Country-level impact of climate change on maternal and newborn health: Associations between temperature, precipitation, maternal mortality, stillbirth, and neonatal mortality in the Democratic Republic of the Congo

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2025-05-29 DOI:10.1016/j.envint.2025.109564

Carrie Ngongo, Donal Bisanzio, Gabriella Corrigan, Karl B. Angendu, Alisha Smith-Arthur, Brian Hutchinson, Pierre Akilimali

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Abstract

Background

Evidence connecting extreme heat to maternal and newborn health outcomes is needed at country level, especially in tropical areas. DHIS2 (District Health Information Software 2) collects aggregated population health data by health zone in the Democratic Republic of the Congo (DRC).

Methods

Drawing from DHIS2 records of 22·7 million DRC births 2018–2023, spatio-temporal modeling assessed associations between maternal mortality, stillbirth, and neonatal mortality and same-month, remotely sensed temperature, precipitation, anomalous high temperature (>95th percentile), and anomalous heavy precipitation (>95th percentile), controlling for month, year, remoteness, and health zone.

Findings

Temperatures > 34 °C and anomalous heavy precipitation were strongly associated with increases in same-month stillbirth and maternal mortality and less strongly associated with neonatal mortality. The stillbirth rate rose by 2·3/1,000 births for every degree increase above 34 °C (95 % CI: 1·9; 2·5) or by 5·9/1,000 births in months > 95th percentile (32·9 °C; 95 % CI: 5·1; 6·7). Maternal mortality rose by 27·3 deaths/100,000 live births for every degree increase above 34 °C (95 % CI: 19·1; 35·7) or by 95·3 deaths/100,000 live births in months > 95th percentile (95 % CI: 71·3; 119·4). Months with anomalous heavy precipitation were associated with an increase of 5·4 stillbirths/1,000 births (95 % CI: 4·8; 6·2) and with 120 maternal deaths/100,000 live births (95 % CI: 100·9; 139·5).

Interpretation

DHIS2 data offer a readily available opportunity to assess associations between climate and country-level population health outcomes. Further work is needed to hone and evaluate effective approaches that protect mothers and newborns in the face of projected warming and rainfall changes. Risk-based planning, geographic targeting, and stakeholder coordination will support appropriate, context-specific responses.

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气候变化对孕产妇和新生儿健康的国家级影响：刚果民主共和国温度、降水、孕产妇死亡率、死产和新生儿死亡率之间的关系

背景：在国家层面，特别是在热带地区，需要将极端高温与孕产妇和新生儿健康结果联系起来的证据。DHIS2（区卫生信息软件2）收集刚果民主共和国按卫生区汇总的人口健康数据。方法利用DHIS2 2018-2023年2270万刚果民主共和国新生儿的记录，通过时空建模评估产妇死亡率、死产和新生儿死亡率与同月、遥感温度、降水、异常高温（>；95个百分点）和异常强降水（>；95个百分点）之间的关系，控制月份、年份、偏远地区、温度 >； 34 °C和异常强降水与同月死产和孕产妇死亡率的增加密切相关，与新生儿死亡率的相关性较弱。在34 °C以上每升高一度，死产率增加2·3/ 1000个新生儿(95 % CI: 1·9；2·5)或5·9/ 1000个月出生 >； 第95百分位(32·9 °C；95 % ci: 5.1；6·7)。在34 °C以上每增加一度，孕产妇死亡率每10万活产增加27.3例死亡(95% %置信区间：19.1；35.7)或每月95.3例死亡/100,000例活产 >； 第95百分位数(95 % CI: 71.3；119·4)。异常强降水月份与死产增加5.4 / 1000例相关(95 % CI: 4.8；6.2)，每10万例活产有120例孕产妇死亡(95% %置信区间：100.9；139·5)。解释dhis2数据为评估气候与国家一级人口健康结果之间的关系提供了一个现成的机会。需要进一步的工作来磨练和评估在预测的变暖和降雨变化面前保护母亲和新生儿的有效方法。基于风险的规划、地理目标和利益相关者协调将支持适当的、针对具体情况的响应。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.