A protocol for an observational cohort study of heat strain and its effect on fetal wellbeing in pregnant farmers in The Gambia [version 2].

Bonell, Ana; Hirst, Jane; Vicedo-Cabrera, Ana M.; Haines, Andy; Prentice, Andrew M; Maxwell, Neil S (2020). A protocol for an observational cohort study of heat strain and its effect on fetal wellbeing in pregnant farmers in The Gambia [version 2]. Wellcome open research, 5, p. 32. Wellcome Trust 10.12688/wellcomeopenres.15731.2

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Introduction: Climate change predictions indicate that global temperatures are likely to exceed those seen in the last 200,000 years, rising by around 4°C above pre-industrial levels by 2100 (without effective mitigation of current emission rates). In regions of the world set to experience extreme temperatures, women often work outside in agriculture even during pregnancy. The implications of heat strain in pregnancy on maternal health and pregnancy outcome are not well understood. This protocol describes a study to assess the physiological response of pregnant women to environmental heat stress and the immediate effect this has on fetal wellbeing. Methods and analysis: The study will be performed in West Kiang district, The Gambia; a semi-arid zone in West Africa with daily maximum temperatures ranging from approximately 32 to 40°C. We will recruit 125 pregnant women of all ages who perform agricultural work during their pregnancy. Participants will be followed every two months until delivery. At each study visit fetal growth will be measured by ultrasound scan. During the course of their working day we will take the following measurements: continuous maternal physiological measurements (heart rate, respiratory rate, chest skin temperature and tri-axis accelerometer data); intermittent maternal tympanic core temperature, four point skin temperature, blood pressure; intermittent fetal heart rate and, if eligible, umbilical artery doppler; intermittent environmental measurements of air temperature, humidity, solar radiation and wind speed. Venous blood and urine will be collected at beginning and end of day for biomarkers of heat strain or fetal distress and hydration status.

Item Type:

Journal Article (Further Contribution)


04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Vicedo Cabrera, Ana Maria


600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services




Wellcome Trust




Andrea Flükiger-Flückiger

Date Deposited:

23 Apr 2020 20:03

Last Modified:

27 Apr 2020 15:25

Publisher DOI:


PubMed ID:


Uncontrolled Keywords:

climate change heat stress maternal pregnancy subsistence farmer





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