气候变化与孕产妇及新生儿人群中的垂直传播感染：一项系统综述。
完整摘要 · 中文译文
背景：气候变化影响传染病动力学并扰乱孕产妇和新生儿健康服务，这两者都是垂直传播感染风险可能增加的途径。 方法：我们系统综述了气候相关环境暴露与孕妇或产时妇女、新生儿和婴儿中与垂直传播相关的感染结局之间关联的证据。筛选、数据提取和偏倚风险评估由两人独立重复进行。由于存在显著异质性，研究结果采用叙述性综合。使用GRADE评分评估证据确定性。 结果：在识别的4，579条记录中，审查了42篇全文，纳入6项研究。研究考察了干旱/饥荒、温度、湿度和气候带与HIV、B组链球菌（GBS）、水痘-带状疱疹病毒（VZV）和细菌性脑膜炎的关系。没有研究报告垂直传播作为结局。较高的温度和湿度与孕妇GBS定植增加相关。三项研究提示较冷和/或较干燥的条件与VZV传播增加或更早的血清学获得相关。一项研究发现干旱相关饥荒与马拉维农村孕妇HIV患病率增加相关。各结局分组的证据确定性均极低。 结论：本综述发现的证据提示气候相关暴露可能通过病原体特异性生物学途径与垂直传播相关感染有关， 更广泛的社会混乱和剥夺。目前证据不足以确定气候变化对垂直传播或相关结局的影响。填补这一空白应成为孕产妇和新生儿健康领域研究与气候适应的优先事项。 系统综述注册：https://www.crd.york.ac.uk/PROSPERO/view/CRD420251124435，PROSPERO CRD420251124435。
完整摘要 · 英文原文
BACKGROUND: Climate change influences infectious disease dynamics and disrupts maternal and neonatal health services, both of which are pathways through which the risk of vertically transmissible infections may increase. METHODS: We systematically reviewed evidence on the association between climate-related environmental exposures and infection-related outcomes relevant to vertical transmission in pregnant or intrapartum women, neonates, and infants. Screening, extraction, and risk-of-bias assessment were performed independently in duplicate. Owing to substantial heterogeneity, findings were synthesised narratively. GRADE scoring was used to assess certainty of evidence. RESULTS: Of 4,579 records identified, 42 full texts were reviewed and 6 studies included. Studies examined drought/famine, temperature, humidity, and climate zone in relation to HIV, group B streptococcus (GBS), varicella-zoster virus (VZV), and bacterial meningitis. No study reported vertical transmission as an outcome. Higher temperature and humidity were associated with increased maternal GBS colonisation. Three studies suggested cooler and/or drier conditions were associated with increased VZV transmission or earlier serological acquisition. One study found drought-associated famine was linked to increased HIV prevalence in pregnant women in rural Malawi. Certainty of evidence was very low across outcome groupings. CONCLUSIONS: This review found evidence suggesting climate-related exposures may be associated with infections relevant to vertical transmission through pathogen-specific biological pathways, broader social disruption, and deprivation. There is currently insufficient evidence to determine the impact of climate change on vertical transmission or related outcomes. Closing this gap should be a priority for research and climate adaptation in maternal and neonatal health. SYSTEMATIC REVIEW REGISTRATION: https://www.crd.york.ac.uk/PROSPERO/view/CRD420251124435, PROSPERO CRD420251124435.