BACKGROUND Acute exposure to high ambient temperature and heat waves during the warm season has been linked with psychiatric disorders. Emerging research has shown that pregnant people, due to physiological and psychological changes, may be more sensitive to extreme heat, and acute exposure has been linked to increased risk of pregnancy complications; however, few studies have examined psychiatric complications. OBJECTIVE Our objective was to examine the association between acute exposure to warm ambient temperatures and emergency department (ED) visits for mental disorders during pregnancy. METHODS A time-stratified case-crossover design with conditional logistic regression was performed on ∼206,000 psychiatric ED visits for pregnant patients in North Carolina, from May to September 2016 to 2019. Daily average ambient temperature was the main exposure and was linked to daily visits by maternal zip code of residence for prenatal mood and anxiety disorders (PMAD), severe mental illness (SMI), mental disorder of pregnancy (MDP), suicidal thoughts (SUIC), and any psychiatric disorder (Any). Effect modification by trimester, residential segregation, economic segregation, urbanicity, and availability of greenspace was also investigated. RESULTS Each 5°C increase in same-day exposure to warm ambient temperature on case days was associated with an increase in incidence rate ratio (IRR) for any psychiatric disorder [IRR = 1.07; 95% confidence interval (CI): 1.01, 1.14] including anxiety (IRR = 1.14; 95% CI: 1.00, 1.30), bipolar disorder (IRR = 1.28; 95% CI: 0.98, 1.67), and suicidal thoughts (IRR = 1.28; 95% CI: 1.00, 1.65) compared to control days. In general, the associations were strongest for warm season temperatures on the same day of exposure or for temperatures averaged over the 3 or 6 d preceding the ED visit. The greatest risk of an incident ED admission for PMAD (RR = 1.20; 95% CI: 1.04, 1.39), particularly for anxiety (RR = 1.30; 95% CI: 1.07, 1.59), and any psychiatric disorder (RR = 1.17; 95% CI: 1.07, 1.28) occurred following cumulative exposure to hot temperatures the week before admission. Higher psychiatric burden from temperature was observed in urban areas and on extreme heat days. CONCLUSIONS For this pregnant population in the southeastern United States, short-term exposure to high ambient temperatures during the warm season was associated with a greater risk of ED visits for an array of psychiatric disorders. Findings show that climate-related increases in ambient temperature may contribute to psychiatric morbidity in pregnant people. https://doi.org/10.1289/EHP13293.

中文翻译：

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怀孕期间精神科急诊就诊与温暖环境温度的关联：时间分层病例交叉研究。


背景技术在温暖季节期间急性暴露于高环境温度和热浪与精神疾病有关。最新研究表明，孕妇由于生理和心理的变化，可能对极端高温更加敏感，而急性暴露与妊娠并发症风险增加有关；然而，很少有研究检查精神并发症。目的 我们的目的是研究怀孕期间急性暴露于温暖的环境温度与因精神障碍而去急诊室 (ED) 就诊之间的关系。方法 2016 年 5 月至 9 月至 2019 年，对北卡罗来纳州大约 206,000 名前往精神科急诊就诊的怀孕患者进行了时间分层病例交叉设计和条件逻辑回归。日平均环境温度是主要暴露因素，并与每日就诊相关根据产前情绪和焦虑障碍 (PMAD)、严重精神疾病 (SMI)、妊娠期精神障碍 (MDP)、自杀念头 (SUIC) 和任何精神障碍 (Any) 的母亲居住地邮政编码。还调查了三个月期、居住隔离、经济隔离、城市化和绿地可用性的影响修改。结果 病例日当日接触温暖环境温度每升高 5°C，任何精神疾病的发病率比 (IRR) 就会增加 [IRR = 1.07；IRR = 1.07； 95% 置信区间 (CI): 1.01, 1.14] 包括焦虑 (IRR = 1.14; 95% CI: 1.00, 1.30)、双向情感障碍 (IRR = 1.28; 95% CI: 0.98, 1.67) 和自杀念头 (IRR = 1.28；95% CI：1.00，1.65）与对照天相比。 一般来说，对于接触同一天的暖季温度或急诊就诊前 3 或 6 天内的平均温度，这种关联最强。 PMAD 入院急诊室的风险最大 (RR = 1.20; 95% CI: 1.04, 1.39)，尤其是焦虑症 (RR = 1.30; 95% CI: 1.07, 1.59) 和任何精神疾病 (RR = 1.17; 95% CI: 1.07, 1.59)。 95% CI: 1.07, 1.28) 发生在入院前一周累积暴露于高温下。在城市地区和极端炎热的日子里，温度造成的精神负担更高。结论 对于美国东南部的孕妇来说，温暖季节短期暴露于高温环境与因一系列精神疾病而到急诊室就诊的风险较高相关。研究结果表明，与气候相关的环境温度升高可能会导致孕妇出现精神疾病。 https://doi.org/10.1289/EHP13293。