Pregnant women who work outdoors in hot and humid environments face significant health risks due to heat stress. A recent study by researchers from the University of Bern, the London School of Hygiene and Tropical Medicine, and the University of Brighton has shed new light on the complex relationship between environmental factors and maternal physiology in this vulnerable population. The study, conducted in the West Kiang district of The Gambia, West Africa, integrated observational data on pregnant women’s physiological responses with modeled climate data to better understand the effects of heat stress on their health.
The researchers found that environmental factors, such as air temperature, relative humidity, and solar radiation, significantly influenced the pregnant women’s skin temperature, tympanic temperature, and estimated core temperature. Importantly, they discovered that women in their third trimester of pregnancy experienced greater heat strain compared to those in their second trimester, highlighting the increased vulnerability as pregnancy progresses. The study also evaluated the applicability of various heat stress indices, such as the Universal Thermal Climate Index (UTCI) and Wet-Bulb Globe Temperature (WBGT), and found them to be useful tools for assessing the physiological impacts of heat stress in this context.
These findings have important implications for developing targeted interventions and public health policies to protect pregnant women working in agricultural settings from the detrimental effects of heat stress, particularly in the face of climate change. The study underscores the need for collaboration between researchers, policymakers, and local communities to address this critical issue and improve maternal and child health outcomes in vulnerable regions.
Combating Heat Stress in Pregnant Subsistence Farmers: A Multifaceted Approach
Pregnant women who work in outdoor, agricultural settings are particularly vulnerable to the harmful effects of heat stress. In the West Kiang district of The Gambia, West Africa, many women engage in subsistence farming, often spending several hours a day laboring in the hot and humid environment. This exposure to extreme heat can have significant physiological impacts, potentially leading to adverse pregnancy outcomes, such as preterm birth, stillbirth, and maternal health complications.
To better understand the complex relationship between environmental factors and maternal physiology in this context, a team of researchers from the University of Bern, the London School of Hygiene and Tropical Medicine, and the University of Brighton conducted a comprehensive study. The researchers integrated observational data on pregnant women’s physiological responses with modeled climate data, providing a more holistic understanding of the pathophysiological effects of heat stress on this vulnerable population.
Uncovering the Physiological Impacts of Heat Stress
The study involved 92 pregnant women from the West Kiang region who were recruited through the local antenatal clinic. These women were observed while performing their daily agricultural tasks, with researchers collecting data on various environmental and physiological parameters. Environmental factors, such as air temperature, relative humidity, solar radiation, and air velocity, were measured using specialized equipment. Simultaneously, the researchers monitored the women’s physiological responses, including skin temperature, tympanic (eardrum) temperature, heart rate, and estimated core temperature.
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The researchers found that environmental factors had a significant impact on the pregnant women’s physiological responses. Specifically, they observed that increases in air temperature, relative humidity, and solar radiation were associated with higher skin temperatures and tympanic temperatures. Interestingly, the study also revealed that women in their third trimester of pregnancy experienced greater heat strain compared to those in their second trimester, highlighting the increased vulnerability as pregnancy progresses.
Evaluating the Utility of Heat Stress Indices
In addition to examining the direct relationships between environmental factors and maternal physiology, the researchers also evaluated the applicability of various heat stress indices in this study context. Heat stress indices, such as the Universal Thermal Climate Index (UTCI) and Wet-Bulb Globe Temperature (WBGT), are tools that integrate environmental variables to model the heat transfer to the human body and provide an effective temperature scale.
The researchers found that these heat stress indices showed strong correlations with the pregnant women’s skin and tympanic temperatures, indicating their potential usefulness in assessing the physiological impacts of heat stress in this context. This finding suggests that incorporating heat stress indices into local weather warning systems could help stakeholders, such as policymakers and public health officials, better interpret, communicate, and potentially prevent the health risks associated with heat exposure for pregnant women working in agriculture.
Implications and Future Directions
The findings of this study have important implications for developing targeted interventions and public health policies to protect pregnant women working in agricultural settings from the detrimental effects of heat stress. As climate change continues to exacerbate the frequency, duration, and severity of extreme heat events in West Africa, the need for such measures becomes increasingly urgent.
The researchers recommend the inclusion of heat stress indices, such as UTCI and WBGT, in local heat-health warning systems to provide more accurate and actionable information for pregnant women and their communities. Additionally, the study highlights the importance of considering the interactive effects of environmental factors, such as the synergistic impact of high air temperature and humidity on maternal physiology.
Moving forward, the researchers suggest that further studies should aim to link the physiological impacts of heat stress to maternal health outcomes, including gestational diabetes, pre-eclampsia, and adverse birth outcomes. Exploring the effectiveness of protective interventions, such as the use of cooling garments or the implementation of work-rest schedules, could also be valuable areas of future research. Ultimately, this study underscores the need for a collaborative, multidisciplinary approach to address the pressing issue of heat stress in vulnerable populations, with the goal of improving maternal and child health outcomes in the face of a rapidly changing climate.
Author credit: This article is based on research by Carole Bouverat, Jainaba Badjie, Tida Samateh, Tida Saidy, Kris A. Murray, Andrew M. Prentice, Neil Maxwell, Andy Haines, Ana Maria Vicedo Cabrera, Ana Bonell.
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