Heat – Not a Small Problem! Investigating the Association Between Heat, Heatwaves, and Birthweight in Sub-Saharan Africa
1
Faculty of Health Sciences, Wits Planetary Health Research, Cape Town, South Africa
2
Centre for Sexual Health, HIV and AIDS Research (CeSHHAR), Harare, Zimbabwe
3
IBM Research Africa, Johannesburg, South Africa
4
University Peleforo Gon Coulibaly, Korhogo, Côte dIvoire
5
Climate System Analysis Group, University of Cape Town, Cape Town, South Africa
Popul. Med. 2026;8(Supplement Supplement 1):A428
ABSTRACT
BACKGROUND:
Climate change harms human health, particularly vulnerable populations including pregnant people and their newborns. A growing body of evidence suggests that maternal heat exposure during pregnancy is associated with low birthweight (LBW) and small for gestational age (SGA). Most studies are from high-income countries, and have relied on regression modelling, limiting temporal resolution. Sub-Saharan Africa (SSA) experiences distinct climate, socioeconomic, and vulnerability contexts, underscoring the need for region-specific evidence using advanced statistical methods. This study aims to investigate the association between maternal heat exposure during pregnancy and term LBW and SGA.
METHODS:
This study is an individual participant data (IPD) meta-analysis using datasets from cohort studies from 7 SSA countries. The outcomes will be SGA, term birthweight, and term LBW. Heat exposure will include mean temperature, diurnal temperature variation, and universal thermal climate index (UTCI). Analyses will first be conducted using logistic regression (LBW/SGA) and linear regression (birthweight). A two-stage meta-analysis will be conducted: First, distributed lag non-linear models (DLNMs) examining non-linear and time-varying effects of heat exposure across gestation, stratified by region, country, and climate zone. Second, a meta-analysis for the pooled estimate. Results will be stratified by maternal factors (e.g. age, education), infant sex, and socioeconomic indicators.
RESULTS:
Analyses will quantify the risk of term LBW and SGA associated with high temperatures and heatwaves and identify gestational windows of heightened vulnerability. It is anticipated that heat and heatwaves will be associated with a higher risk of LBW and SGA, with stronger associations during the first and second trimesters.
CONCLUSIONS:
This study addresses critical evidence gaps on heat exposure and foetal growth in SSA using innovative IPD and DLNM approaches. Findings will inform climate-sensitive maternal and child health policy and guidance, support indicator development for climate-health surveillance, and guide adaptation and resilience strategies in low- and middle-income settings.
Climate change harms human health, particularly vulnerable populations including pregnant people and their newborns. A growing body of evidence suggests that maternal heat exposure during pregnancy is associated with low birthweight (LBW) and small for gestational age (SGA). Most studies are from high-income countries, and have relied on regression modelling, limiting temporal resolution. Sub-Saharan Africa (SSA) experiences distinct climate, socioeconomic, and vulnerability contexts, underscoring the need for region-specific evidence using advanced statistical methods. This study aims to investigate the association between maternal heat exposure during pregnancy and term LBW and SGA.
METHODS:
This study is an individual participant data (IPD) meta-analysis using datasets from cohort studies from 7 SSA countries. The outcomes will be SGA, term birthweight, and term LBW. Heat exposure will include mean temperature, diurnal temperature variation, and universal thermal climate index (UTCI). Analyses will first be conducted using logistic regression (LBW/SGA) and linear regression (birthweight). A two-stage meta-analysis will be conducted: First, distributed lag non-linear models (DLNMs) examining non-linear and time-varying effects of heat exposure across gestation, stratified by region, country, and climate zone. Second, a meta-analysis for the pooled estimate. Results will be stratified by maternal factors (e.g. age, education), infant sex, and socioeconomic indicators.
RESULTS:
Analyses will quantify the risk of term LBW and SGA associated with high temperatures and heatwaves and identify gestational windows of heightened vulnerability. It is anticipated that heat and heatwaves will be associated with a higher risk of LBW and SGA, with stronger associations during the first and second trimesters.
CONCLUSIONS:
This study addresses critical evidence gaps on heat exposure and foetal growth in SSA using innovative IPD and DLNM approaches. Findings will inform climate-sensitive maternal and child health policy and guidance, support indicator development for climate-health surveillance, and guide adaptation and resilience strategies in low- and middle-income settings.
| eISSN: | 2654-1459 |
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