Association between temperature and maternal stress during pregnancy

Yanfen Lin; Wenjing Hu; Jian Xu; Zhongcheng Luo; Xiaofang Ye; Chonghuai Yan; Zhiwei Liu; Shilu Tong

doi:10.1016/j.envres.2017.06.034

Association between temperature and maternal stress during pregnancy

Environ Res. 2017 Oct:158:421-430. doi: 10.1016/j.envres.2017.06.034. Epub 2017 Jul 6.

Authors

Yanfen Lin¹, Wenjing Hu¹, Jian Xu², Zhongcheng Luo¹, Xiaofang Ye³, Chonghuai Yan¹, Zhiwei Liu⁴, Shilu Tong⁵

Affiliations

¹ Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China.
² Xinhua Hospital, MOE-Shanghai Key Laboratory of Children's Environmental Health, Department of Child and Adolescent Healthcare, Shanghai Institute for Pediatric Research, Shanghai Jiao Tong University School of Medicine, Shanghai 200092, China. Electronic address: sonia0616@sjtu.edu.cn.
³ Shanghai Key Laboratory of Meteorology and Health, Shanghai 200135, China.
⁴ International Peace Maternity and Child Health Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China.
⁵ School of Public Health and Social Work, Queensland University of Technology, Brisbane, QLD 4059, Australia.

PMID: 28689033
DOI: 10.1016/j.envres.2017.06.034

Abstract

Background: Maternal psychological stress during pregnancy has essentially been conceptualized as a teratogen. However, little is known about the effect of temperature on maternal stress during pregnancy. The aim of this study is to investigate the relationship between temperature and maternal stress during pregnancy.

Methods: In 2010, a total of 1931 eligible pregnant women were enrolled across Shanghai from four prenatal-care clinics during their mid-to-late pregnancy. Maternal life-event stress and emotional stress levels during pregnancy were assessed by the "Life Event Scale for Pregnant Women" (LESPW) and "Symptom Checklist-90-Revised Scale" (SCL-90-R), respectively. Exposure to ambient temperature was evaluated based on daily regional average in different moving average and lag days. The generalized estimating equations were used to evaluate the relationship between daily average temperature/temperature difference and maternal stress.

Results: After adjusting for relevant confounders, an U-shaped relationship was observed between daily average temperature and maternal Global-Severity-Index (GSI) of the SCL-90-R. Cumulative exposures to extremely low temperatures (< P5, 1.4-10.5℃, lag 0-1 days, 0-2 days and 0-5 days) and extremely high temperatures (≥ P95, 31.2-34.1℃, lag 0-1 days and 0-2 days), and acute exposures to extremely low (lag day 0, 1, 2 and 3) and high (lag day 0, 1) temperatures, all induced higher risks of high GSI (the highest tertile), compared to the risk induced by exposed to an optimal temperature range (20-25℃) (P< 0.05). Increased temperature difference was associated with high maternal GSI (P< 0.05). However, non-significant associations were observed between daily average temperatures/temperature differences and maternal log-transferred LESPW scores.

Conclusions: Cumulative and acute exposures to extremely low/high temperatures may both induce emotional stress during pregnancy.

Keywords: Maternal stress; Pregnancy; Pregnancy complications; Sunlight duration; Temperature.

MeSH terms

Adolescent
Adult
China / epidemiology
Cities
Cold Temperature / adverse effects*
Female
Hot Temperature / adverse effects*
Humans
Pregnancy
Prevalence
Stress, Psychological / epidemiology*
Stress, Psychological / etiology
Young Adult