Heat stress and adverse pregnancy outcome: Prospective cohort study

OBJECTIVE

To explore the relationship between occupational heat exposure, physiological heat strain indicators and adverse outcomes in pregnant women.

DESIGN

Prospective cohort.

SETTING

Workplaces in Tamil Nadu, India.

SAMPLE

A cohort of 800 pregnant women engaged in moderate to heavy physical work in 2017-2019 and 2021-2022.

METHODS

Participants were recruited at between 8 and 14 weeks of gestation. Occupational heat exposure and heat strain indicators were captured each trimester. 'Heat exposed' was defined as heat stress exceeding the threshold limit value (TLV) for safe manual work (with maximum wet-bulb globe temperatures of 27.5°C for a heavy workload and 28.0°C for a moderate workload). Physiological heat strain indicators (HSIs) such as core body temperature (CBT) and urine specific gravity (USG) were measured before and after each shift. Heat-related health symptoms were captured using the modified HOTHAPS questionnaire.

MAIN OUTCOME MEASURES

The main outcome measures included (1) a composite measure of any adverse pregnancy outcome (APO) during pregnancy (including miscarriage, preterm birth, low birthweight, stillbirth, intrauterine growth restriction and birth defects), (2) a composite measure of adverse outcomes at birth (3) and miscarriage.

RESULTS

Of the 800 participants, 47.3% had high occupational heat exposure. A rise in CBT was recorded in 17.4% of exposed workers, and 29.6% of workers experienced moderate dehydration (USG ≥ 1.020). Heat-exposed women had a doubled risk of miscarriage (adjusted odds ratio, aOR 2.4; 95% confidence interval, 95% CI 1.0-5.7). High occupational heat exposure was associated with an increased risk of any adverse pregnancy and foetal outcome (aOR 2.3; 95% CI 1.4-3.8) and adverse outcome at birth (aOR 2.0; 95% CI 1.2-3.3).

CONCLUSIONS

High occupational heat exposure is associated with HSIs and adverse pregnancy outcomes in India.

A Comprehensive Review on Hot Ambient Temperature and its Impacts on Adverse Pregnancy Outcomes

INTRODUCTION

High workplace/ambient temperatures have been associated with Adverse Pregnancy Outcomes (APO). Millions of women working in developing nations suffer due to the rising temperatures caused by climate change. There are few pieces of research linking occupational heat stress to APO, and fresh evidence is required.

METHODOLOGY

We used databases including PubMed, Google Scholar, and Science Direct to search for research on high ambient/workplace temperatures and their effects. Original articles, newsletters, and book chapters were examined. The literature we analysed was categorised as follows: Heat, strain, and physical activity harming both mother and fetus. After categorising the literature, it was examined to identify the major results.

RESULTS

We found a definite association between heat stress and APOs such as miscarriages, premature birth, stillbirth, low birthweight, and congenital abnormalities in 23 research articles. Our work provides important information for future research into the biological mechanisms that create APOs and various prevention measures.

CONCLUSION

Our data suggest that temperature has long-term and short-term effects on maternal and fetal health. Though small in number, this study stressed the need for bigger cohort studies in tropical developing countries to create evidence for coordinated policies to safeguard pregnant women.

Protocol for a Systematic Review of Mobile Phone Technology for Managing Side Effects of Chemotherapy in Cancer Patients:A Research Protocol

Introduction: Mobile phone technology is an evolving trend in the medical field for rendering health-related care services to the needy. Chemotherapy is one of the cancer treatments which leads to certain side effects. These side effects can be managed well with the help of mobile phones, which became an essential thing in our life in recent decades. Aim: To identify the efficacy of using mobile phone technology for managing side effects associated with chemotherapy and improvement in quality of life. Materials and Methods: A systematic review will be conducted on randomised control trials and non-randomised control trials. In this review, Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) will be followed and a literature search will be conducted in PubMed-Medline, CINHAL Cochrane Library, Scopus, Science Direct, Ovid, J-Gate, and Trip databases. The literature search for this systematic review will be done on studies published between 2007 and 2019. The quality of the study will be assessed by the JBI clinical appraisal checklist for Randomised Controlled Trials (RCTs) and Non-Randomised Controlled Trials (Non-RCTs). Studies will be included based on predetermined inclusive criteria like studies published in the English language, with keywords like cancer patients, smartphone/android applications, chemotherapy, quality of life. Results: A descriptive synthesis of the findings of the selected studies will be carried out which will be presented in a narrative summary with statistical findings incorporated. Conclusion: This review will provide up-to-date evidence to support or oppose the hypothesis that mobile phone technology plays an effective role in managing side effects associated with chemotherapy and improve the quality of life of cancer patients.