New Link Video Adriana Chersich Twitter – Here’s how extreme heat affects pregnant women As the world heats up, scientists are documenting premature births and stillbirths, as well as low birth weight babies.
In Kilifi, a large rural coastal town in Kenya, summer days reach 37 degrees Celsius and rarely drop below 21. “This place has always been hot,” says Adelaide Lusambili, an anthropologist at the Aga Khan University in Nairobi, “but now it’s very hot.”
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Like many other parts of the world, Kenya is experiencing an increase in annual temperatures, with more severe, intense and longer heat waves and less cold weather. . Excessive and persistent heat is a serious problem for pregnant women, who are more vulnerable. As the world warms, scientists are seeing an increase in stillbirths and premature or low-birth-weight babies.
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Last summer, Lusambili and her colleagues conducted interviews with expectant and newborn mothers, their family members, health workers and community leaders in Kilifi to understand the potential of overheating for maternal and newborn health. A health worker told them that the risk of stillbirth and premature birth is high.
A growing body of scientific research supports this view, suggesting that hotter than normal days and warmer nights increase adverse outcomes for pregnant women. This ranges from an increased risk of stillbirth – a stillborn baby born after 20 weeks of pregnancy – to an increased risk of preterm birth, a baby born before 37 weeks instead of 40 weeks.
Some studies suggest that high temperatures can cause newborns to gain more weight, which can lead to health problems for the baby. A recent analysis of 70 studies in 27 countries, including the United States, China, some European nations and sub-Saharan African countries, found that every 1.8 degree Fahrenheit increase in temperature — 1 degree Celsius — increases the chance of premature birth and stillbirth. 5 percent jump.
“It may seem small,” said lead author Matthew Chersich, an epidemiologist at the University of the Witwatersrand in South Africa, but research suggests the risk is increasing. As climate change increases the frequency of extreme heat events worldwide, it is clear that rising temperatures are putting pregnant women, new mothers and newborns at greater risk.
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Although scientists have not been able to identify the time during pregnancy when extreme heat affects the disease, exposure to extreme heat appears to be a problem early and late.
What makes all this research difficult is that there is no specific signature (such as a specific mutation) that can link a person’s birth and previous birth to a particular heat event, says Lindsay Darrow, an epidemiologist at the University of Nevada, Reno.
Researchers have used long-term datasets to compare gestational age with day-of-gestational and temperature data to determine how much and what type of heat—intensity or duration—affects this vulnerable segment of society.
Many studies have shown that pregnant women are more prone to hot flashes around their due date. Exposure to extreme temperatures during the last days or weeks of pregnancy can increase the risk of stillbirth or preterm birth—respiratory distress, neurodevelopmental disease, and childhood death. Other studies have shown that when a mother is exposed to high temperatures early in pregnancy, the developing baby may suffer from heart, spinal cord and other conditions. , or brain defects, which may explain premature birth or stillbirth. Some studies suggest that women may be at a higher risk of heat stroke during their pregnancy than at the end.
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At this time, scientists have not determined the exact ways heat affects pregnancy, but there are some hypotheses.
A pregnant woman’s body temperature is higher than average and rises when the temperature drops. Because these women are more thirsty, sweat less, and are less able to keep themselves cool, this is one reason why sweating is so dangerous for this population, and what pregnant women can do.
Dehydration can cause the blood to thicken, increasing the mother’s blood pressure and reducing blood flow and the supply of oxygen and nutrients to the baby. This can lead to low birth weight babies or premature birth.
Heat stress increases inflammation of the maternal part of the uterus – the decidua – which can lead to premature birth. Based on animal studies, warm temperatures can stimulate higher levels of pregnancy hormones such as oxytocin, which can lead to early labor.
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Although this hypothesis seems true, many of us do not know what and to what extent these conditions can affect the body of a pregnant woman in extreme heat, says neonatologist Britt Nakstad from the University of Botswana.
In a June 2022 study, epidemiologist Darrow and colleagues used cervical cancer records from six states — California, Florida, Georgia, Kansas, New Jersey and Oregon — from 1991 to 2017 and found a 3 percent increase in the risk of miscarriage during pregnancy. . There were four hot days last week. These risks increase when temperatures exceed 95 degrees.
In North Carolina, researchers found nighttime temperatures were associated with earlier births. Between 2011 and 2015, they found that every two-degree Fahrenheit (more than 1 degree Celsius) increase in temperature between May and September of 75 degrees Fahrenheit (23ºC) increased the risk of preterm birth by 6 percent.
“What we’re seeing is no recovery from daytime exposure,” said Carolina, a climate health scientist at Duke University and lead author of the North study. “Warm nights are getting stronger and that’s where we should be concerned.”
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In another study that examined the effects of heatstroke on women in 14 low- and middle-income countries, including Ethiopia, Nigeria, Nepal and South Africa, researchers found that pregnant women exposed to extreme heat were at greater risk of preterm labor and delivery. And warm, humid nights. Within seven days before birth.
While heat waves and extreme heat waves are dangerous, what is often overlooked is the seasonal rise in temperature, which can also put pregnant women and their babies at risk. As with many other health and economic issues—including access to shelter, clothing, and air conditioning—some women are more vulnerable to this heat stress than others.
In the US, heat-related adverse pregnancy outcomes are nearly twice as common for black and Hispanic women as for white women. This is not surprising because women of color live in urban, built-up areas that heat up quickly and take longer to cool down due to a lack of green space. It also seems that many of them cannot afford it or do not have access to air during very hot days.
Similarly, researchers studying maternal health in low- and middle-income countries suspect that the effects of climate change-related heat waves and increased heat exposure among pregnant women living in these areas. In these parts of the world, malnourished women continue to do household chores—from long walks to fetch water to farming and gathering firewood—even after their pregnancies end. hot season
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While most research in this area has focused on the effects of heat on pregnant women living in high-income countries, scientists like Lusambili and Cherish are trying to change that. Lusambili’s team is working with groups in the Kilifi community to raise awareness of the dangers of heatstroke and the importance of reducing activity for pregnant women. Chersich hopes to develop an alert system that can warn pregnant women to take precautions on hot days.
U.S. In, for example, information about heat stroke and its effects on pregnancy is still scarce. “We haven’t done a good job of training [health] professionals to talk to their patients about burnout,” Ward said. Efforts to communicate measures to reduce heatstroke such as staying indoors, using air conditioning, visiting people or using coolers backfire.
“There’s a real difference in climate like taking a hot tub,” says Veronica Gillispie-Bell, an obstetrician-gynecologist at Ochsner Health in New Orleans. As health care providers caring for pregnant women, he says, we need to be more aware of the problems and do our best to provide treatment.
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Researchers around the world are drawing a fine line between rising global temperatures and adverse effects on the health of mothers, fetuses and babies. One of them is Professor Matthew Chersich of Wits RHI (Reproductive Health and HIV Research Institute), whose recent work has focused on using data science to understand the effects of heat on expectant mothers and their babies in Africa.
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