Environmental exposures heightened by climate change adversely affect maternal and newborn health, and women are “particularly vulnerable” to these effects, according to a speaker at The Pregnancy Meeting.

“This last year, the climate crisis overtakes pandemics in terms of the greatest worry for global experts,” Jeanne A. Conry, PhD, MD, president of the International Federation of Gynecology and Obstetrics, said in her presentation.

Organizations such as the World Economic Forum in 2021 and the World Meteorological Organization in 2018 identified their environmental concerns, including failure to take action against climate change and extreme weather conditions causing loss of life and biodiversity, she said.

Conry, who is also on the board of directors for the Heartland Health Alliance and The Forum Institute, said that children and pregnant women are among the communities most impacted by natural disasters brought about by climate change.

“Women and children are 14 times more likely to die than men in a natural disaster,” Conry said. “If we look historically at the 2004 tsunami in Asia, 70% of the deaths were women; if we look at the Bangladesh cyclone in 1991, 90% of the deaths were women.”

Disasters such as these can disrupt women’s access to medical supplies and natural resources such as food, especially in the case of pregnant women.

“Pregnant women may be particularly susceptible to dehydration and being displaced from their homes,” Conry said. In low- and middle-income countries where manual labor is common, they may also be subjected to heat and drought.

Elements of climate change

Climate change is a factor in air pollution — higher temperatures increase the amount of allergens and harmful pollutants in the air — which Leonardo Trasande, MD, MPP, and colleagues found in 2016 was associated with preterm births.

They found “approximately 3% of preterm births nationally — about 15,000 deliveries — could be attributed to air pollution,” Conry said. “The costs then are about $5 billion, of which $760 million is spent on direct medical care.”

Increasing global temperatures also play a role in the burden of climate change on women and children.

“Five international articles reviewed found that heat is associated with preterm birth… and four of these international studies showed that heat is associated with low birth weights,” Conry said.

Flooding caused by rising temperatures — and subsequently higher sea levels and the risk for natural disasters such as typhoons — exposes people to pollution and toxic substances; induces stress, anxiety and food insecurity; and interferes with cultural norms, particularly in low-income countries, she said.

“In Bangladesh, some of the research has shown that women are affected disproportionately — culturally, their inhibitions, inadequate social services and inability to seek hygiene is of serious concern,” Conry said.

Rising temperatures have also dried out vegetation, leading to more intense wildfires around the world.

“I live in the fire area of California… so I see the impact on air quality, I see the disruption in family life,” Conry said. “Hospitals are evacuating women at the last minute and evacuating the entire hospital with moments to save people; nurses are putting laboring patients in the back of their car to get them out of the fire. This is the reality that we’re seeing right here, right now, around the world.”

Role of OB/GYNs

Conry mentioned that obstetricians and gynecologists are in a unique position to raise awareness to educate and advocate for mitigation strategies.

“We need to step up, be leaders and share the message that the environmental exposures are a concern for the health of women,” she told Healio. “We are very well-versed in diseases like diabetes and hypertension and their impact on health, but the moment we discuss environmental effects, physicians draw a blank look and say they do not have the evidence. I try to remind them there will never be a double-blind study to look for cause and effect — we cannot control exposures as we do other variables in research studies.”

References:

• Climate change decreases the quality of the air we breathe. https://www.cdc.gov/climateandhealth/pubs/air-quality-final_508.pdf. Accessed Feb. 3, 2022.