Climate Change and Reproductive Health

The climate crisis is resulting in more severe, frequent, and longer lasting extreme weather events such as heat waves, droughts, flooding, and hurricanes. These events disproportionately impact vulnerable populations around the world. Pregnant women, developing fetuses, and newborns are particularly susceptible to climate change associated adverse health effects. Many reproductive health and birth defects are linked to extreme heat, increased ozone and PM2.5 emissions, and wildfire smoke. Scientists are finding that timing of exposure during critical windows may also play a role in pregnancy outcomes including gestational diabetes, maternal hypertension,preterm birth, low birth weight, and still birth, in addition to birth defects such as congenital anomalies, hypospadias, renal agenesis/hypoplasia, spina bifida, and craniofacial defects. [1] [2] [3] [4]

This is the final webinar in the series, “Generation Chemical: How Environmental Exposures Are Affecting Reproductive Health and Development.” During the webinar, Nathan DeNicola, MD, MSHP, FACOG moderated a discussion between Bruce Bekkar, MD, Matthew Franks Chersich, PhD, Mona Abdo, MPH, and James Crooks, PhD, who presented their research on the linkages between climate change related extreme heat, air pollution, wildfire smoke and reproductive health. They discussed the disproportionate toll these reproductive health effects are taking on minority populations and lower income countries, as well as medical, public health, and policy interventions.

Association of Air Pollution and Heat Exposure With Preterm Birth, Low Birth Weight, and Stillbirth in the US: A Call for Action

The study, Association of Air Pollution and Heat Exposure with Preterm Birth, Low Birth Weight, and Stillbirth in the US, is the first large-scale review of common climate change-related impacts and adverse birth outcomes in the US. Author Bruce Bekkar, MD, highlighted findings from this publication which analyzed data from 68 studies of air pollution and heat and their association with preterm delivery, low birth weight and stillbirth, with a mean of over 560,000 births/study and a total of 32 million births across the country. Although more research is needed, strong evidence suggests that the climate crisis is already harming pregnancies—especially for minority moms—in the US and worldwide. Urgent action is needed, both in protecting individual patients from these harmful exposures and by instituting systems change at all levels of government to complete the transition away from fossil fuel burning. Dr. Bekkar also discussed how health care professionals are uniquely suited to accelerate these needed changes.

Systematic review and meta-analysis of the impacts of extreme heat exposure on maternal, fetal and newborn health outcomes

Vulnerable groups, such as pregnant women and newborns, are especially affected by heat. Physiological changes in pregnancy include dehydration, cardiovascular stress, altered glucose metabolism, raised maternal core temperature, shifts in uterine blood flow and diminished placental function. Impacts of heat exposure on birth outcomes include preterm birth and stillbirths, but extreme heat also disrupts healthcare seeking behaviors, quality of care, and health systems functioning. An increased burden of maternal and newborn complications from extreme heat has major implications for settings where pregnancy is already a high-risk event, especially in Africa with high levels of maternal and perinatal mortality. During this talk Matthew Chersich, PhD, covered the different pathways through which extreme heat affects maternal and newborn health, and evidence for each pathway.

Impact of Wildfire Smoke on Adverse Pregnancy Outcomes in Colorado, 2007-2015

Colorado is regularly impacted by long-range transport of wildfire smoke from upwind regions, which is a major source of ambient PM2.5. Maternal exposure to total PM2.5 during pregnancy has been linked to decreased birth weight and other adverse outcomes, although the impact of wildfire smoke contribution has only recently been investigated. Mona Abdo, MPH, presented results of this study looking at associations between adverse pregnancy outcomes and ambient wildfire smoke PM2.5. Investigators found that exposures to wildfire smoke PM2.5 over the full gestation and during the second trimester were positively associated with pre-term birth, while exposure during the first trimester were associated with decreased birth weight. Ms. Abdo also discussed the importance of developing public health interventions aimed at reducing pregnant women’s exposure to wildfire smoke.
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