Climate change and preterm birth: A narrative review

The sizable and multifactorial risks to human health posed by climate change are both increasingly well understood and broadly accepted. One critical aspect of human health that has received comparatively scant attention in this area is the increased risk of preterm birth, deriving from the direct and indirect effects climate change. Preterm birth, delivery prior to 37 weeks’ completed gestation, impacts more than 15 million pregnancies every year. The healthcare costs of caring for preterm infants and their families exceed tens of billions of dollars annually. As such, prematurity conveys significant costs to preterm birth survivors, their families, and society. Climate change is predicted to exert a host of direct and indirect impacts on pregnancy health that translate to an increased risk of preterm delivery, perinatal death, and long-term morbidity. We identified seven impacts of climate change, namely, temperature, precipitation, air quality, food insecurity, displacement, range of vector-borne diseases, and socio-economic inequality, that jointly and individually have the potential to convey an elevated risk of adverse pregnancy outcomes and preterm birth. We performed a literature review using these terms. We present data in a narrative review to highlight the material risk of shortened pregnancy duration posed by climate change. In particular, although targeted interventions may offset some impacts of climate change, it is increasingly apparent that the meta-system impacts exerted by climate change mean that effective and long-term actions by which a significant reduction in pregnancy health risks may be achieved require: (i) tackling the root cause of climate change itself; and (ii) considering vulnerable populations, such as pregnant women, in multisectorial climate adaptation plans. Given the potential risk posed to pregnancy health by preterm birth, we advocate for prematurity/pregnancy health to be considered as a critical factor in the assessment of climate change interventions.