Protecting pregnant women and children from the health effects of climate change

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According to reports from meteorologists, the 2022 fire season could be the worst ever. Wildfires are increasing in frequency and intensity due to climate change1; Severe drought, rising temperatures and high winds have led to more widespread, hotter and faster-burning wildfires in some parts of the United States. Wildfires can further accelerate climate change through the resulting greenhouse gas emissions and deforestation.1

As with other effects of climate change – more intense storms, higher temperatures and a decline in water quality – pregnant women and newborns are particularly vulnerable to health problems related to wildfires.2 Wildfire smoke causes exposure to toxic gases, volatile organic compounds and particulate matter; In pregnant women, these exposures increase the risk of developing high blood pressure during pregnancy and gestational diabetes;3 Conditions that can cause long-term health risks for the mother. Exposure to wildfire smoke or its components has been linked to an increased risk of preterm birth and low birth weight.1 Consequences that can have lifelong health effects in the same situation. Community displacement caused by wildfires can disrupt access to health services, including prenatal and newborn care, and access to social support and other services can negatively impact maternal, postpartum, and newborn health.2 These consequences are borne by marginalized populations and can have long-term and reciprocal effects if newborns continue to suffer from poor health as parents.4

Failure to combat climate change poses a major health risk to the entire population. We believe that addressing the underlying problem by reducing greenhouse gas emissions and strengthening carbon sinks should be a global priority. Special attention should be paid to protect pregnant women and newborns as they are more vulnerable to damage related to climate change. More research is needed on interventions that can mitigate the effects of climate change on these groups, but we believe that action to reduce these impacts must begin now. For the past 25 years, our work has focused on emerging infectious diseases, and we have pointed out the need for special attention to respond to pregnant women and newborns. We believe that the lessons learned from this work will be applied to efforts to prevent the effects of climate change on these populations.

first, Preparedness and response planning to combat the impacts of climate change, including planning specifically for pregnant women and newborns, should be a priority for public health agencies and health systems.. In the year As part of investments in influenza preparedness for the 2000 pandemic, public health leaders emphasized special efforts for vulnerable populations, including pregnant women. In April 2008, the Centers for Disease Control and Prevention (CDC) Infectious Diseases, Public Health, Maternity, and Newborn Care experts and key partners convened to discuss epidemic-related issues for pregnant women, identify knowledge gaps, and develop a public health approach that can be followed during an outbreak. Issues including prophylaxis and treatment, use of vaccines, nonpharmacological interventions, and health care–prenatal and delivery care system planning and linkages are discussed.5 The plans resulting from this meeting facilitated the response to the 2009 H1N1 influenza pandemic.

For example, pre-pandemic discussions about the benefits and risks of using antiviral drugs in pregnant women with influenza prompted the CDC’s recommendation that all pregnant women with known or suspected H1N1 influenza be treated with oseltamivir. ICU admission and mortality decreased. In addition, this planning process brought together many experts and partners, many of whom continued to work together during later outbreaks of infectious diseases such as the Ebola, Zika, and SARS-CoV-2 viruses.

We believe that as the impacts of climate change increase in frequency and intensity, special plans for the needs of pregnant women must be developed now; Such plans may include recommendations for patient-level, health-system-level, and community-level interventions to reduce these impacts. As an example of an intervention that can have an immediate impact, having all pregnant patients—especially those living in areas at high risk of extreme weather events—access to their electronic medical records can ensure a new level of prenatal care. In case of disruption.

It will also be important to develop better ways to monitor the effects of climate change-related events on pregnant women and newborns. Flexible monitoring systems can be set up in advance and then quickly adapted to collect relevant data. For example, after delays in the implementation of research findings related to the 2009 H1N1 influenza were identified, researchers in the United Kingdom “dormant” several surveillance systems for emerging infectious diseases, including one focused on pregnancy. Future pandemic. This program was activated at the beginning of the covid-19 pandemic and provided up-to-date information on the effects of covid-19 on pregnancy.5

Also worth noting are the types of data collection challenges that emerged after Katrina when victims were scattered across the United States. One that uses mobile-phone technology, like v-safe (the CDC’s surveillance system to monitor the safety of the Covid-19 vaccine), can be used to collect data on pregnancy complications and problems among those displaced in affected areas. Severe weather event. Monitoring systems are also needed to identify pregnant people who are particularly vulnerable, such as members of racial or ethnic groups who live in low-income communities and are disproportionately affected by climate change-related events; Interventions can be tailored to high-risk populations. The effectiveness of strategies to reduce the effects of these events on pregnant women should be monitored.

Finally, it is important that maternal and child health professionals begin working with climate scientists to address the impacts of climate change. In recent years, in response to the 2009 H1N1 influenza pandemic and the Zika virus pandemic, the American College of Obstetricians and Gynecologists (ACOG) created a task force (the Expert Task Force on Immunization, Infectious Disease, and Public Health Preparedness) to focus on mitigation. Mortality and mortality from vaccine-preventable diseases. ACOG also maintains a related website (http://www.immunizationforwomen.org) has up-to-date information for Ob/Gyns and works closely with the CDC’s Immunization Practices Advisory Committee to provide immunization recommendations for pregnant women. These collaborative efforts have facilitated the development and dissemination of recommendations related to COVID-19 diagnosis, treatment, and vaccinations during pregnancy. Obstetrics and Gynecology providers need to be educated about the impacts of climate change on the health of their patients. Adding this content to medical school curricula, Ob/Gyn residency training, and credentialing practices will help clinicians become more competent in advising patients on how to reduce their climate-change-related risks and to advocate for climate change and mitigation. Health damage.

Climate change is a major public health threat. National and global leaders must urgently work together to limit fossil fuel emissions. The impact of climate change is a threat to human health, but pregnant women and newborns are at high risk of related harm. Developing skills in preparing for and responding to emerging infectious diseases is important to help minimize negative impacts on these and other vulnerable populations. The health of future generations depends on our actions today.

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