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Weaver EB, Gad L, Zota AR. Climate change as a threat multiplier to environmental reproductive justice. Semin Perinatol 2023; 47:151843. [PMID: 37839904 PMCID: PMC10841484 DOI: 10.1016/j.semperi.2023.151843] [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] [Indexed: 10/17/2023]
Abstract
Legacies of racial capitalism and colonialism drive present day racial disparities in perinatal health outcomes. Climate change amplifies existing social inequalities associated with environmental exposures and reproductive health, of which BIPOC (Black, Indigenous, and people of color) communities bear a disproportionate burden. Through case studies, this article summarizes three examples of climate justice issues with reproductive healthcare outcomes: traffic related air pollution exposure, chemical exposures in personal care products and plastics, and natural disaster frequency. We advocate for incorporation of climate justice and environmental health impact into medical school curriculum, increased prenatal screening for environmental toxins, and physician engagement with local environmental issues.
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Affiliation(s)
- Emily B Weaver
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States
| | - Laila Gad
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States
| | - Ami R Zota
- Department of Environmental Health Sciences Mailman School of Public Health Columbia University New York NY 10032 United States.
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Zhang A, de Ángel Solá D, Acevedo Flores M, Cao L, Wang L, Kim JG, Tarr PI, Warner BB, Rosario Matos N, Wang L. Infants exposed in utero to Hurricane Maria have gut microbiomes with reduced diversity and altered metabolic capacity. mSphere 2023; 8:e0013423. [PMID: 37754563 PMCID: PMC10597457 DOI: 10.1128/msphere.00134-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Accepted: 08/10/2023] [Indexed: 09/28/2023] Open
Abstract
The gut microbiome is a potentially important mechanism that links prenatal disaster exposures with increased disease risks. However, whether prenatal disaster exposures are associated with alterations in the infant's gut microbiome remains unknown. We established a birth cohort study named Hurricane as the Origin of Later Alterations in Microbiome (HOLA) after Hurricane Maria struck Puerto Rico in 2017. We enrolled vaginally born Latino term infants aged 2 to 6 months, including n = 29 infants who were exposed in utero to Hurricane Maria in Puerto Rico and n = 34 infants who were conceived at least 5 months after the hurricane as controls. Shotgun metagenomic sequencing was performed on infant stool swabs. Infants exposed in utero to Hurricane Maria had a reduced diversity in their gut microbiome compared to the control infants, which was mainly seen in the exclusively formula-fed group (P = 0.02). Four bacterial species, including Bacteroides vulgatus, Clostridium innocuum, Bifidobacterium pseudocatenulatum, and Clostridium neonatale, were depleted in the exposure group compared to the control group. Compositional differences in the microbial community and metabolic genes between the exposure and control groups were significant, which were driven by the formula feeding group (P = 0.02 for the microbial community and P = 0.008 for the metabolic genes). Metabolic modules involved in carbohydrate metabolism were reduced in the exposure group. Prenatal maternal exposure to Hurricane Maria was associated with a reduced gut commensal and an altered microbial composition and metabolic potential in the offspring's gut. Breastfeeding can adjust the composition of the gut microbiomes of exposed infants. IMPORTANCE Climate change is a serious issue that is affecting human health. With more frequent and intense weather disasters due to climate change, there is an urgent need to evaluate and understand the impacts of prenatal disaster exposures on the offspring. The prenatal stage is a particularly vulnerable stage for disease origination. However, the impact of prenatal weather disaster exposures on the offspring's gut microbiome has not been evaluated. Our HOLA study starts to fill this knowledge gap and provides novel insights into the microbiome as a mechanism that links prenatal disaster exposures with elevated disease risks. Our major finding that reduced microbial diversity and altered metabolic capacity are associated with prenatal hurricane exposures warrants further studies to evaluate the impact of weather disasters on the unborn.
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Affiliation(s)
- Ai Zhang
- Department of Medicine, Division of Allergy and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - David de Ángel Solá
- Department of Pediatrics, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Midnela Acevedo Flores
- Department of Pediatrics and Obstetrics and Gynecology, San Juan City Hospital Research Unit, San Juan Hospital, San Juan, Puerto Rico
| | - Lijuan Cao
- Department of Medicine, Division of Allergy and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Leran Wang
- Department of Medicine, Division of Infectious Diseases, Edison Family Center for Genome Sciences and Systems Biology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Josh G. Kim
- Department of Medicine, Division of Allergy and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Phillip I. Tarr
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Barbara B. Warner
- Department of Pediatrics, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
| | - Nicolás Rosario Matos
- Department of Pediatrics and Obstetrics and Gynecology, San Juan City Hospital Research Unit, San Juan Hospital, San Juan, Puerto Rico
| | - Leyao Wang
- Department of Medicine, Division of Allergy and Immunology, Washington University School of Medicine in St. Louis, St. Louis, Missouri, USA
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Chowdhury AT, Jabeen S, Sultana ZZ, Rahman AE, Arifeen SE, Hossain A. Evaluating the impact of e-registration and mHealth on institutional delivery in hazard-prone areas of Bangladesh: A protocol for a non-randomized controlled cluster trial. PLoS One 2023; 18:e0271364. [PMID: 37756321 PMCID: PMC10529544 DOI: 10.1371/journal.pone.0271364] [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: 07/11/2022] [Accepted: 08/06/2023] [Indexed: 09/29/2023] Open
Abstract
Despite substantial progress, Bangladesh still has a high rate of maternal deaths owing to difficulties during pregnancy, delivery, and the postpartum period. Increasing facility delivery is mandatory to reach the goal of bringing down the MMR to <70 deaths/100,000 live births by 2030. In the era of digitalization, the introduction of e-registration and mHealth may aid the government in reaching this target. The southern part of Bangladesh is a hazard-prone area, where service uptake from institutions is low. This study aims to determine the effect of an e-registration tracking system and mHealth counseling on institutional deliveries to pregnant mothers in hazard-prone areas of southern Bangladesh. We will conduct an open-label, two-arm, non-randomized controlled cluster trial for six months and use three hazard-prone areas for intervention and another three hazard-prone areas for control. We will collect data at baseline and end-line of the study period using a structured questionnaire. We will enroll at least 268 pregnant mothers from the intervention and 268 pregnant mothers from the control areas after screening based on the inclusion and exclusion criteria. Pregnancy information will be obtained from the Family Welfare Assistant register. The respondents of the intervention arm will be registered in the e-Registration system, and receive voice call and text messages from the midwives to have their deliveries done in healthcare facilities. We will follow the participants until their delivery and exclude those respondents from the study who will have post-dated delivery, migrate out, lost to follow-up, or die during the study period. Random-intercept mixed-effect logistic regression will be performed to explain the relationship of e-registration and mHealth package with institutional delivery. Institutional delivery is still uncommon in Southern Bangladesh despite several interventions. Innovative approaches like e-registration and mHealth counseling may be helpful to bring women to health facilities. The findings from the study might enable the policy makers of Bangladesh to integrate the intervention package into the existing healthcare system. This experiment is registered in the open science framework. Clinical trial registration: Registration number: DOI 10.17605/OSF.IO/YZE5C) and https://www.clinicaltrials.gov/ (registration number: NCT05398978.
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Affiliation(s)
- Anika Tasneem Chowdhury
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Sabrina Jabeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Zeeba Zahra Sultana
- Department of Public Health, School of Health and Life Sciences, North South University, Dhaka, Bangladesh
| | - Ahmed Ehsanur Rahman
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Shams El Arifeen
- Maternal and Child Health Division, International Centre for Diarrhoeal Disease Research (icddr,b), Dhaka, Bangladesh
| | - Ahmed Hossain
- College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
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Impact of COVID-19 on Neuropsychiatric Disorders. J Clin Med 2022; 11:jcm11175213. [PMID: 36079143 PMCID: PMC9456667 DOI: 10.3390/jcm11175213] [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: 08/06/2022] [Revised: 08/27/2022] [Accepted: 09/02/2022] [Indexed: 11/25/2022] Open
Abstract
Since the Coronavirus disease 2019 (COVID-19) pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), many studies have shown that besides common COVID-19 symptoms, patients may develop various neuropsychiatric conditions including anxiety, mood disorders, psychosis, neurodegenerative diseases (e.g., dementia), insomnia, and even substance abuse disorders. COVID-19 can also worsen the patients underlying neuropsychiatric and neurodevelopmental conditions during or after the system phase of disease. In this review, we discuss the impact of SARS-CoV-2 infection on development or status of neuropsychiatric conditions during or following COVID-19.
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