摘要目的:探讨孕期非适宜气温暴露对早产发生风险的影响，并明确易感暴露窗。分析孕期非适宜气温和污染物暴露对早产的交互作用，以期为孕期非适宜气温暴露对早产发生风险的影响提供有力的线索。方法:2021年9月至2023年6月在福建省妇幼保健院招募1 852名孕妇作为研究对象，对其进行问卷调查，并查阅其健康档案，将每名孕妇的常住地址与欧洲中期天气预报中心第五代再分析数据和基于卫星遥感数据采集地理-统计组合模型进行匹配，并持续随访至出现妊娠结局。采用分布滞后非线性模型评估孕期非适宜气温和污染物暴露与早产发生风险之间的关联，同时采用相乘交互作用模型评估孕期非适宜气温和污染物的暴露对早产的交互作用。结果:在调整孕妇年龄、职业、所在地区国内生产总值、孕前BMI、新生儿性别等潜在的混杂因素之后，极端低温（ P1、 P3、 P5）的周均易感暴露窗为1~22周，极端高温（ P95、 P97、 P99）的周均易感暴露窗为27周和32~36周。极端低温［ P1（ OR=1.147，95% CI：1.041~1.265）、 P5（ OR=1.284，95% CI：1.035~1.501）］和极端高温［ P97（ OR=1.146，95% CI：1.039~1.263）、 P99（ OR=1.216，95% CI：1.099~1.345）］与空气动力学粒径≤2.5 μm的颗粒物存在相乘交互作用。 结论:孕期非适宜气温暴露与早产发生风险的增加有关，极端低温易感暴露窗主要集中于孕早期和孕中期，极端高温易感暴露窗主要集中于孕晚期。孕期非适宜气温和污染物暴露存在相乘交互作用，与增加早产发生风险有关。

abstractsObjectives:To investigate the effect of non-optimal temperature exposure during pregnancy on the risk for preterm birth and identify the susceptible exposure window. At the same time, the interaction between non-optimal temperature and pollutants exposure during pregnancy on preterm birth was analyzed, in order to provide strong clues for the influence of non-optimal temperature exposure during pregnancy on the risk for preterm birth.Methods:A total of 1 852 pregnant women were recruited from September 2021 to June 2023 in Fujian Provincial Maternal and Child Health Care Center. Questionnaire survey was conducted, and their health records were analyzed. The permanent address of each pregnant woman was matched with Fifth Generation European Centre for Medium-Range Weather Forecasts Atmospheric Reanalysis of the Global Climate and a geo-statistical combination model based on satellite remote sensing data collection, then follow-up for pregnancy outcome was conducted. Distributed lag nonlinear model was used to assess the association between exposure to non-optimal temperature during pregnancy and the risk for preterm birth and a multiplicative interaction model was used to assess the interaction between exposure to pollutants and non-optimal temperatures during pregnancy on the risk for preterm birth.Results:After adjusting for potential confounders such as maternal age, occupation, Gross Domestic Product of the region, pre-pregnancy preconception BMI, newborn sex, the weekly susceptibility windows of extreme low temperature ( P1, P3, P5) were week 1-22 , and the weekly susceptibility windows of extreme high temperature ( P95, P97, P99) were week 27 and week 32-36. Extreme low temperature [ P1 ( OR=1.147, 95% CI: 1.041-1.265), P5 ( OR=1.284, 95% CI: 1.035-1.501)] and extreme high temperature [ P97 ( OR=1.146, 95% CI: 1.039-1.263), P99 ( OR=1.216, 95% CI: 1.099-1.345)] exhibited multiplicative interaction with PM 2.5. Conclusions:Exposure to non-optimal temperature during pregnancy was associated with an increased risk for preterm birth. The susceptible exposure windows of extreme low temperature were mainly in early and mid-pregnancy, and the susceptible exposure windows of extreme high temperature were mainly in late-pregnancy. Exposure to non-optimal temperatures and pollutants during pregnancy was associated with an increased risk for preterm birth.