Heat exposure, heat-related symptoms, and healthcare–seeking behaviour among pregnant women in Johannesburg: preliminary findings from the Bio-HEAT study
1
Wits Planetary Health Research Division, University of the Witwatersrand, Johannesburg, South Africa
2
Public Health & Primary Care, School of Medicine, Trinity College Dublin, Dublin, Ireland
Popul. Med. 2026;8(Supplement Supplement 1):A2271
ABSTRACT
BACKGROUND:
Pregnant women are physiologically vulnerable to heat exposure, yet evidence on healthcare–seeking for heat-related symptoms remains limited. Delayed or absent care-seeking may hinder management and increase the risk of adverse maternal and fetal outcomes. With rising global temperatures, this study aimed to characterise heat-related symptoms and care-seeking behaviour among pregnant women.
METHODS:
We analysed preliminary data from the ongoing Bio-HEAT cohort study in Johannesburg, South Africa. Pregnant women were recruited at 12–16 weeks’ gestation and followed monthly. At each visit, participants reported whether their health had been affected by heat in the preceding month and, if so, which symptoms were experienced, whether they were perceived as heat-related and whether healthcare was sought. Heat exposure was assessed using wet-bulb temperature (Tw), derived from local temperature and humidity data. Descriptive analyses summarised symptom frequency, heat attribution, and care-seeking behaviour. Regression analyses examined associations between mean Tw over the previous 30 days and reported symptoms. Analyses included 158 participants, comprising 670 visits.
RESULTS:
Overall, 43% of participants reported that their health had been affected by heat. The most commonly perceived heat-related symptoms were headache, tiredness, sleep problems, and dizziness/fainting. Regression analyses showed that each 1 °C increase in Tw was associated with higher odds of reporting dizziness (OR 1.17; CI:1.02-1.33), headache (OR 1.15; CI 1.03-1.28), and tiredness (OR 1.11; CI 1.01-1.22). Healthcare–seeking was low across symptoms: 28.4% of participants who experienced a symptom sought care, most commonly for rash (50%), nausea/vomiting (21.7%), headache (20.9%), and dizziness/fainting (16.7%). No care was sought for anxiety, confusion, diarrhoea and dry mouth.
CONCLUSIONS:
Symptoms consistent with heat-strain are common during pregnancy, yet few women seek care. These findings highlight an opportunity for antenatal care programmes and heat-health messaging to improve symptom recognition and promote early management of heat-related illness as climate change intensifies heat exposure.
Pregnant women are physiologically vulnerable to heat exposure, yet evidence on healthcare–seeking for heat-related symptoms remains limited. Delayed or absent care-seeking may hinder management and increase the risk of adverse maternal and fetal outcomes. With rising global temperatures, this study aimed to characterise heat-related symptoms and care-seeking behaviour among pregnant women.
METHODS:
We analysed preliminary data from the ongoing Bio-HEAT cohort study in Johannesburg, South Africa. Pregnant women were recruited at 12–16 weeks’ gestation and followed monthly. At each visit, participants reported whether their health had been affected by heat in the preceding month and, if so, which symptoms were experienced, whether they were perceived as heat-related and whether healthcare was sought. Heat exposure was assessed using wet-bulb temperature (Tw), derived from local temperature and humidity data. Descriptive analyses summarised symptom frequency, heat attribution, and care-seeking behaviour. Regression analyses examined associations between mean Tw over the previous 30 days and reported symptoms. Analyses included 158 participants, comprising 670 visits.
RESULTS:
Overall, 43% of participants reported that their health had been affected by heat. The most commonly perceived heat-related symptoms were headache, tiredness, sleep problems, and dizziness/fainting. Regression analyses showed that each 1 °C increase in Tw was associated with higher odds of reporting dizziness (OR 1.17; CI:1.02-1.33), headache (OR 1.15; CI 1.03-1.28), and tiredness (OR 1.11; CI 1.01-1.22). Healthcare–seeking was low across symptoms: 28.4% of participants who experienced a symptom sought care, most commonly for rash (50%), nausea/vomiting (21.7%), headache (20.9%), and dizziness/fainting (16.7%). No care was sought for anxiety, confusion, diarrhoea and dry mouth.
CONCLUSIONS:
Symptoms consistent with heat-strain are common during pregnancy, yet few women seek care. These findings highlight an opportunity for antenatal care programmes and heat-health messaging to improve symptom recognition and promote early management of heat-related illness as climate change intensifies heat exposure.
| eISSN: | 2654-1459 |
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