The climate crisis poses a growing and urgent threat to the health of people around the world. Vulnerable populations, such as pregnant women and newborns, are among those most impacted by climate events and environmental change. 

The London School of Hygiene & Tropical Medicine (LSHTM) is pioneering research on the impacts of climate change on maternal and child health, and climate interventions that protect the health of mothers and babies. 

Extreme heat has been found to increase the risk of stillbirths and early newborn deaths, as well as affecting babies before they are born. Recent research, led by the Medical Research Council Unit The Gambia (MRCG) at LSHTM, revealed that heat stress may impact the development of babies even after they’re born up to the age of two. Systematic reviews of evidence showed that high temperatures increase the risk of preterm birth around the time of delivery. 

In addition to heat, air pollution in cities from carbon emissions can also affect pregnant mothers. LSHTM-led research from the Children, Cities & Climate (CCC) Action Lab found that cutting emissions to improve air quality in cities could lead to substantial reductions in premature births and low birthweight births. 

Ahead of World Prematurity Day, Professor Debra Jackson, Takeda Chair in Global Child Health and Co-Director of the Centre for Maternal Adolescent Reproductive & Child Health (MARCH), reflects on her career in public health, highlighting the importance of increasing global efforts to reduce premature births, particularly in the context of climate change:

“In my early career as a nurse in a newborn special care unit, I realised that while treating small newborns with high tech equipment could save them, avoiding prematurity in the first place was the ultimate prevention. Therefore, I embarked on a career in public health with an aim of preventing premature birth and other causes of ill health in newborns and children.   

“Although there have been vast improvements over the course of my career in the treatments to reduce early birth in mothers with premature labour, and technological developments that save even the tiniest of babies, preventing prematurity remains somewhat illusive. Now, 40 years later in the twilight of my career, I am working on the greatest potential threat to public health facing our planet – climate change.

“It is clear that we must recommit to our future and that of our smallest and most vulnerable citizens and support the fight against climate change to protect mothers and babies everywhere from the impacts of being ‘Born too Soon’.”

Researchers across LSHTM in collaboration with MARCH Centre and Centre on Climate Change and Planetary Health (CCCPH) lead and partner on a range of projects on both the impacts of extreme heat on pregnancy and children, and innovative and inclusive healthy climate solutions. Research conducted in Burkina Faso and Kenya by the Climate, Heat and Maternal and Neonatal Health in Africa (CHAMNHA) project revealed that many pregnant women and their families are still not aware of the danger that high temperatures pose for preterm births. In research led by MRCG at LSHTM,  pregnant farmers were found to continue working under heat stress conditions which could impact their, and their unborn babies’ health.

These studies suggest that successful interventions must be co-designed with the communities to inform women on ways to protect themselves and their children from high temperatures. LSHTM is combining efforts with global partners, including the World Health Organization (WHO) and UNICEF, to find adaptation strategies that protect women and babies from extreme heat through several projects, including HIGH Horizons in South Africa and Zimbabwe, Extram Sen in Senegal, HEAPS in Pakistan, and REACH in Zambia and Brazil.

Dr Anshu Banerjee, Director of the Department of Maternal, Newborn, Child and Adolescent Health and Ageing of the WHO, said: “The inequality in survival rates around the world for premature births, with more babies dying in low-income settings, will be compounded by the effects of extreme heat. WHO is committed to working with partners to ensure actions to protect against the effects of extreme heat are integrated into maternal and newborn health programmes, ensure the promotion, prevention and care needed to reduce preterm births and improve women and baby’s survival and health.” 

George Laryea-Adjei, the Director of Programmes, UNICEF, said: “The cost of a warmer and more toxic world is paid by those born too soon. Protecting our planet means preventing prematurity and giving children the chance of a healthy, full life.” 

With the 29th United Nations Climate Change Conference (COP29) currently underway, LSHTM in collaboration with partners, is spotlighting maternal and child health in global climate discussions, and call for ambitious actions that reduce the risks of adverse birth outcomes. This includes reducing carbon emissions which are heating our planet; building healthier environments by reducing pollutants and adapting our communities, health facilities and ecosystems to protect pregnant women from heat stress, extreme weather events, food insecurity and other climate risks.

Dr Ana Bonell, Assistant Professor in the MRCG at LSHTM, and Rachel Juel, representative of the CCC Action Lab, will be bringing LSHTM’s research on climate and maternal and child health to the global arena at COP29. They will be presenting at a side event on 19 November on ‘Equitable climate solutions that protect health and build resilience for women, children and youth’, co-organised by LSHTM. The event will feature evidence of successful interventions that benefit both climate and the health of women, children and youth, and explore the principles of co-design to inspire further action.  

Dr Ana Bonell, an expert in climate change and maternal health said, “With key stakeholders from across governments, finance, research and civil society in attendance, COP29 provides an opportunity to centre maternal health in the global climate agenda. We urgently need ambitious policies and actions that will address the cause of climate change to reduce the risks of women delivering preterm and put health first.”