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How is climate change affecting maternal and fetal health?
18 May 2022
Good health begins in the womb, but the climate change crisis represents a growing threat to pregnant women and their babies.
We have known for decades that early life experiences can affect long-term health. Poor nutrition during pregnancy, for example, has been linked with a range of negative outcomes for children, including high blood pressure and metabolic diseases. The effects of smoking or being exposed to second-hand smoke during pregnancy are also widely recognised, and include increased risk of stillbirths and birth defects. We also know that adverse pregnancy outcomes, including preterm birth and low birthweight, are risk factors for health problems in adulthood. The role of early life influences on long-term health is extensive and complex; in fact, it formed the rationale for my own PhD work on behaviour change during pregnancy.
But the factors that affect pregnancy outcomes and long-term health go far beyond individual behaviours. In reality, a complex system of environmental, social and economic factors is inextricably linked to health outcomes at every stage of life. Climate change is an increasingly salient part of this system, and it can harm early development in various ways.
Air pollution and extreme temperatures threaten maternal health and pregnancy outcomes
Air pollution has been linked to a range of adverse pregnancy outcomes, including preterm labour and low birthweight, which are themselves risk factors for conditions such as cardiovascular disease and diabetes in adulthood. Exposure to pollution can also affect lung development and function, and is thought to contribute to the development of childhood asthma. Air pollution disproportionately affects socioeconomically disadvantaged populations in many countries.
Emerging evidence from around the world suggests that more extreme temperatures – especially high temperatures – linked to climate change are also associated with preterm birth, low birthweight and stillbirth. These findings have garnered some attention in recent years, but plans and resources related to climate change or extreme heat often fail to address pregnant women as a vulnerable population.
Emerging evidence from around the world suggests that more extreme temperatures – especially high temperatures – linked to climate change are associated with preterm birth, low birthweight and stillbirth.
Climate change facilitates the spread of infectious diseases
Some mosquito-borne diseases, such as malaria and Zika virus, are known to harm fetal health and development. Malaria affects placenta function and increases the risk of low birthweight, preterm birth and miscarriage. Zika virus passes from mother to fetus and causes a severe brain defect known as microcephaly (characterised by a small, underdeveloped brain and head) as well as damage to eyes, joints and muscles. As climates become wetter and warmer, mosquito populations will thrive, facilitating the spread of the viruses they carry. If no climate action is taken, mosquito-borne diseases could reach an additional one billion people by 2080, with the majority of first exposures occurring in Europe.
Extreme weather can affect food supplies
For pregnant women and their babies, many nutrients (e.g. vitamins, fat, protein) are critical to support good health and development. However, changing weather patterns and extreme weather events can severely affect food supplies and the availability of key nutrients in some regions. In land-locked, low-income countries especially, food supplies are particularly volatile and reliant on local weather conditions. In these countries, an extreme weather event can reduce nutrient supplies by as much as 7.57%. An estimated 250 million children under five are currently at risk of poor development because of poverty and stunting (impaired growth and development caused by malnutrition, repeated infection and limited psychosocial stimulation). As climate change continues to affect weather patterns and food supplies, malnutrition could pose an even greater threat.
An estimated 250 million children under five are currently at risk of poor development because of poverty and stunting (impaired growth and development).
Climate action is a core part of giving children the best start
Organisations around the world highlight the importance of the first 1,000 days in setting the foundations for lifelong development and health. Giving every baby the best start in life is even written into national policy in the UK, and other governments (e.g. in Australia and the United States) also highlight the importance of this period in shaping a person’s lifelong health and wellbeing. While the role of environmental influences is sometimes acknowledged, the wide-ranging implications of climate change – particularly on the most vulnerable populations – are rarely included in this discussion. Just as the social determinants of health are now firmly established in the public health parlance, the role of climate change must also be seen as a key determinant of health right from the start of life.
This is the second in a series of HPP blogs around healthcare and climate change – read the first instalment here.