Climate Change and Pregnancy: Risks, Mitigation, Adaptation, and Resilience

Abstract

Importance: Climate change is affecting the earth, resulting in more extreme temperatures and weather, rising sea levels, more frequent natural disasters, and displacement of populations of plants and animals, including people and insects. These changes affect food and housing security, vector-borne illnesses, and access to clean air and water, all of which influence human health.Evidence and Results: There are a number of adverse health outcomes linked to heat, air pollution from wildfires, stress from natural disasters, and other elements of climate change. Pregnant people are especially vulnerable to the health harms resulting from climate change, namely, preterm birth, small for gestational age, hypertensive disorders of pregnancy, and other adverse reproductive health and birth outcomes. Strategies to minimize these harms include mitigation and adaptation.Conclusions and Relevance: Physicians are in a unique position to protect the health of pregnant persons and children by advocating for policy changes that address climate change and providing clinical recommendations for patients to protect themselves from the health impacts of climate hazards.Target Audience: Obstetricians and gynecologists, family physicians.Learning objectives: After participating in this activity, physicians should be better able to describe the adverse health effects and pregnancy outcomes associated with elements of climate change; and identify strategies for patients to minimize the health harms from climate change, including mitigation, adaptations, and building resilience. INTRODUCTION: WHY IS CLIMATE CHANGEA PROBLEM FOR HEALTH? Climate change is affecting the earth. We are now seeing more extreme weather and temperatures, rising sea levels, more frequent natural disasters (including wildfires, hurricanes, droughts, and flooding), and displacement of people, animals, insects, and plants around the world. [1][2][3][4] We are seeing a record number of climate-related disasters, with more than 22,000 disasters in the past 50 years, accounting for 45% of disaster-related deaths and 74% of economic losses. 5 Of the natural disasters, droughts, storms, floods, and extreme weather have led to the highest human losses. Climate change also affects food and housing security, vector-borne illness, and access to clean air and water, all of which influence human health. 6 High heat alone is linked to several adverse health outcomes, including stroke, exhaustion, faints, cramps, and, in severe heat, multiorgan dysfunction. 7 M.G.Z. is supported by funding from NIEHS P30-ES030284. This review article was supported in part by the American Academy of Pediatrics and funded in part by a cooperative agreement with the Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry (CDC/ATSDR). The US Environmental Protection Agency (EPA) supports the PEHSUs by providing partial funding to CDC/ATSDR through an interagency agreement. The findings and conclusions presented have not been formally disseminated by CDC/ ATSDR or ...

Climate change and its influence in nephron mass

“…Rising sea levels as a consequence of global warming also increases the risks of coastal flooding, which may lead to displacement and infection risks [ 14 ▪▪ ]. Increased salinity of inland drinking water sources, as a consequence of rising sea levels has also been associated with increased risk of gestational hypertension and preeclampsia [ 13 ▪▪ ].…”

“…All of these conditions may impact a mother's health during pregnancy, impact fetal growth and may increase the risk of PTB. Crucially important also is maternal mental health [ 13 ▪▪ , 14 ▪▪ ]. Anxiety and distress with exposure to heat, pollution and extreme weather events, can impact the health of a pregnancy, maternal safety and nutrition, and fetal wellbeing.…”

“…High-income countries (HICs) are responsible for the greatest emission of greenhouse gases and other pollutants that lead to climate change, but the effects of climate change are being felt most acutely in low- and medium-income countries (LMICs) [ 54 ]. Even in HICs, however, those living in more crowded settings, with fewer green spaces (often urban minoritized populations) live in ‘heat islands’ within cities, are more exposed to heat stress, are more exposed to ambient pollution, and are less resilient to extreme weather events [ 13 ▪▪ ]. Pregnant women in these communities may have fewer resources to protect themselves.…”

“…Less is known about the impact of climate change on pregnancy. Normal pregnancy is associated with impaired thermoregulation and immune responses [ 13 ▪▪ , 14 ▪▪ ]. Pregnant women are more sensitive to temperature, fluid and infection challenges posed by climate change, which may impact fetal development.…”