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Physiological mechanisms of the impact of heat during pregnancy and the clinical implications: review of the evidence from an expert group meeting

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posted on 05.08.2022, 15:01 authored by Louisa Samuels, Britt Nakstad, Nathalie Roos, Ana Bonell, Matthew Chersich, George HavenithGeorge Havenith, Stanley Luchters, Louise-Tina Day, Jane E Hirst, Tanya Singh, Kirsty Elliott-Sale, Robyn Hetem, Cherie Part, Shobna Sawry, Jean Le Roux, Sari Kovats

Many populations experience high seasonal temperatures. Pregnant women are considered vulnerable to extreme heat because ambient heat exposure has been linked to pregnancy complications including preterm birth and low birthweight. The physiological mechanisms that underpin these associations are poorly understood. We reviewed the existing research evidence to clarify the mechanisms that lead to adverse pregnancy outcomes in order to inform public health actions. A multi-disciplinary expert group met to review the existing evidence base and formulate a consensus regarding the physiological mechanisms that mediate the effect of high ambient temperature on pregnancy. A literature search was conducted in advance of the meeting to identify existing hypotheses and develop a series of questions and themes for discussion. Numerous hypotheses have been generated based on animal models and limited observational studies. There is growing evidence that pregnant women are able to appropriately thermoregulate; however, when exposed to extreme heat, there are a number of processes that may occur which could harm the mother or fetus including a reduction in placental blood flow, dehydration, and an inflammatory response that may trigger preterm birth. There is a lack of substantial evidence regarding the processes that cause heat exposure to harm pregnant women. Research is urgently needed to identify what causes the adverse outcomes in pregnancy related to high ambient temperatures so that the impact of climate change on pregnant women can be mitigated.

Funding

Natural Environment Research Council (NERC)

Research Council of Norway (RCN)

The Swedish Research Council for Health, Working Life and Welfare in collaboration with the Swedish Research Council (Forte); coordinated through a Belmont Forum partnership

History

School

  • Design and Creative Arts

Department

  • Design

Published in

International Journal of Biometeorology

Volume

66

Issue

8

Pages

1505 - 1513

Publisher

Springer

Version

VoR (Version of Record)

Rights holder

© The Authors

Publisher statement

This is an Open Access Article. It is published by Springer under the Creative Commons Attribution 4.0 International Licence (CC BY 4.0). Full details of this licence are available at: https://creativecommons.org/licenses/by/4.0/

Acceptance date

01/05/2022

Publication date

2022-05-12

Copyright date

2022

ISSN

0020-7128

eISSN

1432-1254

Language

en

Depositor

Prof George Havenith. Deposit date: 17 May 2022