Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth
BackgroundPreterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the...
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| Format: | Article |
| Language: | English |
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Editorial Committee of Journal of Environmental and Occupational Medicine
2022-03-01
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| Series: | 环境与职业医学 |
| Subjects: | |
| Online Access: | http://www.jeom.org/article/cn/10.11836/JEOM21447 |
| _version_ | 1828350179827253248 |
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| author | Xiaoxin ZHANG Wenjing WANG Zhenghong ZHU Kaipu WU Qianhong LIANG Yanqiu LI Wenjun MA Cunrui HUANG Qiong WANG |
| author_facet | Xiaoxin ZHANG Wenjing WANG Zhenghong ZHU Kaipu WU Qianhong LIANG Yanqiu LI Wenjun MA Cunrui HUANG Qiong WANG |
| author_sort | Xiaoxin ZHANG |
| collection | DOAJ |
| description | BackgroundPreterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear.ObjectiveTo evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth.MethodsA birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P75, P80, P85, P90, and P95) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed.ResultsAmong all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P90 and P95 increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P75, P80, P85, P90, and P95 decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P75 and P80 thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P90 threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing.ConclusionAn elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration. |
| first_indexed | 2024-04-14T01:21:07Z |
| format | Article |
| id | doaj.art-ef08ac755f9b4bf496c92ab583fd22df |
| institution | Directory Open Access Journal |
| issn | 2095-9982 |
| language | English |
| last_indexed | 2024-04-14T01:21:07Z |
| publishDate | 2022-03-01 |
| publisher | Editorial Committee of Journal of Environmental and Occupational Medicine |
| record_format | Article |
| series | 环境与职业医学 |
| spelling | doaj.art-ef08ac755f9b4bf496c92ab583fd22df2022-12-22T02:20:38ZengEditorial Committee of Journal of Environmental and Occupational Medicine环境与职业医学2095-99822022-03-0139328128810.11836/JEOM2144721447Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birthXiaoxin ZHANG0Wenjing WANG1Zhenghong ZHU2Kaipu WU3Qianhong LIANG4Yanqiu LI5Wenjun MA6Cunrui HUANG7Qiong WANG8School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, ChinaNational Center for Chronic and Non-Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 100050, ChinaSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, ChinaSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, ChinaGuangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital), Guangzhou, Guangdong 511402, ChinaGuangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital), Guangzhou, Guangdong 511402, ChinaSchool of Medicine, Jinan University, Guangzhou, Guangdong 510632, ChinaVanke School of Public Health, Tsinghua University, Beijing 100084, ChinaSchool of Public Health, Sun Yat-sen University, Guangzhou, Guangdong 510080, ChinaBackgroundPreterm birth-related complications are the leading cause of death in newborns and children under the age of 5 years. Maternal heat exposure has been associated with both sleep status during pregnancy and the increased risk of preterm birth. However, whether sleep status could mediate the association between heat exposure and preterm birth remains unclear.ObjectiveTo evaluate the association between maternal heat exposure in early pregnancy and preterm birth, and to further explore potential mediation effect of sleep status on the association between heat exposure and preterm birth.MethodsA birth cohort was established in Guangzhou Panyu Maternal Child Health Hospital (Guangzhou Panyu District He Xian Memorial Hospital) from 2017 until now. Pregnant women (with gestational age between 8 and 13 weeks) were included in this study when they presented to the hospital for their first prenatal care visit and signed an informed consent. Then they were followed up until delivery. A total of 3 268 pregnant women were included for the final analysis. Questionnaires were distributed to collect the demographic characteristics, lifestyles, and sleep status of pregnant women. Daily meteorological data during the study period were collected from meteorological monitoring stations in Guangzhou and the average ambient mean temperature of four weeks before the survey was calculated and assigned for each pregnancy. The 75th, 80th, 85th, 90th, and 95th percentiles (P75, P80, P85, P90, and P95) of the average ambient temperature of all pregnant women were used as the thresholds to define heat exposure. Logistic regression was used to evaluate the effects of heat exposure in different definitions on preterm birth and sleep status (sleep duration, night sleep timing, and wake up timing). The mediation effects of sleep status on the relationship between heat exposure and preterm birth were also analyzed.ResultsAmong all the included participants, 165 newborns were preterm births with an incidence rate of 5.0%. Heat exposures with thresholds of P90 and P95 increased the risk of preterm birth, with ORs (95%CIs) of 1.66 (1.04-2.57) and 1.90 (1.03-3.33), respectively (P<0.05). Heat exposures with thresholds of P75, P80, P85, P90, and P95 decreased the sleep duration (<9 h vs. ≥9 h, control group: ≥9 h), and the ORs (95%CIs) were 1.51 (1.25-1.83), 1.44 (1.17-1.77), 1.35 (1.08-1.70), 1.43 (1.09-1.87), and 1.45 (1.00-2.13), respectively. Heat exposures with P75 and P80 thresholds resulted in earlier wake up timing (<8: 00 vs. ≥8: 00, control group: <8: 00), with ORs (95%CIs) of 0.77 (0.63-0.93) and 0.76(0.61-0.93), respectively. No significant association was observed between heat exposure and night sleep timing. The mediation analyses showed that under heat exposure with P90 threshold, a statistically significant mediation effect was observed for sleep duration, and the proportion mediated was 6.07% (95%CI: 0.17%-25.00%) (P<0.05). No significant mediation effect was observed for night sleep timing and wake up timing.ConclusionAn elevated risk of preterm birth after heat exposure in early pregnancy may be partly mediated through reducing sleep duration.http://www.jeom.org/article/cn/10.11836/JEOM21447heat exposureearly pregnancypreterm birthsleepmediation effect |
| spellingShingle | Xiaoxin ZHANG Wenjing WANG Zhenghong ZHU Kaipu WU Qianhong LIANG Yanqiu LI Wenjun MA Cunrui HUANG Qiong WANG Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth 环境与职业医学 heat exposure early pregnancy preterm birth sleep mediation effect |
| title | Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| title_full | Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| title_fullStr | Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| title_full_unstemmed | Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| title_short | Mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| title_sort | mediating role of sleep in association between maternal heat exposure during early pregnancy and risk of preterm birth |
| topic | heat exposure early pregnancy preterm birth sleep mediation effect |
| url | http://www.jeom.org/article/cn/10.11836/JEOM21447 |
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