Flood exposure and pregnancy loss in 33 developing countries.

Area of Science:

• Environmental Health
• Reproductive Epidemiology
• Global Maternal Health

Background:

• Floods impact billions globally, with indirect health consequences often overlooked.
• Vulnerable populations, particularly women in developing countries, face underexplored risks from environmental disasters.
• The specific impact of floods on pregnancy loss remains poorly understood.

Purpose of the Study:

• To evaluate the association between gestational flood exposure and pregnancy loss.
• To identify demographic and socioeconomic factors modifying this risk.
• To estimate the annual burden of flood-associated pregnancy losses in developing countries.

Main Methods:

• Analysis of 90,465 pregnancy loss records from 33 developing countries.
• Cross-referencing pregnancy loss data with spatial-temporal flood databases.
• Statistical modeling to assess the odds ratio of pregnancy loss associated with flood exposure.

Main Results:

• Gestational flood exposure is linked to a 1.08 increased odds of pregnancy loss (95% CI: 1.04-1.11).
• Elevated risks observed for women outside peak reproductive ages (<21 or >35) and during mid-to-late pregnancy.
• Higher risks noted for women relying on surface water, with lower income or education levels.
• Estimated 107,888 excess pregnancy losses annually (2010s) due to floods in 33 countries.
• Consistent upward trend in excess pregnancy losses from 2010-2020, particularly in Central America, the Caribbean, South America, and South Asia.

Conclusions:

• Flood exposure significantly increases pregnancy loss risk, highlighting a critical environmental health threat.
• Disparities in maternal health are exacerbated by floods, disproportionately affecting vulnerable women.
• Urgent interventions are needed to mitigate flood impacts on reproductive health in a changing climate.