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In utero exposure to extreme heat increases neonatal mortality
Tenghui Wang1, Jiafu An2, Bin Chen3,4
1Department of Finance, Faculty of Business, Lingnan University, Hong Kong SAR 999077, China.
Insights
Extreme heat exposure during pregnancy increases neonatal deaths in Sub-Saharan Africa. Vulnerable mothers and infants face higher risks, necessitating targeted climate change adaptation strategies.
Area of Science:
- Environmental Health
- Climate Change Impacts
- Maternal and Child Health
Background:
- Sub-Saharan Africa (SSA) faces the world's highest neonatal mortality rates.
- Climate change is increasing extreme heat events in SSA, impacting vulnerable populations.
- The link between in-utero heat exposure and neonatal mortality in SSA is not well understood.
Purpose of the Study:
- To investigate the association between extreme heat exposure during pregnancy and neonatal mortality in SSA.
- To quantify the impact of heat exposure, considering humidity, on neonatal deaths.
- To identify socioeconomic factors influencing vulnerability to heat exposure.
Main Methods:
- Utilized granular data on extreme heat and birth records from 33 SSA countries.
- Employed nationally representative, repeated cross-sectional Demographic and Health Surveys.
- Applied a heat measure accounting for both temperature and humidity.
Main Results:
- A cumulative 150 °C increase in extreme heat exposure during pregnancy is linked to two additional neonatal deaths per thousand live births.
- Mothers with lower socioeconomic status or limited education experienced more severe negative impacts.
- Reduced prenatal care access may exacerbate the adverse effects of heat exposure.
Conclusions:
- In-utero exposure to extreme heat is a significant contributing factor to neonatal mortality in SSA.
- Climate change adaptation strategies must consider the heightened risks for vulnerable pregnant women and newborns.
- Policy interventions should focus on mitigating heat's impact and supporting at-risk populations.
Abstract:
Sub-Saharan Africa (SSA) has had the highest neonatal mortality rate in the world for the past few decades. In 2021, 27 infants died within the first month of life for every thousand live births in SSA, accounting for 54% of infant deaths (0-12 months) on the continent. Meanwhile, extreme heat events are occurring with increasingly higher frequency in this region due to climate change, worsening the living and health conditions for already vulnerable populations. Despite the prominence of high neonatal mortality rates and the frequent occurrence of extreme weather events in SSA, it remains unclear whether in-utero exposure to extreme heat is a significant contributing factor. Our research investigates this question using granular data on extreme heat and birth records from 33 African countries drawn from the Demographic and Health Surveys. It collects nationally representative, repeated cross-sectional surveys that assess reproductive and health behaviors across the developing countries every 5 years. Employing a measure of heat that simultaneously accounts for the impact of humidity, we show that a cumulative increase of 150 °C in extreme heat exposure during the 9-month pregnancy period is associated with two additional neonatal deaths per thousand live births. Mothers with lower economic status or limited education experience a more pronounced negative impact from exposure to extreme heat, likely due to reduced prenatal care. Our results are relevant to policymakers aiming to curb the negative impacts of climate change by better targeting the victims of extreme heat and developing effective adaptation strategies.
