Abstract：
BACKGROUND: Hypertensive disorders in pregnancy (HDP) are a major cause of maternal mortality and morbidity. Recent studies indicated that pregnant women are the most vulnerable populations to ambient temperature influences, but it affected HDP with inconsistent conclusions. Our objective is to systematically review whether extreme temperature exposure is associated with a changed risk for HDP.
METHODS: We searched PubMed, EMBASE, Web of Science and Cochrane Library databases. We included cohort or case control studies examining the association between extreme temperature exposure before or during pregnancy and HDP. Heat sources such as saunas and hot baths were excluded. We pooled the odds ratio (OR) to assess the association between extreme temperature exposure and preeclampsia or eclampsia.
RESULTS: Fifteen studies involving 4,481,888 patients were included. Five studies were included in the meta-analysis. The overall result demonstrated that in the first half of pregnancy, heat exposure increases the risk of developing preeclampsia or eclampsia and gestational hypertension, and cold exposure decreases the risk. The meta-analysis revealed that during the first half of pregnancy, heat exposure increased the risk of preeclampsia or eclampsia (OR 1.54, 95% confidence interval (CI): 1.10, 2.15), whereas cold exposure decreased the risk (OR 0.90, 95% CI: 0.84, 0.97).
CONCLUSIONS: The ambient temperature is an important determinant for the development of HDP, especially for preeclampsia or eclampsia. The effects of extreme temperatures may be bidirectional during the different trimesters of pregnancy, which should be evaluated by future studies. This review provided hints of temperature regulation in HDP administration.
METHODS: We searched PubMed, EMBASE, Web of Science and Cochrane Library databases. We included cohort or case control studies examining the association between extreme temperature exposure before or during pregnancy and HDP. Heat sources such as saunas and hot baths were excluded. We pooled the odds ratio (OR) to assess the association between extreme temperature exposure and preeclampsia or eclampsia.
RESULTS: Fifteen studies involving 4,481,888 patients were included. Five studies were included in the meta-analysis. The overall result demonstrated that in the first half of pregnancy, heat exposure increases the risk of developing preeclampsia or eclampsia and gestational hypertension, and cold exposure decreases the risk. The meta-analysis revealed that during the first half of pregnancy, heat exposure increased the risk of preeclampsia or eclampsia (OR 1.54, 95% confidence interval (CI): 1.10, 2.15), whereas cold exposure decreased the risk (OR 0.90, 95% CI: 0.84, 0.97).
CONCLUSIONS: The ambient temperature is an important determinant for the development of HDP, especially for preeclampsia or eclampsia. The effects of extreme temperatures may be bidirectional during the different trimesters of pregnancy, which should be evaluated by future studies. This review provided hints of temperature regulation in HDP administration.
摘要：
背景：妊娠期高血压疾病（HDP）是孕产妇死亡和发病的主要原因。最近的研究表明，孕妇是最容易受到环境温度影响的人群，但它影响了HDP，结论不一致。我们的目标是系统评估极端温度暴露是否与HDP风险变化相关。
方法：我们搜索了PubMed，EMBASE,WebofScience和Cochrane图书馆数据库。我们纳入了队列或病例对照研究，研究了怀孕前或怀孕期间极端温度暴露与HDP之间的关系。不包括桑拿和热水澡等热源。我们汇总了比值比（OR）以评估极端温度暴露与先兆子痫或子痫之间的关联。
结果：纳入了15项研究，涉及4,481,888例患者。5项研究纳入荟萃分析。总体结果表明，在怀孕的上半年，热暴露会增加先兆子痫或子痫和妊娠高血压的风险，冷暴露降低了风险。荟萃分析显示，在怀孕的上半年，热暴露会增加先兆子痫或子痫的风险（OR1.54，95％置信区间（CI）：1.10，2.15），而冷暴露降低了风险(OR0.90,95%CI:0.84,0.97)。
结论：环境温度是HDP发展的重要决定因素，尤其是先兆子痫或子痫。极端温度的影响在怀孕的不同阶段可能是双向的，这应该由未来的研究来评估。这篇综述提供了HDP管理中温度调节的提示。
方法：我们搜索了PubMed，EMBASE,WebofScience和Cochrane图书馆数据库。我们纳入了队列或病例对照研究，研究了怀孕前或怀孕期间极端温度暴露与HDP之间的关系。不包括桑拿和热水澡等热源。我们汇总了比值比（OR）以评估极端温度暴露与先兆子痫或子痫之间的关联。
结果：纳入了15项研究，涉及4,481,888例患者。5项研究纳入荟萃分析。总体结果表明，在怀孕的上半年，热暴露会增加先兆子痫或子痫和妊娠高血压的风险，冷暴露降低了风险。荟萃分析显示，在怀孕的上半年，热暴露会增加先兆子痫或子痫的风险（OR1.54，95％置信区间（CI）：1.10，2.15），而冷暴露降低了风险(OR0.90,95%CI:0.84,0.97)。
结论：环境温度是HDP发展的重要决定因素，尤其是先兆子痫或子痫。极端温度的影响在怀孕的不同阶段可能是双向的，这应该由未来的研究来评估。这篇综述提供了HDP管理中温度调节的提示。
