Climate and Environmental Change: A Generation at Risk

Eco-fertility: examining the climate change-total fertility rate nexus in the context of sustainable developmental goals in a systematic review approach

Sustainable Development Goals (SDGs) are paramount as the global community confronts the ramifications of climate alterations, especially its implications on population dynamics. Initial studies suggest an intricate relationship between environmental determinants and reproductive choices. This systematic review elucidates the complex interplay between climate-related challenges and observed global fertility rate variations. A comprehensive search and analysis of literature published in the last 10 years (2013-2023), available in the PubMed database, delineates the relationship between environmental changes and fertility patterns in both human and animal populations. The review highlighted significant effects of climatic fluctuations on reproductive health, manifested as either adaptive or maladaptive responses to environmental stressors. This relationship not only influences population trajectories but may also have complications for the SDGs, specifically those pertaining to health, well-being, and gender equality. The study emphasizes the importance of intertwining demographic insights with ecological considerations. A deeper understanding of the nexus between climate and fertility can augment strategies aimed at global sustainability. The synthesized evidence underscores the urgency for further research, which seeks to seamlessly incorporate eco-fertility perspectives into wider climate and sustainability discussions.

Climate change and gendered vulnerability: A systematic review of women's health

BACKGROUND

Climate change is an urgent global threat, with women in low- and middle-income countries (LMICs) disproportionately facing adverse health outcomes. Gendered roles, combined with socioeconomic, cultural, and environmental factors, exacerbate women's vulnerabilities, increasing the burden of mental health issues, water insecurity, sanitation challenges, and caregiving responsibilities.

OBJECTIVES

This review seeks to systematically examine the intersection between climate change and gendered health vulnerabilities, with a particular focus on women. It explores how climate change intensifies gender-specific risks and identifies pathways for integrating gender-responsive policies to mitigate both short- and long-term health impacts.

DESIGN

Following Arksey and O'Malley's methodological framework, this systematic review mapped key concepts and evidence from studies conducted between January 2011 and January 2024. The review focuses on identifying the multifaceted health impacts of climate change on women, particularly in LMICs and marginalized communities.

DATA SOURCES AND METHODS

A systematic search was conducted in Web of Science and Scopus databases using key terms and Medical Subject Headings related to climate change, women's health, gender inequality, mental health, water security, sanitation, and caregiving burdens. Studies were screened and selected based on relevance to the predefined criteria, with data extracted on study design, key findings, and limitations.

RESULTS

From 2163 citations screened, 61 studies were included in the final analysis. The review highlights that climate change disproportionately affects women, exacerbating pre-existing gender inequalities. Specific impacts include heightened mental health challenges, adverse maternal and newborn health outcomes, increased water insecurity, and an intensified caregiving burden. Women in LMICs are particularly vulnerable due to reduced access to resources, healthcare, and decision-making platforms, further limiting their adaptive capacities.

CONCLUSION

The findings underscore the critical need for gender-responsive climate policies that address both immediate health impacts and the broader socioeconomic and environmental determinants affecting women. Effective climate adaptation strategies must integrate gender perspectives, ensuring that women's specific vulnerabilities are accounted for in policy frameworks. This review advocates for the empowerment of women through increased access to resources and decision-making, thus enhancing their resilience and adaptive capacity in the face of climate change.

Heat Metrics and Maternal-Child Health Diagnoses in Emergency Departments in the United States: A Scoping Review

OBJECTIVE

To summarize current research on associations between heat metrics and emergency department discharge diagnoses for US pregnant women and children from birth to age 18 via a scoping review.

BACKGROUND

Climate change directly contributes to extreme weather conditions and environmental changes and indirectly affects health and the health care system. Pregnant women and children are believed to be more susceptible to extreme heat, but few empirical studies have been conducted evaluating effects of heat metrics on these populations.

METHODS

Ovid MEDLINE, CIHAHL, SCOPUS, Web of Science, JSTOR, and PsycINFO databases were searched using a combination of key words.

RESULTS

Twelve studies were selected for this review. In pregnant women, positive associations were found between mean daily temperature and multiple subtypes of pregnancy complications, including threatened or spontaneous abortion, renal diseases, infectious diseases, diabetes, and hypertension. In children, positive associations were found with all-cause diagnoses; asthma; dehydration; electrolyte disorders; heat-related illness; infection; endocrine, nutritional, and metabolic diseases; injury; and otitis media and external emergency department discharge diagnoses and temperature or heatwave versus non-heatwave.

CONCLUSION

By tracking associations between maternal-child emergency department discharge diagnoses and various heat metrics, researchers can contribute to better clinical practices that promote environmental justice and climate resilience.

Intra-uterine programming of future fertility

The developmental origins of health and disease (DOHaD) shows that a relationship exists between parental environment at large, foeto-placental development and the risk for the offspring to develop non-transmittable disease(s) in adulthood. This concept has been validated in both humans and livestock. In mammals, after fertilization and time spent free in the maternal reproductive tract, the embryo develops a placenta that, in close relationship with maternal endometrium, is the organ responsible for exchanges between dam and foetus. Any modification of the maternal environment can lead to adaptive mechanisms affecting placental morphology, blood flow, foetal-maternal exchanges (transporters) and/or endocrine function, ultimately modifying placental efficiency. Among deleterious environments, undernutrition, protein restriction, overnutrition, micronutrient deficiencies and food contaminants can be outlined. When placental adaptive capacities become insufficient, foetal growth and organ formation is no longer optimal, including foetal gonadal formation and maturation, which can affect subsequent offspring fertility. Since epigenetic mechanisms have been shown to be key to foetal programming, epigenetic modifications of the gametes may also occur, leading to inter-generational effects. After briefly describing normal gonadal development in domestic species and inter-species differences, this review highlights the current knowledge on intra-uterine programming of offspring fertility with a focus on domestic animals and underlines the importance to assess transgenerational effects on offspring fertility at a time when new breeding systems are developed to face the current climate changes.

The Climate Crisis and Breastfeeding: Opportunities for Resilience

The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.