Physiological mechanisms of the impact of heat during pregnancy and the clinical implications: review of the evidence from an expert group meeting

Louisa Samuels, Britt Nakstad, Nathalie Roos, Ana Bonell, Matthew Chersich, George Havenith, Stanley Luchters, Louise Tina Day, Jane E. Hirst, Tanya Singh, Kirsty Elliott-Sale, Robyn Hetem, Cherie Part, Shobna Sawry, Jean Le Roux, Sari Kovats

Research output: Contribution to journalReview articlepeer-review

58 Citations (Scopus)


Many populations experience high seasonal temperatures. Pregnant women are considered vulnerable to extreme heat because ambient heat exposure has been linked to pregnancy complications including preterm birth and low birthweight. The physiological mechanisms that underpin these associations are poorly understood. We reviewed the existing research evidence to clarify the mechanisms that lead to adverse pregnancy outcomes in order to inform public health actions. A multi-disciplinary expert group met to review the existing evidence base and formulate a consensus regarding the physiological mechanisms that mediate the effect of high ambient temperature on pregnancy. A literature search was conducted in advance of the meeting to identify existing hypotheses and develop a series of questions and themes for discussion. Numerous hypotheses have been generated based on animal models and limited observational studies. There is growing evidence that pregnant women are able to appropriately thermoregulate; however, when exposed to extreme heat, there are a number of processes that may occur which could harm the mother or fetus including a reduction in placental blood flow, dehydration, and an inflammatory response that may trigger preterm birth. There is a lack of substantial evidence regarding the processes that cause heat exposure to harm pregnant women. Research is urgently needed to identify what causes the adverse outcomes in pregnancy related to high ambient temperatures so that the impact of climate change on pregnant women can be mitigated.

Original languageEnglish
Pages (from-to)1505-1513
Number of pages9
JournalInternational Journal of Biometeorology
Issue number8
Publication statusPublished - Aug 2022


  • Clinical medicine
  • Foetus
  • Heat stress
  • Labour
  • Newborn
  • Pregnancy
  • Pregnant women


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