Active Pregnancy, Children & Inherited Conditions Climate, Earth & Environment

Assessment of biological vulnerability and effects of extreme heat on maternal, fetal and newborn health: implications for policy and action

Funder Wellcome Charity-funded
Associated organisations London School of Hygiene & Tropical Medicine · Aga Khan University (Pakistan) · University of Oxford Europe PMC affiliations are not treated as award recipients or mapped locations.
Funding £1.9M
Period Jan 2024 — Dec 2027

In plain English

AI plain-English summary

Extreme heat is causing more miscarriages, stillbirths, and low-birthweight babies, but the biological pathways behind these effects remain poorly understood, especially in low-income countries. This research addresses a critical gap: while heatwaves are known to harm pregnant women and newborns, most evidence comes from wealthy nations with air conditioning and good healthcare. The team will study 6,000 pregnant women in Pakistan, linking household-level heat exposure to serial physiological measurements in a subset of 3,000. They will also analyse existing biobanked samples from previous pregnancy trials to identify biological markers of heat vulnerability. If successful, the project could transform how heat-health warnings are designed for pregnant women in developing countries. It would provide concrete evidence on when during pregnancy heat is most dangerous, and which clinical interventions—such as hydration protocols or adjusted clinic schedules—could reduce harm. The findings could also inform urban planning, such as where to locate maternity clinics relative to heat-prone areas, and help set evidence-based thresholds for heatwave alerts that account for pregnancy. This is applied research with direct policy implications for maternal health programmes in climate-vulnerable regions.

View original technical description
Extreme heat adversely affects pregnant women and babies, and is associated with hypertension, miscarriages, stillbirths, and low-birthweight. An in-depth study is needed on pathways and the direct and indirect effects of extreme heat during pregnancy and early life, especially in developing countries where there is a dearth of existing evidence. We aim to assess the impact of extreme heat stress on maternal, fetal, and newborn health and how it interacts with confounding effects of social determinants, nutrition, and seasonal drivers. To understand the biological mechanisms of increased vulnerability to extreme heat exposure, we plan two work packages: (1) capitalisation of available large datasets and bio-banked laboratory specimens from previous large trials/studies of pregnancy outcomes: (2) prospective, population-based, birth cohort (n=6000 pregnant women) from peri-urban and rural settings in Pakistan, linking environmental heat measurements at household/individual level with serial physiological measurements in a subset (n=3000) linked to pregnancy, fetal and birth outcomes. We will also assess the processes and pathways of these effects in the subset by measuring clinical variables (including Echo, ultrasound, ECG), and urine and blood biomarkers related to adverse effects of extreme heat on maternal, fetal and newborn health.

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Researchers

Aris Papageorghiou (EPMC Awardee)Jai Das (EPMC Awardee)Lumaan Sheikh (EPMC Awardee)Simon Cousens (EPMC Awardee)Stephen Kennedy (EPMC Awardee)Zainab Samad (EPMC Awardee)Zulfiqar Bhutta (EPMC Awardee)

Related Research

Grants with similar aims, by meaning.

Effects of extreme heat on maternal, placental and fetal physiology, lactation and newborn health in India
The HEaT INFORM Pregnancy Study
Investigating the Biological pathways from HEAT exposure to preterm birth and other adverse maternal and child health outcomes in South Africa (the Bio-HEAT study)
Investigating the pathways linking heat exposure to mental health outcomes: mechanisms and interventions in a Ghanaian cohort (HEAT-MIND)
Heat matters; mechanisms impacting maternal and offspring mental health

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