Prenatal exposure to elevated ambient temperature may cause bronchopulmonary dysplasia: Evidence from twin pairs across China

Yuan Zheng; Xinqi Zhong; Wan Peng; Qijiong Zhu; Lv Wang; Changshun Xia; Yixiang Huang; Jiahong Xu; Zhiqing Chen; Yuwei Fan; Yiyu Lai; Qiliang Cui; Tao Liu

doi:10.1016/j.scitotenv.2024.177406

Prenatal exposure to elevated ambient temperature may cause bronchopulmonary dysplasia: Evidence from twin pairs across China

Sci Total Environ. 2024 Nov 12:177406. doi: 10.1016/j.scitotenv.2024.177406. Online ahead of print.

Authors

Yuan Zheng¹, Xinqi Zhong², Wan Peng¹, Qijiong Zhu³, Lv Wang⁴, Changshun Xia², Yixiang Huang¹, Jiahong Xu¹, Zhiqing Chen³, Yuwei Fan², Yiyu Lai², Qiliang Cui⁵, Tao Liu⁶

Affiliations

¹ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China.
² Department of Obstetrics and Gynecology; Department of Neonatology; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine; The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
³ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China.
⁴ Guangzhou Eighth People's Hospital, Guangzhou Medical University, China.
⁵ Department of Obstetrics and Gynecology; Department of Neonatology; Guangdong Provincial Key Laboratory of Major Obstetric Diseases; Guangdong Provincial Clinical Research Center for Obstetrics and Gynecology; Guangdong-Hong Kong-Macao Greater Bay Area Higher Education Joint Laboratory of Maternal-Fetal Medicine; The Third Affiliated Hospital, Guangzhou Medical University, Guangzhou, China. Electronic address: [email protected].
⁶ Department of Public Health and Preventive Medicine, School of Medicine, Jinan University, Guangzhou 510632, China; China Greater Bay Area Research Center of Environmental Health, School of Medicine, Jinan University, Guangzhou 510632, China; Key Laboratory of Viral Pathogenesis & Infection Prevention and Control, Jinan University, Ministry of Education, Guangzhou 510632, China. Electronic address: [email protected].

PMID: 39542279
DOI: 10.1016/j.scitotenv.2024.177406

Abstract

Exposure to high ambient temperature (TM) may affect lung development, but the association of prenatal TM exposure with bronchopulmonary dysplasia (BPD) is unclear. We explored the impact of prenatal TM exposure on BPD, and identify the critical exposure windows. Individual information of participants was collected from 21 hospitals across China. Daily TM and PM_2.5 were obtained from ERA-5 reanalysis, and the Tracking Air Pollution in China, respectively. BPD was diagnosis based on the 2001 criteria set by the National Institute of Child Health and Human Development (NICHD). Generalized linear model (GLM) was used to explored the impact of TM exposure on BPD during entire pregnancy. Distributed lag non-linear model was utilized to assess the week-specific association between maternal TM exposure and BPD. The study included 8343 twin pairs, among whom 363 (4.35 %) twin pairs were classified as BPD cases. Compared with the reference TM (14.2 °C), exposures to the 75th (22.5 °C) and 95th (24.9 °C) centile of TM were associated with higher BPD risks during the entire pregnancy, with OR = 2.02 (95 % CI: 1.56-2.61) and OR = 2.27 (95 % CI: 1.17-4.40), respectively. In week-specific analyses, compared with the reference TM (14.2 °C) with minimum BPD risk in GLM during the entire pregnancy, exposures to the 75th (22.5 °C) and 95th (24.9 °C) centile of TM during the 1st to 3rd, and 17th to 23rd gestational weeks were positively associated with BPD, with the highest associations in the 20th (HR = 1.25, 95 % CI: 1.12, 1.39) and 1st (HR = 1.32, 95 % CI: 1.11, 1.58) gestational week, respectively. Moreover, effects of high TM on BPD were more pronounced in participants with pregnancy complications and rural residents. Prenatal exposure to elevated TM was associated with higher BPD risk in twins, especially during the early and middle pregnancy periods, and in participants with pregnancy complications and rural residents.

Keywords: Ambient temperature; Bronchopulmonary dysplasia; Prenatal exposure; Twins fetal.