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极端天气事件与中低收入国家的孕产妇健康:范围综述。

Extreme weather events and maternal health in low-income and middle-income countries: a scoping review.

机构信息

London School of Hygiene and Tropical Medicine, London, UK

Centre on Climate Change and Planetary Health, Faculty of Public Health and Policy, London School of Hygiene and Tropical Medicine, London, UK.

出版信息

BMJ Open. 2024 Jun 3;14(6):e079361. doi: 10.1136/bmjopen-2023-079361.

Abstract

BACKGROUND

Despite global efforts to improve maternal health and healthcare, women throughout the world endure poor health during pregnancy. Extreme weather events (EWE) disrupt infrastructure and access to medical services, however little is known about their impact on the health of women during pregnancy in resource-poor settings.

OBJECTIVES

This review aims to examine the current literature on the impact of EWE on maternal health to identify the pathways between EWE and maternal health in low-income and middle-income countries to identify gaps.

ELIGIBILITY CRITERIA

Studies were eligible for inclusion if they were published before 15 December 2022 and the population of the studies included pregnant and postpartum women (defined at up to 6 weeks postpartum) who were living in low-income and middle-income countries. The exposure of the included study must be related to EWE and the result to maternal health outcomes.

SOURCES OF EVIDENCE

We searched the literature using five databases, Medline, Global Health, Embase, Web of Science and CINAHL in December 2022. We assessed the results using predetermined criteria that defined the scope of the population, exposures and outcomes. In total, 15 studies were included.

CHARTING METHODS

We identified studies that fit the criteria and extracted key themes. We extracted population demographics and sampling methodologies, assessed the quality of the studies and conducted a narrative synthesis to summarise the key findings.

RESULTS

Fifteen studies met the inclusion criteria. The quantitative studies (n=4) and qualitative (n=11) demonstrated an association between EWE and malnutrition, mental health, mortality and access to maternal health services.

CONCLUSION

EWE negatively impact maternal health through various mechanisms including access to services, stress and mortality. The results have demonstrated concerning effects, but there is also limited evidence surrounding these broad topics in low-resource settings. Research is necessary to determine the mechanisms by which EWE affect maternal health.

PROSPERO REGISTRATION NUMBER

CRD42022352915.

摘要

背景

尽管全球都在努力改善孕产妇健康和医疗保健,但世界各地的女性在怀孕期间仍面临健康状况不佳的问题。极端天气事件(EWE)破坏了基础设施和医疗服务的获取,但对于它们在资源匮乏环境中对孕妇健康的影响知之甚少。

目的

本综述旨在研究 EWE 对孕产妇健康的影响,以确定 EWE 与中低收入国家孕产妇健康之间的关联途径,从而发现研究中的空白。

纳入标准

如果研究发表于 2022 年 12 月 15 日之前,并且研究人群包括居住在中低收入国家的孕妇和产后妇女(定义为产后 6 周内),研究的暴露因素与 EWE 相关,结果与孕产妇健康结局相关,则研究可被纳入。

证据来源

我们于 2022 年 12 月在五个数据库(Medline、Global Health、Embase、Web of Science 和 CINAHL)中搜索文献。我们使用预先确定的标准评估研究结果,该标准定义了研究人群、暴露因素和结局的范围。最终,有 15 项研究被纳入。

图表制作方法

我们确定了符合标准的研究,并提取了关键主题。我们提取了研究人群的人口统计学和抽样方法,评估了研究质量,并进行了叙述性综合,以总结主要发现。

结果

有 15 项研究符合纳入标准。其中,定量研究(n=4)和定性研究(n=11)表明 EWE 与营养不良、心理健康、死亡率和孕产妇保健服务获取之间存在关联。

结论

EWE 通过多种机制对孕产妇健康产生负面影响,包括服务获取、压力和死亡率。研究结果表明 EWE 产生了令人担忧的影响,但在资源匮乏的环境中,关于这些广泛主题的证据也有限。有必要进行研究以确定 EWE 影响孕产妇健康的机制。

PROSPERO 注册号:CRD42022352915。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/91dd/11149126/8eeadec69f96/bmjopen-2023-079361f01.jpg

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