Investigating the pathways linking heat exposure to mental health outcomes: mechanisms and interventions in a Ghanaian cohort (HEAT-MIND)

Perinatal depression affects 50% of women in Ghana, with suicidal ideation rates at 13-17%. Heat is a risk factor for depression and anxiety, but little is known about impacts on perinatal mental health. We will employ three approaches to causally examine mechanisms linking preconception, prenatal and postpartum heat exposure to maternal depression and anxiety. We integrate persons with lived experience (LE) as core research team members to develop the study approach, contextualize findings and maximize impact. In work package WP1, we leverage the extant Ghana Randomized Air Pollution and Health Study (GRAPHS) where higher prenatal heat exposure is associated with maternal stress and an extensive data repository allows investigation of multiple plausible mechanistic mediators. In WP2, we develop a new pregnancy cohort to understand how biological, social and psychological mechanisms link prenatal heat exposure to maternal depression and anxiety and examine effect modification by other exposures. In WP3 we pilot a heat warning system to reduce the impact of ambient heat on maternal mental health outcomes and investigate impacts on the mechanistic pathways identified in WP1 and WP2. This work will support a causal association between prenatal health and maternal depression and anxiety, elucidate mechanistic pathways, and identify novel interventions.