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Population and Environment
Published in: Population and Environment 4/2020

23-04-2020 | Original Paper

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

Authors: Frank Davenport, Audrey Dorélien, Kathryn Grace

Published in: Population and Environment | Issue 4/2020

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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.
next article Economic outlook and the gender gap in attitudes about climate change

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Appendix
Available only for authorised users
Footnotes
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.
 
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Metadata
Title
Investigating the linkages between pregnancy outcomes and climate in sub-Saharan Africa
Authors
Frank Davenport
Audrey Dorélien
Kathryn Grace
Publication date
23-04-2020
Publisher
Springer Netherlands
Published in
Population and Environment / Issue 4/2020
Print ISSN: 0199-0039
Electronic ISSN: 1573-7810
DOI
https://doi.org/10.1007/s11111-020-00342-w

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