Abstract

Background:

The frequency and severity of extreme weather events such as wildfires are expected to increase due to climate change. Childbearing women, that is, women who are pregnant, soon to be pregnant, or have recently given birth, may be particularly vulnerable to the effect of wildfire exposure.

Objectives:

This review sought to systematically assess what is known about birth outcomes, health, and health care needs of childbearing women during and after exposure to wildfires.

Methods:

An integrative review methodology was utilized to enable article selection, data extraction, and synthesis across qualitative and quantitative studies. Comprehensive searches of SCOPUS (including MEDLINE and Embase), CINAHL, PubMed, and Google Scholar identified studies for inclusion with no date restriction. Included studies were independently appraised by two reviewers using the Crowe Critical Appraisal Tool. The findings are summarized and illustrated in tables.

Results:

Database searches identified 480 records. Following title, abstract, and full text screening, sixteen studies published between 2012 and 2022 were identified for this review. Eleven studies considered an association between in utero exposure to wildfire and impacts on birth weight and length of gestation. One study reported increased rates of maternal gestational diabetes mellitus and gestational hypertension following exposure; whereas one study reported differences in the secondary sex ratio. Two studies reported higher incidence of birth defects following in utero exposure to wildfire smoke. Three studies reported increased mental health morbidity, and one study associated a reduction in breastfeeding among women who evacuated from a wildfire disaster.

Discussion:

Evidence indicates that wildfire exposure may be associated with changes to birth outcomes and increased morbidity for childbearing women and their babies. These effects may be profound and have long-term and wide-ranging public health implications. This research can inform the development of effective clinical and public health strategies to address the needs of childbearing women exposed to wildfire disaster. https://doi.org/10.1289/EHP10544

中文翻译：

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野火灾害后育龄妇女的出生结果、健康和保健需求：一项综合的科学现状审查

摘要

背景：

由于气候变化，预计野火等极端天气事件的频率和严重程度将会增加。育龄妇女，即怀孕、即将怀孕或最近分娩的妇女，可能特别容易受到野火暴露的影响。

目标：

本综述旨在系统地评估在野火暴露期间和之后育龄妇女的出生结果、健康和医疗保健需求的已知情况。

方法：

采用综合审查方法来实现跨定性和定量研究的文章选择、数据提取和综合。对 SCOPUS（包括 MEDLINE 和 Embase）、CINAHL、PubMed 和 Google Scholar 的全面搜索确定了纳入的研究，没有日期限制。纳入的研究由两名评审员使用 Crowe 批判性评估工具独立评估。调查结果在表格中进行了总结和说明。

结果：

数据库搜索确定了 480 条记录。在标题、摘要和全文筛选之后，本次审查确定了 2012 年至 2022 年间发表的 16 项研究。11 项研究考虑了子宫内暴露于野火与对出生体重和妊娠时间的影响之间的关联。一项研究报告了暴露后母体妊娠期糖尿病和妊娠期高血压的发病率增加；而一项研究报告了第二性别比例的差异。两项研究报告称，子宫内暴露于野火烟雾后出生缺陷的发生率较高。三项研究报告了心理健康发病率增加，一项研究与从野火灾难中撤离的妇女减少母乳喂养有关。

讨论：

有证据表明，野火暴露可能与生育结果的变化和育龄妇女及其婴儿的发病率增加有关。这些影响可能是深远的，并具有长期和广泛的公共卫生影响。这项研究可以为制定有效的临床和公共卫生战略提供信息，以解决遭受野火灾害的育龄妇女的需求。https://doi.org/10.1289/EHP10544