Wits RHI, Faculty of Health Sciences, University of Witwatersrand, Johannesburg, South Africa.
Climate System Analysis Group, University of Cape Town, Rondebosch, South Africa.
BMJ Open. 2024 Jan 23;14(1):e077768. doi: 10.1136/bmjopen-2023-077768.
Globally, recognition is growing of the harmful impacts of high ambient temperatures (heat) on health in pregnant women and children. There remain, however, major evidence gaps on the extent to which heat increases the risks for adverse health outcomes, and how this varies between settings. Evidence gaps are especially large in Africa. We will conduct an individual participant data (IPD) meta-analysis to quantify the impacts of heat on maternal and child health in sub-Saharan Africa. A detailed understanding and quantification of linkages between heat, and maternal and child health is essential for developing solutions to this critical research and policy area.
We will use IPD from existing, large, longitudinal trial and cohort studies, on pregnant women and children from sub-Saharan Africa. We will systematically identify eligible studies through a mapping review, searching data repositories, and suggestions from experts. IPD will be acquired from data repositories, or through collaboration with data providers. Existing satellite imagery, climate reanalysis data, and station-based weather observations will be used to quantify weather and environmental exposures. IPD will be recoded and harmonised before being linked with climate, environmental, and socioeconomic data by location and time. Adopting a one-stage and two-stage meta-analysis method, analytical models such as time-to-event analysis, generalised additive models, and machine learning approaches will be employed to quantify associations between exposure to heat and adverse maternal and child health outcomes.
The study has been approved by ethics committees. There is minimal risk to study participants. Participant privacy is protected through the anonymisation of data for analysis, secure data transfer and restricted access. Findings will be disseminated through conferences, journal publications, related policy and research fora, and data may be shared in accordance with data sharing policies of the National Institutes of Health.
CRD42022346068.
在全球范围内,人们越来越认识到高环境温度(热)对孕妇和儿童健康的有害影响。然而,关于高温增加不良健康后果风险的程度,以及这种风险在不同环境下的变化,仍然存在重大证据差距。在非洲,证据差距尤其大。我们将进行一项个体参与者数据(IPD)荟萃分析,以量化高温对撒哈拉以南非洲母婴健康的影响。详细了解和量化高温与母婴健康之间的联系,对于解决这一关键研究和政策领域的问题至关重要。
我们将使用来自撒哈拉以南非洲的大型纵向试验和队列研究中现有的个体参与者数据(IPD)。我们将通过映射审查、搜索数据存储库以及专家建议,系统地确定符合条件的研究。IPD 将从数据存储库中获取,或通过与数据提供者合作获取。现有的卫星图像、气候再分析数据和基于站点的天气观测将用于量化天气和环境暴露。在将 IPD 按位置和时间与气候、环境和社会经济数据进行链接之前,将对其进行重新编码和协调。采用单阶段和两阶段荟萃分析方法,将采用时间事件分析、广义加性模型和机器学习方法等分析模型来量化暴露于高温与不良母婴健康结局之间的关联。
该研究已获得伦理委员会的批准。对研究参与者的风险极小。通过对数据进行匿名化分析、安全数据传输和限制访问,保护参与者的隐私。研究结果将通过会议、期刊出版物、相关政策和研究论坛传播,并且可以根据美国国立卫生研究院的数据共享政策共享数据。
CRD42022346068。