Skip to main content

Advertisement

SpringerLink
Log in

Investigating the linkages between pregnancy outcomes and climate in sub-Saharan Africa

  • Original Paper
  • Published:
Population and Environment Aims and scope Submit manuscript

Abstract

Poor pregnancy outcomes include miscarriages, stillbirths, and low birth weights. Stress from heat and lack of resources play a potentially important role in producing these poor outcomes. Women and couples who experience these poor outcomes rather than a healthy birth suffer psychological, physical, social, and financial costs as well. We use detailed reproductive data in combination with fine-scale climate data to examine pregnancy outcomes among women in sub-Saharan Africa, a region that shelters some of the poorest families in the world. Fine-scale precipitation and temperature data allow each pregnancy to be matched to the relevant climate exposures. We investigate the linkages between climate and pregnancy outcomes using linear probability models with fixed effects to minimize confounding due to factors that vary by location, season, and year. We analyze retrospective pregnancy data from more than 65,000 pregnancies recorded in 23 surveys across 15 African countries. Our results indicate that pregnancy outcomes are indeed impacted by exposure to hot days even after considering other individual-level characteristics. This research provides insight into the linkages between climate and a major adverse health outcome faced by women. In doing so, this research expands scientific understanding of the impact of environmental factors on fertility outcomes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Notes

  1. Stillbirth is defined by the World Health Organization as a “baby born with no signs of life at or after 28 weeks gestation” (Lawn et al. 2016).

  2. Multinomial logistic regression models (MLM) were also used as these more closely matched the process of interest. The results from these models are not presented in this paper but are available from the authors. The results from the MLM and the LPM are consistent in terms of significance and direction of the relationship for the simpler models. One advantage that LPM had over MLM is that it could accommodate the large amount of fixed effects which we include in our most conservative model.

  3. As an additional sensitivity analysis, we estimated models using DHS cluster by calendar month fixed effects. We found similar results as in model 3, but they were not statistically significant due to a loss of statistical power; the number of observations dropped by more than 55% when we included cluster by calendar month fixed effects as opposed to country-specific livelihood zone by calendar month fixed effects.

  4. We find similar results, when we estimated a survival model, available from the authors. The largest impacts occurred during the first 4 months and the effects were larger the greater the proportion of hot days that occurred during the pregnancy.

References

  • Adair, L. S., Fall, C. H., Osmond, C., Stein, A. D., Martorell, R., Ramirez-Zea, M., et al. (2013). Associations of linear growth and relative weight gain during early life with adult health and human capital in countries of low and middle income: findings from five birth cohort studies. Lancet, 382(9891), 525–534.

    Article  Google Scholar 

  • Bailey, R. C., Jenike, M. R., Ellison, P. T., Bentley, G. R., Harrigan, A. M., & Peacock, N. R. (1992). The ecology of birth seasonality among agriculturalists in Central Africa. Journal of Biosocial Science, 24(03), 393–412.

    Article  Google Scholar 

  • Barreca, A. I. (2010). The long-term economic impact of in utero and postnatal exposure to malaria. The Journal of Human Resources, 45(4), 865–892.

    Article  Google Scholar 

  • Barreca, A., Deschenes, O., & Guldi, M. (2018). Maybe next month? Temperature shocks and dynamic adjustments in birth rates. Demography, 55(4), 1269–1293.

    Article  Google Scholar 

  • Baschieri, A., & Hinde, A. (2007). The proximate determinants of fertility and birth intervals in Egypt: an application of calendar data. Demographic Research, 16(3), 59–96.

    Article  Google Scholar 

  • Basu, R., Malig, B., & Ostro, B. (2010). High ambient temperature and the risk of preterm delivery. American Journal of Epidemiology, 172(10), 1108–1117.

    Article  Google Scholar 

  • Bhutta, Z. A., Ahmed, T., Black, R. E., Cousens, S., Dewey, K., Giugliani, E., et al. (2008). What works? Interventions for maternal and child undernutrition and survival. Lancet, 371(9610), 417–440.

    Article  Google Scholar 

  • Black, R. E., Allen, L. H., Bhutta, Z. A., Caulfield, L. E., De Onis, M., Ezzati, M., et al. Maternal and child undernutrition study group. (2008). Maternal and child undernutrition: global and regional exposures and health consequences. Lancet, 371(9608), 243–260.

  • Bongaarts, J. (1978). A framework for analyzing the proximate determinants of fertility. Population and Development Review, 4(1), 105–132.

    Article  Google Scholar 

  • Bongaarts, J., & Potter, R. G. (1983). Fertility, Biology, and Behavior: An analysis of the proximate determinates. New York: Academic Press.

  • Bongaarts, J. (2015). Modeling the fertility impact of the proximate determinants: time for a tune-up. Demographic Research, 33, 535–560.

    Article  Google Scholar 

  • Brauner-Otto, S. R. (2014). Environmental quality and fertility: the effects of plant density, species richness, and plant diversity on fertility limitation. Population and Environment, 36(1), 1–31.

    Article  Google Scholar 

  • Brown, M. E., & Funk, C. C. (2008). Food security under climate change. Science, 319(5863), 580–581.

    Article  Google Scholar 

  • Brown, M. E., Grace, K., Shively, G., Johnson, K. B., & Carroll, M. (2014). Using satellite remote sensing and household survey data to assess human health and nutrition response to environmental change. Population and Environment, 36(1), 48–72.

    Article  Google Scholar 

  • Brown, M. E., Antle, J. M., Backlund, P., Carr, E. R., Easterling, W. E., Walsh, M. K., & Tebaldi, C. (2015). Climate change, global food security, and the US food system. Washington, DC: United States Department of Agriculture. http://www.usda.gov/oce/climate_change/FoodSecurity.htm, accessed October 15, 2015.

  • Buckles, K. S., & Hungerman, D. M. (2013). Season of birth and later outcomes: old questions, new answers. The Review of Economics and Statistics, 95(3), 711–724.

    Article  Google Scholar 

  • Butler, A. S., & Behrman, R. E. (Eds.). (2007). Preterm birth: causes, consequences, and prevention. National Academies Press.

  • Caldwell, J. C. (1979). Education as a factor in mortality decline an examination of Nigerian data. Population Studies, 33(3), 395–413.

    Article  Google Scholar 

  • Caldwell, J. C. (1994). How is greater maternal education translated into lower child mortality? Health Transition Review, 4(2), 224–229.

    Google Scholar 

  • Chi, B. H., Wang, L., Read J. S., Taha, E. T., Sinkala, M., Brown E. R., Valentine, M., Martinson, F., & Goldenberg, R. L. (2007). Predictors of stillbirth in sub-saharan Africa. Obstetrics & Gynecology, 110(5), 989–997.

  • Currie, J., & Vogl, T. (2013). Early-life health and adult circumstance in developing countries. Annual Review of Economics, 5(1), 1–36.

    Article  Google Scholar 

  • Curtis, S. L. (1997). Using calendar data to study contraceptive use. Paper presented at the IUSSP/EVALUATION project seminar on methods for evaluating family planning program impact, May 14–16 1997, Costa Rica.

  • Davenport, F., Grace, K., Funk, C., & Shukla, S. (2017). Child health outcomes in sub-Saharan Africa: a comparison of changes in climate and socio-economic factors. Global Environmental Change, 46, 72–87.

    Article  Google Scholar 

  • Davenport, F., Funk, C., & Galu, G. (2018). How will east African maize yields respond to climate change and can agricultural development mitigate this response? Climatic Change, 147(3–4), 491–506. https://doi.org/10.1007/s10584-018-2149-7.

    Article  Google Scholar 

  • Desai, M., ter Kuile, F. O., Nosten, F., McGready, R., Asamoa, K., Brabin, B., & Newman, R. D. (2007). Epidemiology and burden of malaria in pregnancy. The Lancet Infectious Diseases, 7(2), 93–104.

    Article  Google Scholar 

  • Deschênes, O., Greenstone, M., & Guryan, J. (2009). Climate change and birth weight. The American Economic Review, 99(2), 211–217.

    Article  Google Scholar 

  • Dorélien, A. (2016). Birth seasonality in sub-Saharan Africa. Demographic Research, 34, 761–796.

    Article  Google Scholar 

  • Frisch, R. E. (1978). Population food intake and fertility. Science, 199(4324), 22–30.

    Article  Google Scholar 

  • Frøen, J. F., et al. (2011). Stillbirths: why they matter. Lancet, 377(9774), 1353–1366.

    Article  Google Scholar 

  • Funk, C., Michaelsen, J., & Marshall, M. T. (2012). Mapping recent decadal climate variations in precipitation and temperature across eastern Africa and the Sahel. In Remote sensing of drought: Innovative monitoring approaches (pp. 331–358). Boca Raton: CRC Press.

    Google Scholar 

  • Grace, K. (2017). Considering climate in studies of fertility and reproductive health in poor countries. Nature Climate Change, 7, 479–485.

    Article  Google Scholar 

  • Grace, K., et al. (2015). Linking climate change and health outcomes: examining the relationship between temperature, precipitation and birth weight in Africa. Global Environmental Change, 35, 125–137.

    Article  Google Scholar 

  • Grace, K., Nagle, N. N., Burgert-Brucker, C. R., Rutzick, S., Van Riper, D. C., Dontamsetti, T., & Croft, T. (2019). Integrating environmental context into DHS analysis while protecting participant confidentiality: a new remote sensing method. Population and Development Review, 45(1), 197–218.

    Article  Google Scholar 

  • Hertel, T. W. (2016). Food security under climate change. Nature Climate Change, 6(1), 10–13.

    Article  Google Scholar 

  • Hobcraft, J. (1993). Women’s education, child welfare and child survival: a review of the evidence. Health Transition Review, 159–175.

  • Huss-Ashmore, R. (1988). Seasonal patterns of birth and conception in rural highland Lesotho. Human Biology, 493–506.

  • Isen, A., Rossin-Slater, M., & Walker, R. (2017). Relationship between season of birth, temperature exposure, and later life wellbeing. Proceedings of the National Academy of Sciences, 114(51), 13447–13452.

    Article  Google Scholar 

  • Jurkovic, D. (1998). Modern management of miscarriage: is there a place for non-surgical treatment? Ultrasound in Obstetrics & Gynecology, 11(3), 161–163.

    Article  Google Scholar 

  • Kramer, M. S. (1987). Determinants of low birth weight: methodological assessment and meta-analysis. Bulletin of the World Health Organization, 65(5), 663.

    Google Scholar 

  • Lakew, D., Dereje T., & Haile, M. (2017). Determinants of stillbirth among women deliveries at Amhara region, Ethiopia. BMC pregnancy and childbirth, 17(1), 375.

  • Lam, D. A., & Miron, J. A. (1996). The effects of temperature on human fertility. Demography, 33(3), 291–305.

    Article  Google Scholar 

  • Larsen, A. F., Headey, D., & Masters, W. A. (2019). Misreporting month of birth: diagnosis and implications for research on nutrition and early childhood in developing countries. Demography, 56(2), 707–728.

    Article  Google Scholar 

  • Lawn, J. E., Blencowe, H., Waiswa, P., Amouzou, A., Mathers, C., Hogan, D., Flenady, V., Frøen, J. F., Qureshi, Z. U., Calderwood, C., & Shiekh, S. (2016). Stillbirths: rates, risk factors, and acceleration towards 2030. Lancet, 387(10018), 587–603.

    Article  Google Scholar 

  • Levine, R. J. (1991). Seasonal variation in human semen quality. In Temperature and environmental effects on the testis (pp. 89–96). Boston: Springer.

    Chapter  Google Scholar 

  • McClure, E. M., Saleem, S., Jehan, I., Pasha, O., & Goldenberg, R. L. (2008). Stillbirths in developing countries. Expert Review of Obstetrics & Gynecology, 3(5), 657–664.

  • McMichael, A. J. (2015). Extreme weather events and infectious disease outbreaks. Virulence, 6(6), 543–547.

    Article  Google Scholar 

  • Molina, M., Durwood, Zaelke., Sarma, K. M., Andersen, S. O., Ramanathan, V., & Kaniaru, D. (2009). Reducing abrupt climate change risk using the Montreal Protocol and other regulatory actions to complement cuts in CO2 emissions. Proceedings of the National Academy of Sciences, 106(49), 20616–20621.

  • Mosher, S. W. (1979). Birth seasonally among peasant cultivators: the interrelationship of workload, diet, and fertility. Human Ecology, 7(2), 151–181.

    Article  Google Scholar 

  • Mwabu, G. (2008). The production of child health in Kenya: a structural model of birth weight. Journal of African Economies, 18(2), 212–260.

    Article  Google Scholar 

  • Okun, M. L., Roberts, J. M., Marsland, A. L., & Hall, M. (2009). How disturbed sleep may be a risk factor for adverse pregnancy outcomes a hypothesis. Obstetrical & Gynecological Survey, 64(4), 273.

    Article  Google Scholar 

  • Panter-Brick, C. (1996). Proximate determinants of birth seasonality and conception failure in Nepal. Population Studies, 50(2), 203–220.

    Article  Google Scholar 

  • Pascual, M., Chaves, L. F., Cash, B., Rodó, X., & Yunus, M. (2008). Predicting endemic cholera: the role of climate variability and disease dynamics. Climate Research, 36(2), 131–140.

    Article  Google Scholar 

  • Perez-Heydrich, C., Warren, J. L., Burgert, C. R., & Emch, M. E. (2016). Influence of demographic and health survey point displacements on raster-based analyses. Spatial Demography, 4(2), 135–153.

    Article  Google Scholar 

  • Rayco-Solon, P., Fulford, A. J., & Prentice, A. M. (2005). Differential effects of seasonality on preterm birth and intrauterine growth restriction in rural Africans. The American Journal of Clinical Nutrition, 81(1), 134–139.

    Article  Google Scholar 

  • Rocha, R., & Soares, R. R. (2015). Water scarcity and birth outcomes in the Brazilian semiarid. Journal of Development Economics, 112, 72–91.

    Article  Google Scholar 

  • Ruff, C. B. (1994). Morphological adaptation to climate in modern and fossil hominids. American Journal of Physical Anthropology, 37(S19), 65–107.

    Article  Google Scholar 

  • Rutstein, S. O. & Johnson, K. (2004). The DHS wealth index. DHS comparative reports no. 6. Calverton, Maryland, USA: ORC Macro. Available at http://dhsprogram.com/pubs/pdf/CR6/CR6.pdf.

  • Sasson, I., & Weinreb, A. (2017). Land cover change and fertility in west-Central Africa: rural livelihoods and the vicious circle model. Population and Environment, 38(4), 345–368.

    Article  Google Scholar 

  • Sedgh, G., Singh, S., & Hussain, R. (2014). Intended and unintended pregnancies worldwide in 2012 and recent trends. Studies in Family Planning, 45(3), 301–314.

    Article  Google Scholar 

  • Seidman, D. S., Samueloff, A., Mor-Yosef, S., & Schenker, J. G. (1990). The effect of maternal age and socioeconomical background on neonatal outcome. International Journal of Gynecology & Obstetrics, 33(1), 7–12.

    Article  Google Scholar 

  • Sharma, V. (2009). Hidden burden of malaria in Indian women. Malaria Journal, 8(1).

  • Sheffield, J., Goteti, G., & Wood, E. F. (2006). Development of a 50-year high-resolution global dataset of meteorological forcings for land surface modeling. Journal of Climate, 19(13), 3088–3111. https://doi.org/10.1175/JCLI3790.1.

    Article  Google Scholar 

  • Singh, S., Sedgh, G., & Hussain, R. (2010). Unintended pregnancy: worldwide levels, trends, and outcomes. Studies in Family Planning, 41(4), 241–250.

    Article  Google Scholar 

  • Steele, F., Curtis, S. L., & Choe, M. (1999). The impact of family planning service provision on contraceptive-use dynamics in Morocco. Studies in Family Planning, 30(1), 28–42.

    Article  Google Scholar 

  • Strand, L. B., Barnett, A. G., & Tong, S. (2011). The influence of season and ambient temperature on birth outcomes: a review of the epidemiological literature. Environmental Research, 111(3), 451–462.

    Article  Google Scholar 

  • Suh, S. (2014). Rewriting abortion: Deploying medical records in jurisdictional negotiation over a forbidden practice in Senegal. Social Science & Medicine, 108, 20–33.

    Article  Google Scholar 

  • Suh, S. (2017). Accounting for abortion: accomplishing transnational reproductive governance through post-abortion care in Senegal. Global Public Health, 1–18.

  • Swamy, G. K., Edwards, S., Gelfand, A., James, S. A., & Miranda, M. L. (2012). Maternal age, birth order, and race: differential effects on birthweight. Journal of Epidemiology and Community Health, 66(2), 136–142.

    Article  Google Scholar 

  • Tanser, F. C., Sharp, B., & Le Sueur, D. (2003). Potential effect of climate change on malaria transmission in Africa. Lancet, 362(9398), 1792–1798.

    Article  Google Scholar 

  • Wardlaw, T. M. (Ed.). (2004). Low birthweight: country, regional and global estimates. UNICEF.

  • Wilde, J., Apouey, B. H., & Jung, T. (2017). The effect of ambient temperature shocks during conception and early pregnancy on later life outcomes. European Economic Review, 97, 87–107.

    Article  Google Scholar 

Download references

Acknowledgements

Dorélien and Grace gratefully acknowledge funding support from the Minnesota. Population Center which is funded by a grant from the Eunice Kennedy Shriver National Institute of Child Health and Human Development Population Research Infrastructure Program (P2C HD041023). Grace also acknowledges support from the National Science Foundation Grant #1639214. Grace and Davenport were also generously supported through the United States Agency for International Development (USAID) cooperative agreement #72DFFP19CA00001. The author team is also thankful for the assistance of Rachel Magennis.

Author information

Authors and Affiliations

  1. Department of Geography and Climate Hazards Center, University of California, Santa Barbara, Santa Barbara, CA, USA

    Frank Davenport

  2. Humphrey School of Public Affairs and Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA

    Audrey Dorélien

  3. Department of Geography, Environment and Society and Minnesota Population Center, University of Minnesota, Minneapolis, MN, USA

    Kathryn Grace

Authors
  1. Frank Davenport
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Audrey Dorélien
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kathryn Grace
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Kathryn Grace.

Additional information

Publisher’s note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Audrey Dorelien, Frank Davenport, and Kathryn Grace authorship are shared equally.

Electronic supplementary material

ESM 1

(PDF 807 kb)

Appendix

Appendix

Table 6 Comparing birth outcomes based on pre-pregnancy and first trimester rainfall and temperature conditions (all pregnancies lasting more than 2 months)
Full size table
Table 7 Comparing birth outcomes based on pre-pregnancy and first trimester rainfall and temperature conditions (all pregnancies lasting more than 5 months)
Full size table
Table 8 Comparing birth outcomes based on pre-pregnancy and first trimester rainfall and temperature conditions (all pregnancies lasting more than 7 months)
Full size table

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Davenport, F., Dorélien, A. & Grace, K. Investigating the linkages between pregnancy outcomes and climate in sub-Saharan Africa. Popul Environ 41, 397–421 (2020). https://doi.org/10.1007/s11111-020-00342-w

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11111-020-00342-w

Keywords

Search

Navigation