A prospective study of heat exposure and miscarriage

ABSTRACT Given the scientific consensus regarding the role of climate change in causing increased temperatures and higher frequency of extreme weather events in the coming decades, it is crucial to clarify the effects of climate change on human reproduction. A substantial body of research has documented that exposure to heat is

associated with adverse pregnancy and neonatal outcomes, including preeclampsia, gestational hypertension, low birth weight, and preterm birth. However, there has been limited assessment of the association between ambient heat and spontaneous abortion (SAB), defined as a pregnancy loss before 20 weeks’ gestation. SAB

is a particularly challenging reproductive event to measure because many SABs occur early in gestation, often before pregnancy recognition. The ideal study design for accurately measuring SAB is a preconception cohort where early reproductive events are closely monitored. In addition, most research on the health effects of heat

have measured ambient rather than personal temperature exposure, despite the fact that ambient temperature does not sufficiently represent the environmental conditions individuals experience as they move throughout time and space. In the present proposal, we will utilize the infrastructure of an ongoing preconception cohort

study, Pregnancy Study Online (PRESTO), to explore the role of ambient and personal heat exposure in the etiology of SAB. PRESTO has successfully enrolled a geographically, racially, and socioeconomically diverse cohort of couples trying to conceive from across the United States and Canada, and using these data, we have

prospectively identified SAB, including early SAB (