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Abstract
Studies on the effect of heat stress on pregnant women are scarce, particularly in highly vulnerable populations. To support the risk assessment of pregnant subsistence farmers in the West Kiang district, The Gambia we conducted a study on the pathophysiological effects of extreme heat stress and assessed the applicability of heat stress indices. From ERA5 climate reanalysis we added location-specific modelled solar radiation to datasets of a previous observational cohort study involving on-site measurements of 92 women working in the heat. Associations between physiological and environmental variables were assessed through Pearson correlation coefficient analysis, mixed effect linear models with random intercepts per participant and confirmatory composite analysis. We found Pearson correlations between r-values of 0 and 0.54, as well as independent effects of environmental variables on skin- and tympanic temperature, but not on heart rate, within a confidence interval of 98%. Pregnant women experienced stronger pathophysiological effects from heat stress in their third rather than in their second trimester. Environmental heat stress significantly altered maternal heat strain, particularly under humid conditions above a 50% relative humidity threshold, demonstrating interactive effects. Based on our results, we recommend including heat stress indices (e.g. UTCI or WBGT) in local heat-health warning systems.
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1 University of Bern, Oeschger Center for Climate Change Research, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157)
2 London School of Hygiene and Tropical Medicine, Medical Research Unit The Gambia, London, England (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
3 London School of Hygiene and Tropical Medicine, Medical Research Unit The Gambia, London, England (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X); London School of Hygiene and Tropical Medicine, Centre On Climate Change and Planetary Health, London, England (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
4 University of Brighton, Environmental Extremes Laboratory, Brighton, England (GRID:grid.12477.37) (ISNI:0000 0001 2107 3784)
5 London School of Hygiene and Tropical Medicine, Centre On Climate Change and Planetary Health, London, England (GRID:grid.8991.9) (ISNI:0000 0004 0425 469X)
6 University of Bern, Oeschger Center for Climate Change Research, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157); University of Bern, Institute of Social and Preventive Medicine, Bern, Switzerland (GRID:grid.5734.5) (ISNI:0000 0001 0726 5157)