Abstract
BackgroundPneumonia is the leading cause of death and hospitalization among young children worldwide, but its risk factors remain unclear.ObjectiveTo evaluate the effect of maternal exposure to diurnal temperature variation (DTV) during preconceptional and prenatal periods on childhood pneumonia.MethodsA retrospective cohort study by case-control design was conducted for pneumonia (N = 699) and normal (N = 811) children under age of 14 who were enrolled in XiangYa Hospital, Changsha, China from May 2017 to April 2019. Demographic data including gender, age, birth season, gestational age, parity, mode of delivery, and parental atopy were collected from the electronic medical records in the hospital system. We obtained the data of daily DTV in Changsha during 2003–2019 from China Meteorological Administration. Maternal exposure to DTV during preconceptional and prenatal periods was respectively calculated by the average of daily DTV during one year and three months before conception and entire pregnancy as well as the three trimesters. The association between maternal exposure to outdoor DTV and childhood pneumonia was analyzed by multiple logic regression model.ResultsWe found that childhood pneumonia was significantly associated with exposure to an increase in DTV during one year before conception and entire pregnancy, with ORs (95 % CI) = 2.53 (1.56–4.10) and 1.85 (1.24–2.76). We further identified a significant risk of pneumonia of DTV exposure during the first and second trimester of pregnancy. Sensitivity analysis showed that boys were more susceptible to the effect of prenatal exposure to outdoor DTV during pregnancy particularly in the first two trimesters compared to girls.ConclusionsPreconceptional and prenatal exposure to DTV plays an important role in development of childhood pneumonia, especially during the first and second trimesters of pregnancy.
Highlights
Pneumonia is the leading cause of death and hospitalization among young children worldwide, but its risk factors remain unclear
Preconceptional and prenatal exposure to diurnal temperature variation (DTV) plays an important role in development of childhood pneumonia, especially during the first and second trimesters of pregnancy
We found that maternal exposure to DTV was significantly associated with childhood pneumonia, for a long-term exposure, with the adjusted odds ratio (OR) of 2.53 (1.56–4.10) for per 1°C increase in DTV exposure during one year before conception
Summary
Pneumonia is the leading cause of death and hospitalization among young children worldwide, but its risk factors remain unclear. Pneumonia is the leading cause of death and hospitalization among children under age of 5 worldwide [1, 2]. According to a recent epidemiological report, pneumonia has resulted in 808,694 deaths of children in 2017, which accounts for 15 % of all deaths in children under 5 years [4]. China has witnessed a very high prevalence of childhood pneumonia over recent years [5]. It is crucial to investigate the risk factors contributing to the frequent occurrence of childhood pneumonia, which would have a great implication for its effective reduction and early prevention
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