Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine, Banjul, The Gambia.
Centre on Climate Change and Planetary Health, London School of Hygiene and Tropical Medicine, London, UK.
Int J Gynaecol Obstet. 2023 Feb;160(2):430-436. doi: 10.1002/ijgo.14480. Epub 2022 Oct 10.
To evaluate the use of UmbiFlow™ in field settings to assess the impact of heat stress on umbilical artery resistance index (RI).
This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal.
A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature.
The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.
评估 UmbiFlow™ 在现场环境中用于评估热应激对脐动脉阻力指数（RI）的影响。
本可行性研究在冈比亚西部的 West Kiang 进行，该地区农村地区越来越容易受到极端高温的影响。我们招募了在怀孕期间从事体力劳动（如务农）的单胎妊娠女性，将其纳入观察性队列研究。在妊娠 28 周或以上的女性休息时、典型工作期间和工作结束时测量脐动脉 RI。不良妊娠结局（APO）分为死产、早产、低出生体重或小于胎龄儿，其他所有结局均为正常。
共纳入 40 名参与者；23 例正常分娩，17 例 APO。脐动脉 RI 与热应激呈非线性关系，通过通用热气候指数和湿球黑球温度分别显示出 32°C 和 30°C 时胎盘功能不全的潜在阈值值。
Umbiflow 设备被证明是一种评估胎盘功能的有效现场方法。RI 的动态变化可能开始解释极端高温与 APO 之间的关联，并确定了效应的阈值。
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