摘要
全球变暖作为当今世界最严峻的挑战之一,对人类健康构成严重威胁.目前研究主要关注高温对弱势群体(如老年人、儿童等)的直接影响,而关于高温暴露对不良出生结局的具体影响程度、致病机理以及应对策略的认识仍然存在一定的局限性与不足.本文系统梳理了高温暴露与不良出生结局之间的流行病学证据,深入挖掘了其背后的生物学机制,并针对这些机制提出了应对策略.流行病学证据表明,高温暴露可增加流产、死胎、早产、低出生体重和先天畸形等不良出生结局的发病风险.这一风险的产生与孕妇体温过高、失水、胎盘功能异常、激素调节失衡以及氧化应激/炎症反应等多种生物学机制密切相关.未来的研究应进一步探索这些生物学机制,以期找到更为精确的作用通路和关键节点.在此基础上制定出科学、有效的预防和治疗措施,最大程度地降低高温暴露对下一代健康的不利影响.
As global warming intensifies,the rising temperature is posing a great threat to human health,particularly among vulnerable population groups such as the elderly,young children,and pregnant women.Fetal development is highly vulnerable to the ambient environment,and exposure to high temperatures may contribute to adverse birth outcomes,which can significantly impact the postnatal growth and development of children,and cause significant socioeconomic burdens.Nevertheless,how high temperature influences the risk of adverse birth outcomes and how to mitigate these effects remain unclear.This article systematically reviews epidemiological evidence about the impact of high-temperature exposure on adverse birth outcomes,summarizes the underlying biological mechanisms,and proposes coping strategies.An increasing amount of evidence indicates that high-temperature exposure could contribute to a spectrum of adverse birth outcomes,including spontaneous abortion,stillbirth,preterm birth,low birth weight,and congenital anomalies.The underlying mechanisms involve increased maternal core temperature and dehydration,disruptions in placental function,alterations in hormonal profiles,augmented oxidative stress,and inflammatory responses.Accordingly,appropriate measures can be taken to mitigate the adverse effects of high temperature on birth outcomes,such as maintaining appropriate body temperature and sufficient water intake,inhibiting uterine contractions,regulating hormones,and suppressing oxidative stress and inflammation.Previous research has shed partial light on this significant scientific issue.However,ongoing studies still face some challenges:Firstly,the lack of a standardized definition for high-temperature exposure complicates the identification and categorization.Variations in the definition of high-temperature exposure,encompassing different intensities and durations,can lead to disparate conclusions.Secondly,discrepancies between pregnant women’s actual high-temperature exposure and outdoor conditions impact the accuracy of analysis results.The actual duration of high-temperature exposure should exclude the period spent in air-conditioned indoor environments,yet obtaining this information is challenging.Thirdly,critical exposure windows and sensitive populations remain undefined.Moreover,the underlying mechanisms are not yet fully understood.The associations between specific indicators and adverse birth outcomes are relatively straightforward to identify,but establishing causality is complex.Overall,these factors impede the development of further prevention and control measures.Future research should pay more attention to the following aspects:(1)Standardizing the definition of high-temperature exposure,which may involve different regional,demographic,and other characteristic factors;(2)gathering precise epidemiological and specific subject information.Based on the large-scale datasets,more detailed stratified studies should be conducted to identify these critical parameters,including threshold temperatures and exposure windows.Additionally,a more comprehensive exploration of the molecular mechanism is essential to provide precise scientific support for the development of targeted prevention and treatment strategies.To fulfill these objectives,it is essential to integrate expertise from multidisciplinary fields,including epidemiology,biomedicine,meteorology,and other relevant disciplines.Through collaborative endeavors,more efficacious strategies can be identified to mitigate the adverse impact of high-temperature exposure on maternal and child health in the foreseeable future,ensuring an improved start for every new life.
作者
李亚泰
潘明明
薛源
陈宇
冯斐斐
邓启红
Yatai Li;Mingming Pan;Yuan Xue;Yu Chen;Feifei Feng;Qihong Deng(College of Public Health,Zhengzhou University,Zhengzhou 450001,China;School of Civil Engineering,Zhengzhou University,Zhengzhou 450001,China)
出处
《科学通报》
北大核心
2025年第22期3594-3603,共10页
Chinese Science Bulletin
基金
中原科技创新领军人才计划(224200510007)
国家自然科学基金(42277430)资助。
