The impact of high temperatures on spontaneous abortion: A systematic review and meta-analysis

Muayad Albadrani(1), Shyamkumar Sriram(2),


(1) Department of Family and Community Medicine and Medical Education, College of Medicine, Taibah University, Madinah 42353, Saudi Arabia; Health and Life Research Center, Taibah University, Madinah 42353, Saudi Arabia
(2) Department of Rehabilitation and Health Services, College of Health and Public Service, University of North Texas, Denton 76203, TX, USA
Corresponding Author

Abstract


Spontaneous abortion occurs in approximately one in five pregnancies and may be influenced by environmental factors, particularly heat exposure. This study reviewed and synthesized research on the relationship between high temperatures and spontaneous abortion. A systematic literature search identified eight studies from various regions. Data were extracted and analyzed using standardized methods, with quality assessed through Joanna Briggs Institute tools. Meta-analysis showed a pooled spontaneous abortion rate of 13.1%, with higher temperatures consistently linked to increased pregnancy loss. Seasonal variations, regional differences, and socioeconomic factors also influenced the findings. Vulnerable groups, including African Americans and those from lower socioeconomic backgrounds, were disproportionately affected. These findings highlight the potential impact of climate change on early pregnancy outcomes, emphasizing the need for targeted interventions to protect at-risk populations.

References


Larsen EC, Christiansen OB, Kolte AM, Macklon N. New

insights into mechanisms behind miscarriage. BMC

Med 2013; 11(1): 154.

Lu Y, Zhang Y, Guan Q, Xu L, Zhao S, Duan J, Wang Y, Xia

Y, Xu Q. Exposure to multiple trace elements and

miscarriage during early pregnancy: A mixtures

approach. Environment International 2022; 162:

Wood S. Medical management of missed abortion: a

randomized clinical trial. Obstetrics & Gynecology

; 99(4): 563–6.

Zhao S, Xu J, Li W, Lu Y, Huang L, Xu H, Shi M, Wang Y,

Zhu Q, Xu Q. High-temperature exposure and risk of

spontaneous abortion during early pregnancy: a case

control study in Nanjing, China. Environ Sci Pollut

Res 2022; 30(11): 29807–13.

Weng S, Chang J, Yeh M, Wang S, Lee C, Chen Y. Do

stillbirth, miscarriage, and termination of pregnancy increase risks of attempted and completed suicide

within a year? A population‐based nested case

control study. BJOG 2018; 125(8): 983–90.

Shaohua L, Shorey S. Psychosocial interventions on

psychological outcomes of parents with perinatal loss:

A systematic review and meta-analysis. International

Journal of Nursing Studies 2021; 117: 103871.

Dimitriadis E, Menkhorst E, Saito S, Kutteh WH, Brosens JJ.

Recurrent pregnancy loss. Nat Rev Dis Primers 2020;

(1): 98.

Feodor Nilsson S, Andersen P, Strandberg‐Larsen K, Nybo

Andersen A. Risk factors for miscarriage from a

prevention perspective: a nationwide follow‐up study.

BJOG 2014; 121(11): 1375–85.

Zhang S, Yang Y, Xie X, Li H, Han R, Hou J, Sun J, Qian Z

(Min), Wu S, Huang C, Howard SW, Tian F, Deng W,

Lin H. The effect of temperature on cause-specific

mental disorders in three subtropical cities: A case

crossover study in China. Environment International

; 143: 105938.

Yu X, Miao H, Zeng Q, Wu H, Chen Y, Guo P, Zhu Y.

Associations between ambient heat exposure early in

pregnancy and risk of congenital heart defects: a large

population-based study. Environ Sci Pollut Res 2022;

(5): 7627–38.

Zhou W, Ming X, Chen Q, Liu X, Yin P. The acute effect

and lag effect analysis between exposures to ambient

air pollutants and spontaneous abortion: a case

crossover study in China, 2017–2019. Environ Sci

Pollut Res 2022; 29(44): 67380–9.

Yang D, Chen L, Yang Y, Shi J, Xu J, Li C, Wu Y, Ji X.

Influence of ambient temperature and diurnal

temperature variation on the premature rupture of

membranes in East China: A distributed lag nonlinear

time series analysis. Environmental Research 2021;

: 111145.

Nyadanu SD, Tessema GA, Mullins B, Pereira G. Prenatal

acute thermophysiological stress and spontaneous

preterm birth in Western Australia, 2000–2015: A

space-time-stratified

case-crossover

analysis.

International Journal of Hygiene and Environmental

Health 2022; 245: 114029.

Asamoah B, Kjellstrom T, Östergren P-O. Is ambient heat

exposure levels associated with miscarriage or

stillbirths in hot regions? A cross-sectional study

using survey data from the Ghana Maternal Health

Survey 2007. Int J Biometeorol 2018; 62(3): 319–30.

Sun X, Luo X, Cao G, Zhao C, Xiao J, Liu X, Dong M, Wang

J, Zeng W, Guo L, Wan D, Ma W, Liu T. Associations

of ambient temperature exposure during pregnancy

with the risk of miscarriage and the modification

effects of greenness in Guangdong, China. Science of

The Total Environment 2020; 702: 134988.

Liberati A. The PRISMA statement for reporting systematic

reviews and meta-analyses of studies that evaluate

healthcare interventions: explanation and elaboration.

BMJ 2009; 339(jul21 1): 2700-2700,.

Higgins JPT, Thomas J, Chandler J, Cumpston M, Li T, Page

MJ, Welch VA (editors). Cochrane Handbook for

Systematic Reviews of Interventions. Chichester

(UK): John Wiley & Sons; 2019.

Joanna Briggs Institute. Critical appraisal tools. http://

joannabriggs.org/research/critical-appraisal

tools.html. Accessed 26 April 2024. 2016; .

Wang KN, Bell JS, Chen EYH, Gilmartin-Thomas JFM,

Ilomäki J. Medications and Prescribing Patterns as

Factors Associated with Hospitalizations from Long

Term Care Facilities: A Systematic Review. Drugs

Aging 2018; 35(5): 423–57.

Chersich MF, Pham MD, Areal A, Haghighi MM, Manyuchi

A, Swift CP, Wernecke B, Robinson M, Hetem R,

Boeckmann M, Hajat S. Associations between high

temperatures in pregnancy and risk of preterm birth,

low birth weight, and stillbirths: systematic review

and meta-analysis. BMJ 2020; : m3811.

Davenport F, Dorélien A, Grace K. Investigating the

linkages between pregnancy outcomes and climate in

sub-Saharan Africa. Popul Environ 2020; 41(4): 397

Hajdu T, Hajdu G. Post-conception heat exposure increases

clinically unobserved pregnancy losses. Sci Rep 2021;

(1): 1987.

Hajdu T, Hajdu G. Climate change and the mortality of the

unborn. Journal of Environmental Economics and

Management 2023; 118: 102771.

Qu Y, Zhang W, Ryan I, Deng X, Dong G, Liu X, Lin S.

Ambient extreme heat exposure in summer and

transitional months and emergency department visits

and hospital admissions due to pregnancy

complications. Science of The Total Environment

; 777: 146134.

Wesselink AK, Wise LA, Hatch EE, Mikkelsen EM, Savitz

DA, Kirwa K, Rothman KJ. A Prospective Cohort

Study of Seasonal Variation in Spontaneous Abortion.

Epidemiology 2022; 33(3): 441–8.

Gericke GS, Hofmeyr GJ, Laburn H, Isaacs H. Does heat

damage fetuses? Med Hypotheses 1989; 29(4): 275–8.

Banks S, King SA, Irvine DS, Saunders PTK. Impact of a

mild scrotal heat stress on DNA integrity in murine

spermatozoa. Reproduction 2005; 129(4): 505–14.

Eisenberg ML, Sapra KJ, Kim SD, Chen Z, Buck Louis GM.

Semen quality and pregnancy loss in a contemporary

cohort of couples recruited before conception: data

from the Longitudinal Investigation of Fertility and

the Environment (LIFE) Study. Fertil Steril 2017;

(4): 613–9.

Robinson L, Id G, Sj C, M R, D M, S L, J K-B, A C. The

effect of sperm DNA Amadi JA, Odwe G, Obare F,

Sambai B and Kangwana B. Interventions addressing

the impacts of climate change on sexual and

reproductive health and rights in sub-Saharan Africa:

A scoping review. Plos one, 2025.

fragmentation on miscarriage rates: a systematic review and

meta-analysis.

Human reproduction (Oxford,

England) 2012; 27(10).

Sakkas D, Alvarez JG. Sperm DNA fragmentation:

mechanisms of origin, impact on reproductive

outcome, and analysis. Fertil Steril 2010; 93(4):

–36.

Stan CM, Boulvain M, Pfister R, Hirsbrunner-Almagbaly P.

Hydration for treatment of preterm labour. Cochrane

Database Syst Rev 2013; (11): CD003096.

Li D-K, Janevic T, Odouli R, Liu L. Hot tub use during

pregnancy and the risk of miscarriage. Am J Epidemiol

; 158(10): 931–7.

Schifano P, Lallo A, Asta F, De Sario M, Davoli M,

Michelozzi P. Effect of ambient temperature and air

pollutants on the risk of preterm birth, Rome 2001

Environ Int 2013; 61: 77–87.

Du S, Bai S, Zhao X, Lin S, Zhai Y, Wang Z, Wang Z. The

effect and its critical window for ambient temperature

and humidity in pregnancy on term low birth weight.

Environ Sci Pollut Res 2022; 29(36): 54531–42.

Wang H, Li J, Liu H, Guo F, Xue T, Guan T, Li J.

Association of maternal exposure to ambient

particulate pollution with incident spontaneous

pregnancy loss. Ecotoxicology and Environmental

Safety 2021; 224: 112653.

Wang F, Shi C, Dong J, Nie H. Association between ambient

temperature and atopic dermatitis in Lanzhou, China:

a time series analysis. Environ Sci Pollut Res 2021;

(47): 67487–95.

Basagaña X, Michael Y, Lensky IM, Rubin L, Grotto I,

Vadislavsky E, Levi Y, Amitai E, Agay-Shay K. Low

and High Ambient Temperatures during Pregnancy

and Birth Weight among 624,940 Singleton Term

Births in Israel (2010–2014): An Investigation of

Potential Windows of Susceptibility. Environ Health

Perspect 2021; 129(10): 107001.

Spolter F, Kloog I, Dorman M, Novack L, Erez O, Raz R.

Prenatal exposure to ambient air temperature and risk

of early delivery. Environment International 2020;

: 105824.

Bogan M, Al B, Kul S, Zengin S, Oktay M, Sabak M,

Gümüşboğa H, Bayram H. The effects of desert dust

storms, air pollution, and temperature on morbidity

due to spontaneous abortions and toxemia of

pregnancy: 5-year analysis. Int J Biometeorol 2021;

(10): 1733–9.

Strand LB, Barnett AG, Tong S. Maternal exposure to

ambient temperature and the risks of preterm birth and

stillbirth in Brisbane, Australia. Am J Epidemiol 2012;

(2): 99–107.

Gilbert-Barness E. Teratogenic causes of malformations.

Ann Clin Lab Sci 2010; 40(2): 99–114.

Nunes B, Paixão E, Dias CM, Nogueira P, Marinho Falcão

J. Air conditioning and intrahospital mortality during

the 2003 heatwave in Portugal: evidence of a

protective effect. Occup Environ Med 2011; 68(3):

–23.

Rogot E, Sorlie PD, Backlund E. Air-conditioning and

mortality in hot weather. Am J Epidemiol 1992;

(1): 106–16.


Full Text: PDF

Article Metrics

Abstract View : 437 times
PDF Download : 166 times

Refbacks

  • There are currently no refbacks.