Heat during Pregnancy and Reduced Fetal Growth: Critical Windows of Exposure and the Intertwined Role of Air Pollution, Vegetation, and Social Stressors

Increased ambient heat exposure poses a health risk to pregnant women, which may be amplified by environmental and social determinants, but these interactions have been insufficiently characterized. We examined critical windows for the associations between heat exposure during pregnancy and fetal growth and investigated the role of air pollution, vegetation, and social stressors in these associations. Weekly exposure to ambient temperature and air pollutants (PM<sub>2.5</sub>, NO<sub>2</sub>, O<sub>3</sub>) from highly resolved spatiotemporal models, vegetation, and contextual deprivation were estimated for 20,904 French women (2002-2017). Distributed lag nonlinear models evaluated associations between heat and term birth weight (tBW), tBW <i>Z</i>-score, and small-for-gestational-age. We further adjusted our models for air pollutants and stratified on vegetation and social determinants. Heat exposure during the first two trimesters was associated with reduced fetal growth. A mean temperature of 21.6 °C (95th percentile vs median 13.6 °C) during weeks 2-15 was associated with a reduced tBW (-199 g [95% CI: -268; -131]). These associations differed after adjusting for O<sub>3</sub> exposure. Trends for stronger associations were observed in women with low vegetation exposure, low social position, and high contextual deprivation. This study highlights how heat stress during early pregnancy could reduce birth weight.

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Journal
Environmental Science & Technology
Published
2026-02-24
DOI
https://doi.org/10.1021/acs.est.5c10602
Primary Topic
Climate Change and Health Impacts
Type
article
Field-Weighted Citation Impact
0.00

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article

Heat during Pregnancy and Reduced Fetal Growth: Critical Windows of Exposure and the Intertwined Role of Air Pollution, Vegetation, and Social Stressors

Vérène Wagner, Christine Monfort, Aurélie Nakamura, Rim Slama et al.
Environmental Science & Technology
Climate Change and Health Impacts
article

Heat during Pregnancy and Reduced Fetal Growth: Critical Windows of Exposure and the Intertwined Role of Air Pollution, Vegetation, and Social Stressors

Vérène Wagner, Christine Monfort, Aurélie Nakamura, Rim Slama, Ian Hough, Muriel Tafflet, Lucie Adélaïde, Morgane Stempfelet, Ludivine Launay, Ariane Guilbert, Lepeule Johanna, Guy Launoy, Sam Bayat, Marie-Aline Charles, Maximilien Génard-Walton, Barbara Heude, Cécile Chevrier, Mathilde Pascal, Itai Kloog
article en

Abstract

Increased ambient heat exposure poses a health risk to pregnant women, which may be amplified by environmental and social determinants, but these interactions have been insufficiently characterized. We examined critical windows for the associations between heat exposure during pregnancy and fetal growth and investigated the role of air pollution, vegetation, and social stressors in these associations. Weekly exposure to ambient temperature and air pollutants (PM<sub>2.5</sub>, NO<sub>2</sub>, O<sub>3</sub>) from highly resolved spatiotemporal models, vegetation, and contextual deprivation were estimated for 20,904 French women (2002-2017). Distributed lag nonlinear models evaluated associations between heat and term birth weight (tBW), tBW <i>Z</i>-score, and small-for-gestational-age. We further adjusted our models for air pollutants and stratified on vegetation and social determinants. Heat exposure during the first two trimesters was associated with reduced fetal growth. A mean temperature of 21.6 °C (95th percentile vs median 13.6 °C) during weeks 2-15 was associated with a reduced tBW (-199 g [95% CI: -268; -131]). These associations differed after adjusting for O<sub>3</sub> exposure. Trends for stronger associations were observed in women with low vegetation exposure, low social position, and high contextual deprivation. This study highlights how heat stress during early pregnancy could reduce birth weight.

Environmental Science & TechnologyVol. 60(9)
Ben-Gurion University of the Negev (IL), Centre National de la Recherche Scientifique (FR), Inserm (FR), École des Hautes Études en Santé Publique (FR), Université Paris Cité (FR), Université Paris Sciences et Lettres (FR), Centre Hospitalier Universitaire de Grenoble (FR), Center for Environmental Health (US), Sorbonne Université (FR), Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement (FR), Health Services Research & Development (US), Université Sorbonne Paris Nord (FR), Sorbonne Paris Cité (FR), Center for Research in Environmental Epidemiology (ES), Santé Publique France (FR), Centre François Baclesse (LU), École Normale Supérieure (BI), Institut de Biologie de l'École Normale Supérieure (FR), Hospital Plató (ES), Pulmonary Associates (US), Institut thématique Santé Publique (FR), Institut pour l'avancée des biosciences (FR), Université de Rennes (FR), Université Grenoble Alpes (FR), Icahn School of Medicine at Mount Sinai (US)
Université Grenoble Alpes, European Commission, Public Health Agency, Agence Nationale de la Recherche, Institut National de la Santé et de la Recherche Médicale, Fondation pour la Recherche Médicale, Fondation de France, Ministère de l'Education Nationale, de l'Enseignement Superieur et de la Recherche, Centre National de la Recherche Scientifique, Ben-Gurion University of the Negev, Socialdepartementet, Université Paris-Sud, Agence Nationale de Sécurité Sanitaire de l’Alimentation, de l’Environnement et du Travail, Mutuelle Générale de l'Education Nationale, École des Hautes Études en Santé Publique, Institut pour la Recherche en Santé Publique, Institut National de Recherche pour l'Agriculture, l'Alimentation et l'Environnement, CHIST-ERA
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