1
|
Li J, Liu Y, He J, Yao W. Baicalin ameliorates heat stress-induced hepatic injury and intestinal microecology dysbiosis in late gestational mice. ECOTOXICOLOGY AND ENVIRONMENTAL SAFETY 2024; 283:116832. [PMID: 39137469 DOI: 10.1016/j.ecoenv.2024.116832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 07/16/2024] [Accepted: 07/31/2024] [Indexed: 08/15/2024]
Abstract
Heat stress (HS) disrupts intestinal microbiota, glycolipid metabolism, and hepatic mitochondrial function in late gestational mice. Baicalin (BAI), a Chinese herbal medicine known for its heat-clearing and anti-inflammatory properties, has shown promise in modulating intestinal microecology and mitigating inflammation in various organs. This study investigates whether baicalin attenuates HS-induced intestinal microbial dysbiosis and liver damage in pregnant mice during late gestation. Twenty-four pregnant mice were randomly assigned to four groups, including thermoneutral (TN) (24 ± 1 ℃), HS (35 ± 1 ℃), HS+BAI200 (oral gavaged with 200 mg/kg BW of BAI), and HS+BAI400 (oral gavaged with 400 mg/kg BW of BAI). 400 mg/kg BAI treatment markedly decreased the rectal temperature and increased fetal weight in HS pregnant mice. Furthermore, 400 mg/kg BAI administration effectively ameliorated HS-induced hepatic damage and lipid disorders, reducing HSP70, AST, and ALT levels while increasing TG concentration. Notably, it activated a network of genes involved in lipid synthesis, including fatty acid synthase (FAS), acetyl-CoA carboxylase (ACC), and oxidation, such as peroxisome proliferator-activated receptor alpha (PPARα), carnitine palmityl transferase 1 beta (CPT1β). Moreover, BAI intervention restored the intestinal morphology and barrier function, evidenced by increased intestinal villus height, the ratio of villus height to crypt depth, and colonic goblet cells numbers. 400 mg/kg of BAI treatment up-regulated the expression of tight junction proteins, such as claudin-1 and Zonula Occludens-1 (ZO-1), in the jejunum and ileum, counteracting HS-induced downregulation. High-throughput sequencing showed that BAI treatment altered cecal microbial composition, increasing the relative abundance of beneficial Bacteroidota and decreasing Deferribacterota, Turicibacter, and Akkermansia. Spearman's correlation analysis highlighted significant correlations between differential cecal microbiota and physiological indexes. In conclusion, BAI administration alleviated adverse impacts in heat-exposed mice during late gestation, improving maternal physiological parameters, and ameliorating hepatic damage with altered cecal microbial composition. The findings suggest that BAI may regulate the gut-liver axis by modulating intestinal morphology, microecology, and hepatic function.
Collapse
Affiliation(s)
- Jingzheng Li
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Yunyang Liu
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095, China
| | - Jianwen He
- Affiliated Hospital of Shaanxi University of Chinese Medicine, Shaanxi University of Chinese Medicine, Xianyang 712000, China.
| | - Wen Yao
- Department of Animal Nutrition and Feed Science, College of Animal Science and Technology, Nanjing Agricultural University, Nanjing 210095, China; Key Lab of Animal Physiology and Biochemistry, Ministry of Agriculture and Rural Affairs of the People's Republic of China, Nanjing Agricultural University, Nanjing 210095, China.
| |
Collapse
|
2
|
Bonell A, Ioannou LG, Hirst JE, Flouris A. Understanding the physiological and biological response to ambient heat exposure in pregnancy: protocol for a systematic review and meta-analysis. BMJ Open 2024; 14:e085314. [PMID: 38969375 PMCID: PMC11227802 DOI: 10.1136/bmjopen-2024-085314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Accepted: 06/21/2024] [Indexed: 07/07/2024] Open
Abstract
INTRODUCTION Climate change increases not only the frequency, intensity and duration of extreme heat events but also annual temperatures globally, resulting in many negative health effects, including harmful effects on pregnancy and pregnancy outcomes. As temperatures continue to increase precipitously, there is a growing need to understand the underlying biological pathways of this association. This systematic review will focus on maternal, placental and fetal changes that occur in pregnancy due to environmental heat stress exposure, in order to identify the evidence-based pathways that play a role in this association. METHODS AND ANALYSIS We will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We will search PubMed and Ovid Embase databases from inception using tested and validated search algorithms. Inclusion of any studies that involve pregnant women and have measured environmental heat stress exposure and either maternal, placental or fetal physiological or biochemical changes and are available in English. Modelling studies or those with only animals will be excluded. The risk of bias will be assessed using the Office of Health Assessment and Translation tool. Abstract screening, data extraction and risk of bias assessment will be conducted by two independent reviewers.Environmental parameters will be reported for each study and where possible these will be combined to calculate a heat stress indicator to allow comparison of exposure between studies. A narrative synthesis will be presented following standard guidelines. Where outcome measures have at least two levels of exposure, we will conduct a dose-response meta-analysis should there be at least three studies with the same outcome. A random effects meta-analysis will be conducted where at least three studies give the same outcome. ETHICS AND DISSEMINATION This systematic review and meta-analysis does not require ethical approval. Dissemination will be through peer-reviewed journal publication and presentation at international conferences/interest groups. PROSPERO REGISTRATION NUMBER CRD42024511153.
Collapse
Affiliation(s)
- Ana Bonell
- Medical Research Council Unit The Gambia, London School of Hygiene & Tropical Medicine, London, UK
| | - Leonidas G Ioannou
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| | - Jane Elizabeth Hirst
- The George Institute for Global Health, Imperial College London, London, UK
- Nuffield Department of Women's & Reproductive Health, University of Oxford, Oxford, UK
| | - Andreas Flouris
- FAME Laboratory, Department of Physical Education and Sport Science, University of Thessaly, Volos, Greece
| |
Collapse
|
3
|
Wang L, Di J, Wang Q, Zhang H, Zhao W, Shi X, Di Q, Ji JS, Liang W, Huang C. Heat exposure induced risks of preterm birth mediated by maternal hypertension. Nat Med 2024; 30:1974-1981. [PMID: 38750350 DOI: 10.1038/s41591-024-03002-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 04/15/2024] [Indexed: 07/21/2024]
Abstract
Heat exposure is associated with an increased risk of preterm birth (PTB), with previous work suggesting that maternal blood pressure may play a role in these associations. Here we conducted a cohort study of 197,080 singleton live births across 8 provinces in China from 2015 to 2018. The study first estimated the associations between heat exposure, maternal hypertension and clinical subtypes of PTB, and then quantified the role of maternal hypertension in heat and PTB using mediation analyses. We show that heat exposure (>85th, 90th and 95th percentiles of local temperature distributions) spanning from conception to the 20th gestational week was associated with a 15-21% increase in PTB, and a 20-22% increase in medically indicated PTB. Heat exposure is likely to increase the risk of maternal hypertension and elevated blood pressure. Maternal hypertension mediated 15.7% and 33.9% of the effects of heat exposure (>90th percentile) on PTB and medically indicated PTB, respectively. Based on this large-population study, we found that exposure to heat in early pregnancy can increase the risk of maternal hypertension, thereby affecting the incidence of PTB.
Collapse
Affiliation(s)
- Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Huanhuan Zhang
- School of Public Health, Zhengzhou University, Zhengzhou, China
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoming Shi
- National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Institute of Healthy China, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China.
- Institute of Healthy China, Tsinghua University, Beijing, China.
| |
Collapse
|
4
|
Wang L, Zhang C, Di J, Wang Q, Ren M, Huang A, Chen S, Zhao W, Hu H, Wang A, Di Q, Ji JS, Liang W, Huang C. Increased risk of preterm birth due to heat exposure during pregnancy: Exploring the mechanism of fetal physiology. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 931:172730. [PMID: 38663596 DOI: 10.1016/j.scitotenv.2024.172730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2023] [Revised: 04/07/2024] [Accepted: 04/22/2024] [Indexed: 05/09/2024]
Abstract
BACKGROUND Heat exposure during pregnancy can increase the risk of preterm birth (PTB) through a range of potential mechanisms including pregnancy complications, hormone secretion and infections. However, current research mainly focuses on the effect of heat exposure on pathophysiological pathways of pregnant women, but ignore that maternal heat exposure can also cause physiological changes to the fetus, which will affect the risk of PTB. OBJECTIVE In this study, we aimed to explore the mediating role of fetal heart rate (FHR) in the relationship between maternal heat exposure and PTB incidence. METHODS We assigned heat exposure to a multi-center birth cohort in China during 2015-2018, which included all 162,407 singleton live births with several times FHR measurements during the second and third trimesters. We examined the associations between heat exposure, FHR and PTB in the entire pregnancy, each trimester and the last gestational month. The inverse odds ratio-weighted approach applied to the Cox regression was used to identify the mediation effect of heat exposure on PTB and its clinical subtypes via FHR. FINDINGS Exposure to heat significantly increased the risk of PTB during the third trimester and the entire pregnancy, hazard ratios and 95 % CIs were 1.266 (1.161, 1.379) and 1.328 (1.218, 1.447). Heat exposure during the third trimester and entire pregnancy increased FHR in the third trimester by 0.24 bpm and 0.14 bpm. The proportion of heat exposure mediated by FHR elevation on PTB and its subtype ranged from 3.68 % to 24.06 %, with the significant mediation effect found for both medically indicated PTB and spontaneous PTB. CONCLUSIONS This study suggests that heat exposure during pregnancy has an important impact on fetal health, and FHR, as a surrogate marker of fetal physiology, may mediate the increased risk of PTB caused by extreme heat. Monitoring and managing physiological changes in the fetus would constitute a promising avenue to reduce adverse birth outcomes associated with maternal heat exposure.
Collapse
Affiliation(s)
- Liyun Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Chunying Zhang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiangli Di
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Qiong Wang
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Meng Ren
- School of Public Health, Sun Yat-sen University, Guangzhou, China
| | - Aiqun Huang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Sidi Chen
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wei Zhao
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanqing Hu
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ailing Wang
- National Center for Women and Children's Health, Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Qian Di
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - John S Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
| | - Wannian Liang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China
| | - Cunrui Huang
- Vanke School of Public Health, Tsinghua University, Beijing, China; Institute of Healthy China, Tsinghua University, Beijing, China.
| |
Collapse
|
5
|
Xiao H, Li Y, Liu X, Wen Q, Yao C, Zhang Y, Xie W, Wu W, Wu L, Ma X, Li Y, Ji A, Cai T. High ambient temperature may increase the risk of anemia in pregnancy: Identifying susceptible exposure windows. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 926:172059. [PMID: 38556012 DOI: 10.1016/j.scitotenv.2024.172059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 03/16/2024] [Accepted: 03/26/2024] [Indexed: 04/02/2024]
Abstract
Anemia in pregnancy (AIP) is associated with multiple severe maternal and perinatal adverse outcomes. However, there is a lack of evidence on the association between environmental factors and AIP. Aim to explore the association between ambient temperature and the risk of AIP, and identify susceptible exposure windows, we conducted a matched case-control study from 2013 to 2016 in Xi'an, China, which included 710 women with AIP and 1420 women without AIP. The conditional logistic regression model was used to evaluate the association between ambient temperature and AIP at different gestational weeks and gestational months. The association between extreme temperature and AIP was evaluated using the distributed lag nonlinear model (DLNM). We conducted stratified analyses of age, parity, and season of conception, and estimated the interaction between ambient temperature and air pollutants on AIP. Ambient temperature was significantly positively associated with the risk of AIP, and the susceptible exposure windows were 2-25 gestational weeks and 1-6 gestational months, respectively. The strongest effect was observed in the week 8 and month 2, for each 1 °C increase in weekly and monthly mean temperature, the odds ratio (OR) for AIP was 1.038 (95 % confidence interval (CI): 1.022, 1.055) and 1.040 (95 % CI: 1.020, 1.060), respectively. Extreme heat may increase the risk of AIP. Stratified analyses showed that there was no significant difference among different age, parity, and season of conception groups. No significant interaction effect of ambient temperature with air pollution on AIP was found. In summary, high ambient temperature may increase the risk of AIP, and the first and second trimesters may be susceptible exposure windows. Understanding the effect of temperature on pregnant women will be beneficial to reduce the occurrence of AIP.
Collapse
Affiliation(s)
- Hua Xiao
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yunlong Li
- Department of Hematology, Chongqing Hospital of Jiangsu Province Hospital (Qijiang People Hospital), Chongqing 401420, China
| | - Xiaoling Liu
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Qin Wen
- Medical Center of Hematology, Xinqiao Hospital, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), 400037, China
| | - Chunyan Yao
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Weijia Xie
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Wenhui Wu
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Long Wu
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Xiangyu Ma
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Yafei Li
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China
| | - Ailing Ji
- Department of Digital Health, Chongqing College of Architecture and Technology, Chongqing 401331, China.
| | - Tongjian Cai
- Department of Epidemiology, College of Preventive Medicine, State Key Laboratory of Trauma and Chemical Poisoning, Army Medical University (Third Military Medical University), Chongqing 400038, China.
| |
Collapse
|
6
|
Stein PJS, Stein MA, Groce N, Kett M, Akyeampong EK, Alford WP, Chakraborty J, Daniels-Mayes S, Eriksen SH, Fracht A, Gallegos L, Grech S, Gurung P, Hans A, Harpur P, Jodoin S, Lord JE, Macanawai SS, McClain-Nhlapo CV, Mezmur BD, Moore RJ, Muñoz Y, Patel V, Pham PN, Quinn G, Sadlier SA, Shachar C, Smith MS, Van Susteren L. Advancing disability-inclusive climate research and action, climate justice, and climate-resilient development. Lancet Planet Health 2024; 8:e242-e255. [PMID: 38580426 DOI: 10.1016/s2542-5196(24)00024-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 11/30/2023] [Accepted: 02/14/2024] [Indexed: 04/07/2024]
Abstract
Globally, more than 1 billion people with disabilities are disproportionately and differentially at risk from the climate crisis. Yet there is a notable absence of climate policy, programming, and research at the intersection of disability and climate change. Advancing climate justice urgently requires accelerated disability-inclusive climate action. We present pivotal research recommendations and guidance to advance disability-inclusive climate research and responses identified by a global interdisciplinary group of experts in disability, climate change, sustainable development, public health, environmental justice, humanitarianism, gender, Indigeneity, mental health, law, and planetary health. Climate-resilient development is a framework for enabling universal sustainable development. Advancing inclusive climate-resilient development requires a disability human rights approach that deepens understanding of how societal choices and actions-characterised by meaningful participation, inclusion, knowledge diversity in decision making, and co-design by and with people with disabilities and their representative organisations-build collective climate resilience benefiting disability communities and society at large while advancing planetary health.
Collapse
Affiliation(s)
- Penelope J S Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Michael Ashley Stein
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA.
| | - Nora Groce
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; International Disability Research Centre, University College London, London, UK
| | - Maria Kett
- International Disability Research Centre, University College London, London, UK
| | - Emmanuel K Akyeampong
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Willliam P Alford
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Jayajit Chakraborty
- Bren School of Environmental Science and Management, University of California-Santa Barbara, Santa Barbara, CA, USA
| | | | - Siri H Eriksen
- Faculty of Landscape and Society, Norwegian University of Life Sciences, Ås, Norway
| | - Anne Fracht
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Luis Gallegos
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; The United Nations Institute for Training and Research, Quito, Ecuador
| | - Shaun Grech
- Community Based Inclusive Development Initiative, CBM, Bensheim, Germany
| | - Pratima Gurung
- National Indigenous Disabled Women Association Nepal, Kusunti, Nepal
| | - Asha Hans
- School of Women's Studies, Utkal University, Bhubaneswar, India
| | - Paul Harpur
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; TC Beirne School of Law, University of Queensland, Brisbane, QLD, Australia
| | | | - Janet E Lord
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Center for International and Comparative Law, University of Baltimore, Baltimore, MD, USA
| | | | | | | | - Rhonda J Moore
- All of US Research Program, National Institutes of Health, Washington, DC, USA
| | | | - Vikram Patel
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Department of Global Health and Social Medicine, Harvard Medical School, Cambridge, MA, USA
| | - Phuong N Pham
- Harvard Humanitarian Initiative, Cambridge, MA, USA; Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Gerard Quinn
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA; Faculty of Law, University of Galway, Galway, Ireland
| | | | - Carmel Shachar
- Health Law and Policy Clinic at the Center for Health Law and Policy Innovation, Harvard Law School, Cambridge, MA, USA
| | - Matthew S Smith
- Harvard Law School Project on Disability, Harvard Law School, Cambridge, MA, USA
| | - Lise Van Susteren
- Department of Psychiatry and Behavorial Sciences, George Washington University School of Medicine and Health Sciences, Washington, DC, USA
| |
Collapse
|
7
|
Kadio K, Filippi V, Congo M, Scorgie F, Roos N, Lusambili A, Nakstad B, Kovats S, Kouanda S. Extreme heat, pregnancy and women's well-being in Burkina Faso: an ethnographical study. BMJ Glob Health 2024; 8:e014230. [PMID: 38382997 PMCID: PMC10897842 DOI: 10.1136/bmjgh-2023-014230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2023] [Accepted: 01/14/2024] [Indexed: 02/23/2024] Open
Abstract
Climate change is an increasing threat to the health of populations in Africa, with a shift in seasonal temperatures towards more extreme heat exposures. In Burkina Faso, like other countries in the Sahel, many women have little protection against exposure to high temperatures, either outside or inside the home or place of work. This paper investigates how women perceive the impacts of heat on their physical and mental health, in addition to their social relationships and economic activities. Qualitative methods (in-depth interviews and focus group discussions) were conducted with women, community representatives and healthcare professionals in two regions in Burkina Faso. A thematic analysis was used to explore the realities of participants' experiences and contextual perspectives in relation to heat. Our research shows extreme temperatures have a multifaceted impact on pregnant women, mothers and newborns. Extreme heat affects women's functionality and well-being. Heat undermines a woman's ability to care for themselves and their child and interferes negatively with breast feeding. Heat negatively affects their ability to work and to maintain harmonious relationships with their partners and families. Cultural practices such as a taboo on taking the baby outside before the 40th day may exacerbate some of the negative consequences of heat. Most women do not recognise heat stress symptoms and lack awareness of heat risks to health. There is a need to develop public health messages to reduce the impacts of heat on health in Burkina Faso. Programmes and policies are needed to strengthen the ability of health professionals to communicate with women about best practices in heat risk management.
Collapse
Affiliation(s)
- Kadidiatou Kadio
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| | | | - Mariam Congo
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| | - Fiona Scorgie
- Wits Reproductive Health Institute (WRHI), University of the Witwatersrand, Johannesburg, South Africa
| | - Nathalie Roos
- Department of Medicine, Karolinska Institutet, Stockholm, Sweden
| | | | - Britt Nakstad
- University of Oslo, Oslo, Norway
- Department of Pediatrics and Adolescent Health, University of Botswana, Gaborone, Botswana
| | - Sari Kovats
- London School of Hygiene & Tropical Medicine, London, UK
| | - Seni Kouanda
- Centre national de la recherche scientifique et technologique (CNRST), Institut de Recherche en Sciences de la Santé, Ouagadougou, Centre, Burkina Faso
| |
Collapse
|
8
|
Lakhoo DP, Chersich MF, Jack C, Maimela G, Cissé G, Solarin I, Ebi KL, Chande KS, Dumbura C, Makanga PT, van Aardenne L, Joubert BR, McAllister KA, Ilias M, Makhanya S, Luchters S. Protocol of an individual participant data meta-analysis to quantify the impact of high ambient temperatures on maternal and child health in Africa (HE 2AT IPD). BMJ Open 2024; 14:e077768. [PMID: 38262654 PMCID: PMC10824032 DOI: 10.1136/bmjopen-2023-077768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 11/13/2023] [Indexed: 01/25/2024] Open
Abstract
INTRODUCTION Globally, recognition is growing of the harmful impacts of high ambient temperatures (heat) on health in pregnant women and children. There remain, however, major evidence gaps on the extent to which heat increases the risks for adverse health outcomes, and how this varies between settings. Evidence gaps are especially large in Africa. We will conduct an individual participant data (IPD) meta-analysis to quantify the impacts of heat on maternal and child health in sub-Saharan Africa. A detailed understanding and quantification of linkages between heat, and maternal and child health is essential for developing solutions to this critical research and policy area. METHODS AND ANALYSIS We will use IPD from existing, large, longitudinal trial and cohort studies, on pregnant women and children from sub-Saharan Africa. We will systematically identify eligible studies through a mapping review, searching data repositories, and suggestions from experts. IPD will be acquired from data repositories, or through collaboration with data providers. Existing satellite imagery, climate reanalysis data, and station-based weather observations will be used to quantify weather and environmental exposures. IPD will be recoded and harmonised before being linked with climate, environmental, and socioeconomic data by location and time. Adopting a one-stage and two-stage meta-analysis method, analytical models such as time-to-event analysis, generalised additive models, and machine learning approaches will be employed to quantify associations between exposure to heat and adverse maternal and child health outcomes. ETHICS AND DISSEMINATION The study has been approved by ethics committees. There is minimal risk to study participants. Participant privacy is protected through the anonymisation of data for analysis, secure data transfer and restricted access. Findings will be disseminated through conferences, journal publications, related policy and research fora, and data may be shared in accordance with data sharing policies of the National Institutes of Health. PROSPERO REGISTRATION NUMBER CRD42022346068.
Collapse
Affiliation(s)
- Darshnika Pemi Lakhoo
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Chris Jack
- Climate System Analysis Group, University of Cape Town, Rondebosch, South Africa
| | - Gloria Maimela
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Guéladio Cissé
- University Peleforo Gon Coulibaly, Korhogo, Côte d'Ivoire
| | - Ijeoma Solarin
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | | | - Kshama S Chande
- Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa
| | - Cherlynn Dumbura
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
| | - Prestige Tatenda Makanga
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
- Place Alert Labs, Department of Surveying and Geomatics, Faculty of the Built Environment, Midlands State University, Gweru, Zimbabwe
| | - Lisa van Aardenne
- Climate System Analysis Group, University of Cape Town, Rondebosch, South Africa
| | - Bonnie R Joubert
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina, USA
| | - Kimberly A McAllister
- National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Durham, North Carolina, USA
| | - Maliha Ilias
- National Heart, Lung, and Blood Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
| | | | - Stanley Luchters
- Centre for Sexual Health and HIV/AIDS Research, Harare, Zimbabwe
- Liverpool School of Tropical Medicine, Liverpool, UK
- Department of Public Health and Primary Care, Ghent Unviersity, Ghent, Belgium
| |
Collapse
|
9
|
Ayejoto DA, Agbasi JC, Nwazelibe VE, Egbueri JC, Alao JO. Understanding the connections between climate change, air pollution, and human health in Africa: Insights from a literature review. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, TOXICOLOGY AND CARCINOGENESIS 2023; 41:77-120. [PMID: 37880976 DOI: 10.1080/26896583.2023.2267332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Climate change and air pollution are two interconnected global challenges that have profound impacts on human health. In Africa, a continent known for its rich biodiversity and diverse ecosystems, the adverse effects of climate change and air pollution are particularly concerning. This review study examines the implications of air pollution and climate change for human health and well-being in Africa. It explores the intersection of these two factors and their impact on various health outcomes, including cardiovascular disease, respiratory disorders, mental health, and vulnerable populations such as children and the elderly. The study highlights the disproportionate effects of air pollution on vulnerable groups and emphasizes the need for targeted interventions and policies to protect their health. Furthermore, it discusses the role of climate change in exacerbating air pollution and the potential long-term consequences for public health in Africa. The review also addresses the importance of considering temperature and precipitation changes as modifiers of the health effects of air pollution. By synthesizing existing research, this study aims to shed light on complex relationships and highlight the key findings, knowledge gaps, and potential solutions for mitigating the impacts of climate change and air pollution on human health in the region. The insights gained from this review can inform evidence-based policies and interventions to mitigate the adverse effects on human health and promote sustainable development in Africa.
Collapse
Affiliation(s)
- Daniel A Ayejoto
- Department of Environmental and Sustainability Sciences, Texas Christian University, Fort Worth, Texas, USA
| | - Johnson C Agbasi
- Department of Geology, Chukwuemeka Odumegwu Ojukwu University, Uli, Anambra State, Nigeria
| | - Vincent E Nwazelibe
- Department of Earth Sciences, Albert Ludwig University of Freiburg, Freiburg, Germany
| | - Johnbosco C Egbueri
- Department of Geology, Chukwuemeka Odumegwu Ojukwu University, Uli, Anambra State, Nigeria
| | - Joseph O Alao
- Department of Physics, Air Force Institute of Technology, Kaduna, Nigeria
| |
Collapse
|
10
|
Lokmic-Tomkins Z, Bhandari D, Watterson J, Pollock WE, Cochrane L, Robinson E, Su TT. Multilevel interventions as climate change adaptation response to protect maternal and child health: a scoping review protocol. BMJ Open 2023; 13:e073960. [PMID: 37500279 PMCID: PMC10387736 DOI: 10.1136/bmjopen-2023-073960] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/29/2023] Open
Abstract
INTRODUCTION Growing evidence suggests that climate change-related extreme weather events adversely impact maternal and child health (MCH) outcomes, which requires effective, sustainable and culturally appropriate interventions at individual, community and policy levels to minimise these impacts. This scoping review proposes to map the evidence available on the type, characteristics and outcomes of multilevel interventions implemented as adaptational strategies to protect MCH from the possible adverse effects of climate change. METHODS The following databases will be searched: Embase, MEDLINE, Emcare, EPPI-Centre database of health promotion research (BiblioMap) EPPI-Centre Database for promoting Health Effectiveness Reviews (DoPHER), Global Health, CINAHL, Joanna Briggs Institute EBP Database, Maternity and Infant Care Database, Education Resource Information Center, PsycINFO, Scopus, Web of Science and Global Index Medicus, which indexes Latin America and the Caribbean, Index Medicus for the South-East Asia Region, African Index Medicus, Western Pacific Region Index Medicus. Cochrane Central Register of Controlled Trials, WHO International Clinical Trials Registry Platform, ClinicalTrials.gov, conference proceedings, thesis and dissertations, policy and guidelines and their reference lists will also be searched. Two reviewers will independently screen titles and abstracts and full text based on predefined eligibility criteria. The Preferred Reporting Items for Systematic Reviews and Meta-analyses Extension for Scoping Reviews using the Population, Concept and Context framework and the Template for Intervention Description and Replication checklist will be used to structure and report the findings. ETHICS AND DISSEMINATION Ethics permission to conduct the scoping review is not required as the information collected is publicly available through databases. Findings will be disseminated through a peer-reviewed publication and conference presentations.
Collapse
Affiliation(s)
- Zerina Lokmic-Tomkins
- School of Nursing and Midwifery, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Dinesh Bhandari
- School of Nursing and Midwifery, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Jessica Watterson
- Department of Human-Centred Computing, Monash University, Clayton, VIC, Australia
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, Selangor, Malaysia
| | - Wendy E Pollock
- School of Nursing and Midwifery, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Lindy Cochrane
- Brownless Biomedical Library, The University of Melbourne - Parkville Campus, Melbourne, Victoria, Australia
| | - Eddie Robinson
- School of Nursing and Midwifery, Monash University Faculty of Medicine Nursing and Health Sciences, Clayton, Victoria, Australia
| | - Tin Tin Su
- South East Asia Community Observatory (SEACO), Jeffrey Cheah School of Medicine and Health Sciences, Monash University - Malaysia Campus, Bandar Sunway, Selangor, Malaysia
| |
Collapse
|
11
|
Raiten DJ, Bremer AA. Exploring the intersection of climate/environmental change, food systems, nutrition, and health: global challenge, opportunity, or both? Am J Clin Nutr 2023; 117:224-226. [PMID: 36811569 PMCID: PMC10196608 DOI: 10.1016/j.ajcnut.2022.11.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 12/27/2022] Open
Affiliation(s)
- Daniel J Raiten
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA.
| | - Andrew A Bremer
- Pediatric Growth and Nutrition Branch, Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), National Institutes of Health (NIH), Bethesda, MD, USA
| |
Collapse
|
12
|
Woodruff TJ, Charlesworth A, Zlatnik MG, Pandipati S, DeNicola N, Latif I. Code OB: We need urgent action on climate change and toxic chemicals. Int J Gynaecol Obstet 2023; 160:363-365. [PMID: 36649076 DOI: 10.1002/ijgo.14566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Affiliation(s)
- Tracey J Woodruff
- Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California San Francisco, San Francisco, California, USA
| | - Annemarie Charlesworth
- Program on Reproductive Health and the Environment, Environmental Research and Translation for Health (EaRTH) Center, University of California San Francisco, San Francisco, California, USA
| | - Marya G Zlatnik
- Division of Maternal Fetal Medicine and Program in Reproductive Health & the Environment, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco (UCSF), San Francisco, California, USA
| | - Santosh Pandipati
- Obstetrix Medical Group of California, APC, San Jose, California, USA
| | - Nathaniel DeNicola
- Department of Obstetrics and Gynecology, Johns Hopkins Health System, Washington, District of Columbia, USA
| | | |
Collapse
|
13
|
Yang HY, Lee JKW, Chio CP. Extreme temperature increases the risk of stillbirth in the third trimester of pregnancy. Sci Rep 2022; 12:18474. [PMID: 36323816 PMCID: PMC9630541 DOI: 10.1038/s41598-022-23155-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 10/25/2022] [Indexed: 11/16/2022] Open
Abstract
Epidemiological studies have reported the association between extreme temperatures and adverse reproductive effects. However, the susceptible period of exposure during pregnancy remains unclear. This study aimed to assess the impact of extreme temperature on the stillbirth rate. We performed a time-series analysis to explore the associations between temperature and stillbirth with a distributed lag nonlinear model. A total of 22,769 stillbirths in Taiwan between 2009 and 2018 were enrolled. The mean stillbirth rate was 11.3 ± 1.4 per 1000 births. The relative risk of stillbirth due to exposure to extreme heat temperature (> 29 °C) was 1.18 (95% CI 1.11, 1.25). Pregnant women in the third trimester were most susceptible to the effects of extreme cold and heat temperatures. At lag of 0-3 months, the cumulative relative risk (CRR) of stillbirth for exposure to extreme heat temperature (29.8 °C, 97.5th percentile of temperature) relative to the optimal temperature (21 °C) was 2.49 (95% CI: 1.24, 5.03), and the CRR of stillbirth for exposure to extreme low temperature (16.5 °C, 1st percentile) was 1.29 (95% CI: 0.93, 1.80). The stillbirth rate in Taiwan is on the rise. Our findings inform public health interventions to manage the health impacts of climate change.
Collapse
Affiliation(s)
- Hsiao-Yu Yang
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,grid.19188.390000 0004 0546 0241Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan ,grid.412094.a0000 0004 0572 7815Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Jason Kai Wei Lee
- grid.4280.e0000 0001 2180 6431Human Potential Translational Research Programme, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Global Asia Institute, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431N.1 Institute for Health, National University of Singapore, Singapore, Singapore ,grid.4280.e0000 0001 2180 6431Institute for Digital Medicine, National University of Singapore, Singapore, Singapore ,grid.452264.30000 0004 0530 269XSingapore Institute for Clinical Sciences, Agency for Science, Technology, and Research (A*STAR), Singapore, Singapore
| | - Chia-Pin Chio
- grid.19188.390000 0004 0546 0241Institute of Environmental and Occupational Health Sciences, National Taiwan University College of Public Health, No. 17 Xuzhou Road, Taipei, 10055 Taiwan ,Department of Medical Research, Tung’ Taichung Metro Harbor Hospital, Taichung, Taiwan
| |
Collapse
|