纽约州桑迪飓风期间大规模停电后，多胎妊娠并发症的风险增加。
Increased risk of multiple pregnancy complications following large-scale power outages during Hurricane Sandy in New York State.
机构信息
Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; Department of Occupational Health and Occupational Medicine, Guangdong Provincial Key Laboratory of Tropical Disease Research, School of Public Health, Southern Medical University, Guangzhou 510515, China.
Department of Environmental Health Sciences, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA.
出版信息
Sci Total Environ. 2021 May 20;770:145359. doi: 10.1016/j.scitotenv.2021.145359. Epub 2021 Jan 24.
BACKGROUND
Large-scale power outages (PO) are increasing in the context of climate change. Although some research has been conducted into the adverse health impacts of POs, significant gaps remain regarding whether POs would affect the health of pregnant women. We investigated the association between ED visits due to pregnancy complications and the occurence, intensity, and duration of large-scale POs in eight Sandy-affected counties in New York State (NYS).
METHODS
In this cross-sectional study, daily ED visits for pregnancy complications and large-scale PO data in eight counties in NYS from October to December in 2005-2014 were collected. Using time-series analysis, we estimated the relative increase in ED visits for pregnancy complications during POs compared with non-PO periods at lag 0-7 days. Short-term health impacts of PO intensity and PO duration were investigated. Estimations were also stratified by sociodemographic characteristics and disease subtypes including threatened or spontaneous abortion, threatened or early labor, hypertension complications, infections of genitourinary tract, renal diseases, gestational diabetes mellitus, mental illnesses, and cardiovascular diseases during pregnancy.
RESULTS
From October to December in 2005-2014, there were 307,739 ED visits for pregnancy complications in the eight counties. We found significant increases in ED visits for overall pregnancy complications (16.6%, 95% confidence interval [CI]: 10.3%, 23.2%) during the Hurricane-PO period at lag 0-7 days. The ED visits increased by 8.8% per level increase in PO intensity and 1.4% per day increase in PO duration. Specifically, threatened/early delivery and gestational diabetes mellitus during the PO period increased by 26.7% (95% CI: 8.2%, 48.4%) and 111.8% (95% CI: 16.7%, 284.4%), respectively. Young adult, Black, Hispanic, and uninsured individuals were at higher risk of complications.
CONCLUSIONS
POs may adversely impact pregnancy, especially for certain pregnancy complications and among low sociodemographic women.
背景
在气候变化的背景下，大规模停电（PO）的情况越来越多。尽管已经有一些研究探讨了 PO 对健康的不利影响，但关于 PO 是否会影响孕妇的健康，仍存在很大的差距。我们调查了在纽约州（NYS）受桑迪影响的八个县，由于妊娠并发症导致的 ED 就诊与大规模 PO 的发生、强度和持续时间之间的关联。
方法
在这项横断面研究中，我们收集了 2005 年至 2014 年 10 月至 12 月期间 NYS 八个县的每日 ED 妊娠并发症就诊和大规模 PO 数据。我们使用时间序列分析，估计了 PO 期间与非 PO 期间相比，ED 妊娠并发症就诊的相对增加，滞后 0-7 天。还调查了 PO 强度和 PO 持续时间的短期健康影响。估计结果还按社会人口特征和疾病亚型进行分层，包括威胁性或自发性流产、威胁性或早产、高血压并发症、生殖道感染、肾脏疾病、妊娠期糖尿病、精神疾病和妊娠期间的心血管疾病。
结果
在 2005 年至 2014 年 10 月至 12 月期间，这八个县共有 307739 次 ED 妊娠并发症就诊。我们发现，在滞后 0-7 天期间，飓风 PO 期间整体妊娠并发症的 ED 就诊人数增加了 16.6%（95%可信区间[CI]：10.3%，23.2%）。PO 强度每增加一个水平，ED 就诊人数增加 8.8%，PO 持续时间每增加一天，ED 就诊人数增加 1.4%。具体来说，PO 期间的威胁性/早产分娩和妊娠期糖尿病分别增加了 26.7%（95% CI：8.2%，48.4%）和 111.8%（95% CI：16.7%，284.4%）。年轻成年人、黑人、西班牙裔和没有保险的人患并发症的风险更高。
结论
PO 可能对妊娠产生不利影响，尤其是对某些妊娠并发症和社会经济地位较低的妇女。
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