Evidence map›Paper›PMID 42410409›Full record

ArticleBMC public health2026

Investigating environmental heat exposure and its effects on maternal and fetal health in rural Northern Ghana (Physio-HeMAB Study): a study protocol for a cluster randomized trial.

Rachel Sophie Zimmer, Edmund Yeboah, Lila Sax Dos Santos Gomes, Lena Fiebig, Antonio Torres Reyes, Alina Hermann, Aaron Kampim, Callistus Ireneous Nakpih, Annalena Horst, Michael Bergner and 9 more

Abstract readClinical Trial Protocol
In one paragraph

Article in BMC public health, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Rachel Sophie ZimmerGlobal and Planetary Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Edmund YeboahHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Lila Sax Dos Santos GomesYarrow Global Consulting gGmbH, Staffort, Germany.
Lena FiebigGlobal and Planetary Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Antonio Torres ReyesGlobal and Planetary Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Alina HermannHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Aaron KampimNavrongo Health Research Center, Research and Development Devision, Ghana Health Service, Navrongo, Ghana.
Callistus Ireneous NakpihC.K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
Annalena HorstGlobal and Planetary Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Michael BergnerDepartment of Obstetrics and Prenatal Medicine, University Hospital Halle, Halle (Saale), Germany.
Marcus RiemerDepartment of Obstetrics and Prenatal Medicine, University Hospital Halle, Halle (Saale), Germany.
Stephanie WallwienerDepartment of Obstetrics and Prenatal Medicine, University Hospital Halle, Halle (Saale), Germany.
Gilbert Abotisem AbiiroUniversity of Development Studies, Tamale, Ghana.
James AkaziliC.K. Tedam University of Technology and Applied Sciences, Navrongo, Ghana.
Jan W KantelhardtInstitute of Physics, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany.
Martina Anna MaggioniHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Manuela De AllegriHeidelberg Institute of Global Health, Faculty of Medicine and University Hospital, Heidelberg University, Heidelberg, Germany.
Daniel Azongo *Navrongo Health Research Center, Research and Development Devision, Ghana Health Service, Navrongo, Ghana.
Eva J Kantelhardt *Global and Planetary Health Working Group, Martin-Luther-University Halle-Wittenberg, Halle (Saale), Germany. eva.kantelhardt@uk-halle.de.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClimate change increases the frequency and intensity of heat events. Previous studies have established a correlation between heat exposure and adverse pregnancy outcomes, including preterm birth, stillbirth, and other maternal and fetal health complications. However, evidence on the physiological pathways underlying heat strain during pregnancy and on whether heat adaptation strategies can modify these responses remains limited, particularly in low-resource settings. This study aims to assess the effects of environmental heat exposure on maternal and fetal physiological responses among pregnant women exposed and unexposed to a heat adaptation strategy.

methodsPhysio-HeMAB is an interventional, cluster-randomized study hosted by the Health and Demographic Surveillance System in Navrongo, Ghana. This study integrates: (i) high-resolution environmental monitoring including Wet-Bulb Globe Temperature at household level and Universal Thermal Climate Index environmental data at regional level; (ii) continuous maternal physiological assessment via wearable devices measuring heart rate, heart rate variability, core body temperature, physical activity, and sleep; and (iii) fetal health assessments, including fetal heart rate and Doppler indices. This multimodal framework supports detailed assessment of how varying levels of environmental heat exposure relate to maternal physiological changes and fetal health indicators. Descriptive and multivariable statistical methods will be used to analyze the data. DISCUSSION: A better understanding of the physiological mechanisms of heat strain during pregnancy, and an evaluation of whether targeted adaptation strategies can mitigate its effects, are essential for protecting maternal and neonatal health. This Physio-HeMAB study integrates individual-level physiological responses to environmental heat exposure and heat adaptation strategies. This approach strengthens the evidence for developing context-specific and gender-responsive public health interventions.

trial registrationThis study was registered in the Pan African Clinical Trials Registry as PACTR202601761543866 on 05 January 2026.

Indexed as

Environmental ExposureHot TemperatureMaternal HealthRural PopulationAdultFemaleGhanaHumansPregnancyRandomized Controlled Trials as TopicClimate change adaptationFetal healthHeatHeat stressPhysiological monitoringPhysiologyPregnancyWearable sensors

Identifiers

PMID42410409
PMCPMC13340408

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.