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目的量化评估广州地区日均气温与早产的关联性。方法采用时间序列方法,利用广州市白云与越秀2个区2005—2011年的早产、气象与空气污染物资料,应用分布滞后非线性模型研究日均气温与早产的关联性,并评估高低气温对早产的冷热效应及累积冷热效应。结果广州市白云与越秀2个区2005—2011年共活产分娩263 322名,早产儿22 903例,早产率为8.70%(95%CI:8.59%~8.81%);日均出生早产儿(9.01±5.61)例;日均气温为(23.35±6.51)℃;日均相对湿度为(66.98±13.98)%;日均SO2浓度为(43.48±28.88)μg/m3;日均NO2浓度为(50.60±50.14)μg/m3;日均PM10浓度为(80.46±61.61)μg/m3。日均气温在不同滞后日与早产的关联呈非线性,暴露—反应关系近似U形,根据累积相对危险度最小的值对应确定参照气温为25.9℃。在滞后期第0~21天内,日均气温的累积风险效应从31℃开始显现出统计学意义,RR值为1.280 3(95%CI:1.014 9~1.615 1),并在34℃时达到最大,RR值为1.689 9(95%CI:1.076 7~2.652 6)。对于冷效应及累积冷效应,在整个滞后期内均无统计学意义。对于热效应,高温(日均气温为32℃),滞后1 d时风险效应最大,RR值为1.052 8(95%CI:1.014 2~1.092 9);对于累积热效应,在滞后期为第0~14天内达到最大,RR值为1.511 7(95%CI:1.210 5~1.887 8)。结论在广州地区,高温是造成早产的重要影响因素,可增加早产的发生风险。
Objective To quantitatively evaluate the correlation between average daily temperature and preterm labor in Guangzhou. Methods Time series method was used to study the relationship between average daily temperature and preterm birth by using the non-linear model of distribution lag using the premature birth, meteorological and air pollutants data from 2005 to 2011 in two districts of Guangzhou Baiyun and Yuexiu. Premature delivery of hot and cold effects and cumulative effects of cold and heat. Results A total of 263 322 live births and 22 903 premature infants were born in Baiyun and Yuexiu districts of Guangzhou from 2005 to 2011. The preterm birth rate was 8.70% (95% CI: 8.59% -8.81% 9.01 ± 5.61). The average daily temperature was (23.35 ± 6.51) ℃ and the average daily relative humidity was (66.98 ± 13.98)%. The average daily SO2 concentration was (43.48 ± 28.88) μg / m3. The average NO2 concentration was (50.60) ± 50.14) μg / m3. The average daily PM10 concentration was (80.46 ± 61.61) μg / m3. The correlation between daily mean temperature and premature labor was non-linear on different lag days, and the relationship between exposure and reaction was approximately U-shaped. The reference temperature was 25.9 ℃ according to the value of cumulative relative risk minimum. During the lag 0 to 21 days, the cumulative risk effect of daily mean air temperature began to show statistical significance at 31 ° C with an RR of 1.280 3 (95% CI: 1.014 9 to 1.615 1) and reached its maximum at 34 ° C , RR was 1.689 9 (95% CI: 1.076 7 ~ 2.652 6). For the cold effect and cumulative cold effect, there was no statistical significance in the whole lag period. For the thermal effects, high temperature (average daily temperature is 32 ℃), the maximum risk effect is 1d after lag, RR value is 1.052 8 (95% CI: 1.014 2 ~ 1.092 9); for the cumulative thermal effect, the lag period is 0-14 The maximum was reached within days, with an RR of 1.5117 (95% CI: 1.210 5 to 1.887 8). Conclusions In Guangzhou, high temperature is an important factor in preterm birth and increases the risk of preterm birth.