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Will climate variability worsen the outcome of childbirth?

Will climate variability worsen the outcome of childbirth?

 


According to systematic reviews and meta-analyses, exposure to extreme heat during pregnancy may be associated with an increased risk of preterm birth and stillbirth.

Pregnant people exposed to high temperatures are more likely to give birth prematurely, with odds increasing by 5% (95% CI 3% -7%) for every 1 ° C increase and 16% during heat waves. (95% CI 10% -23%), reported by Dr. Matthew Francis Chersich and his colleagues at the University of the Witwatersland in Johannesburg, South Africa.

The risk of stillbirth increased by 5% per 1 ° C (95% CI 1% -8%), the researchers write. BMJ..

The group also observed an association between elevated temperatures and low birth weight. However, this relationship was less strong and inconsistent when compared to the consequences of preterm birth and stillbirth. It was most effective for women with low socioeconomic status.

“Pregnant women are worth being in line with groups that are usually considered to be at increased risk for fever-related conditions,” Chersich and colleagues write. As the frequency and intensity of heat waves increased, the group stated that more research and policy intervention should be a “top priority.”

“Currently, we’re only talking about fever-sensitive groups like children and the elderly, but few are talking about pregnant women,” said Dr. Shao Lin, an epidemiologist at the University of Albany, New York. .. Climate change for human health. Lin, who was not involved in the study, said pregnant women may experience physiological changes that affect metabolism and circulation, making them more susceptible to heat stroke.

Although the study’s effect size was small, pregnant women could face significant risks as temperatures rise around the world, Lin said.

In this review, Chersich and colleagues looked for clinical studies investigating the association between heat exposure during pregnancy and preterm birth, birth weight, and stillbirth.

The review included a total of 70 studies, most of which investigated the effects of fever on preterm birth. The survey was conducted in 27 countries, 7 of which were low- or medium-income. Two-thirds of the study was published after 2015, and all but two were published after 2000.

There were 40 of the 47 studies reporting an association between elevated temperature and preterm birth, 18 of 28 studies reporting an association with low birth weight, and 8 studies reporting an association with stillbirth.

The median preterm birth rate in all the studies included was 5.6%. Eleven studies reported the highest preterm birth among women under 25 or over 35, and six studies reported a higher rate of preterm birth among women in the lower socio-economic group. In four studies in the United States, researchers found that black women had a higher incidence of preterm birth than white women.

Most studies of preterm birth reported a dose-response relationship, and the rate of preterm birth increased with increasing temperature or longer heat exposure.

In all studies included in this review, the median per 1,000 stillbirths was 6.2. A meta-analysis showed a 24% increased risk of stillbirth (OR 1.24, 95% CI 1.12 to 1.36) with lag measured on individual days of the last week of pregnancy, three times the risk when efficacy was measured. I reported that it was over. Whole semester or whole pregnancy (OR 3.39, 95% CI 2.33-4.96).

For low birth weight results, the median was 3%. The median observed risk of low birth weight associated with high temperature was 1.09 (interquartile range 1.04-1.47). However, researchers pointed out that the effect of temperature on body weight is generally small.

Chersich et al. Wrote that their review emphasized the need to study interventions that could reduce heat-related problems in pregnant women. This includes providing home-based services from community health workers, financial support for late-stage pregnant people, monitoring mothers’ hydration, and cooling delivery wards in low- and middle-income countries.

The group recognized that the study was limited by various temperature standards in the study and exposures such as air pollution that could have affected the outcome of childbirth. In addition, about one-third of the articles contained did not provide a detailed description of the study population and settings, and one-quarter used the analytical method improperly.

  • Amanda d’Ambrosio A reporter for MedPage Today’s corporate and research team. She covers obstetrics and gynecology and other clinical news and writes a feature article on the US healthcare system. To follow

Disclosure

This study was funded by the Swedish Research Council for Health, Working Life and Welfare in collaboration with the Natural Environment Research Council, the Norwegian Research Council (RCN), and the Swedish Research Council.

Chersich and some co-authors reported investing in the fossil fuel industry through pensions. In addition, it has a relevant relationship with the University of the Witwaters Land’s Global Change Institute, with some funders interested in coal mines and renewable energy.



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