【摘要】 目的 预测在不同气候变化情景下，中国与温度升高相关的超额死胎数及其空间分布特征，为合理配置卫生资源提供参考依据。方法 国际耦合模式比较计划(coupled model intercomparison project, CMIP)能提供大气温度等气候变量的预测数据，是气候变化相关研究的重要工具。第六阶段国际耦合模式比较计划(CMIP6)基于不同的共享社会经济路径(shared socioeconomic pathways, SSPs)情景对温度进行预测。本研究以2015年为基准期，计算2021—2100年SSP126、SSP245和SSP585情景(分别表示可持续发展路径和低辐射排放、中间路径和中等辐射排放、以传统化石燃料为主的路径和高辐射排放)下的温度变化。通过整合联合国提供的中国死胎人数和世界人口项目提供的高分辨率怀孕次数，计算得到高分辨率的死胎人数。基于温度变化数据、高分辨率死胎人数及现有的暴露反应关系(RR=1.05,95%CI:1.01～1.08),计算2021—2100年与温度升高相关的超额死胎数。结果 到本世纪末，在SSP126、SSP245和SSP585情景下，中国每年与温度升高相关的超额死胎数分别为9 353(95%CI:2 082～13 794)人、13 643(95%CI:3 006～20 340)人和30 817(95%CI:7 072～44 778)人。与温度升高相关的超额死胎数呈现出随时间增加的趋势，且主要集中在第三级阶梯区域(即大兴安岭、太行山、巫山和雪峰山以东的地区)。结论 温度升高将导致中国的死胎负担增加，尤其在第三级阶梯区域。缓解气候变化有助于保障孕产妇及新生儿健康。更多还原

【Abstract】 Objective To project the temporal trend and spatial distribution of excess stillbirths attributable to rising temperatures in China under different climate change scenarios, so as to provide a reference for the rational allocation of health resources. Methods The Coupled Model Intercomparison Project(CMIP) is an important tool for climate change research, providing projections of climate variables such as atmospheric temperature. The Coupled Model Intercomparison Project Phase 6(CMIP6) provides temperature projections under different shared socioeconomic pathways(SSPs). In this study, 2015 was used as the baseline period to calculate temperature changes under the SSP126, SSP245 and SSP585 scenarios(denoting the sustainable pathway and low radiative forcing, the intermediate pathway and intermediate radiative emissions, and the traditional fossil fuel-dominated pathway and high radiative forcing, respectively) from 2021 to 2100. High-resolution stillbirths were calculated by integrating the number of stillbirths in China from the United Nations and the high-resolution number of pregnancies from the WorldPop. Based on temperature changes, high-resolution stillbirths and the established exposure-response relationship(RR=1.05, 95% CI:1.01-1.08), the number of excess stillbirths attributable to rising temperatures was calculated. Results By the end of this century, under the SSP126, SSP245 and SSP585 scenarios, the number of excess stillbirths attributable to rising temperatures in China was 9 353(95% CI:2 082-13 794), 13 643(95% CI:3 006-20 340), and 30 817(95% CI:7 072-44 778) per year, respectively. The number of excess stillbirths attributable to rising temperatures showed an increasing trend over time, with the majority of excess stillbirths occurring in the third topographic ladder. Conclusion Rising temperatures will lead to an increased burden of stillbirths in China, especially in the third topographic ladder. Mitigating climate change would therefore safeguard maternal and newborn health.更多还原