Study protocol for an observational cohort study of heat stress impacts in pregnancy in The Gambia, West Africa
Bonell A., G. Ioannou L., Sesay A., A. Murray K., Bah B., Jeffries D., E. Moore S., Vicero-Cabrera A., S Maxwell N., E Hirst J., Tan C., Saucy A., Watters D., Sonko B., Okoh E., Idris Y., Oluwatosin Adefila W., Manneh J., Leigh-Nabou M., Bojang S., Flouris A., Haines A., Prentice A., N Sferruzzi-Perri A.
Climate change has increased global temperatures. Women exposed to heat during their pregnancy have an increased risk of poor maternal and pregnancy outcomes including preterm birth and stillbirth. However, there is a poor understanding of the biological pathways that result in these poor outcomes when pregnant women are exposed to heat. This study will follow 764 pregnant women in two sites in The Gambia, West Africa - an area that is particularly at risk of heat waves and other extreme weather events. The study aims to understand or determine the following: the heat exposure pregnant women are being exposed to; the impact of heat stress on pregnant women; the impact of heat stress on the placenta; the impact of heat stress on birth outcomes; the epigenetic changes in the placenta and/or infant related to the heat stress exposure. This observational study will recruit from two sites - cool coast and hot interior. Pregnant women will be closely followed up during the course of their pregnancy with regular ultrasound scans, questionnaires and both physiology and environmental monitoring. At delivery, birth data will be collected as well as samples from the placenta and cord blood. The final visit will be conducted at 1 month where the baby will be assessed for feeding, growth, sleep and neuro-behaviour and final samples taken.