与某些个体特征有关,例如母亲年龄较大或年龄较大的婴儿以及较低的社区一级SES。对于个人和社区一级SES的组合,发现对生活在SES较低社区中的低学历母亲的婴儿,最高和最显着的估计效果是建议的,并建议采用个人和社区一级SES的效果。对于评估高温对分娩结局的影响,估算气候变化对健康的影响以及确定哪些亚人群和因素与这种关联中的差异最相关具有重要意义。

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