# Climate Change Impacts on Maternal Health in a Southern Birth Cohort: A Causal Analysis

> **NIH NIH R03** · NORTH CAROLINA STATE UNIVERSITY RALEIGH · 2022 · $83,108

## Abstract

PROJECT SUMMARY
 The American College of Obstetricians and Gynecologists recognizes that climate change is a significant
health concern for pregnant women. Pregnancy is an understudied critical window, and few studies have
examined the impact of the climate crisis on pregnant women and their unborn. Severe Maternal Morbidity
(SMM) is currently a surveillance indicator used by the Centers for Disease Prevention and Control to measure
and monitor improvements in maternal health; however, it has yet to be used in the context of climate change.
SMM is a composite of 21 life-threatening conditions that arise during the process of labor and delivery. These
conditions are known as “near miss” complications (i.e., an event in which a woman nearly dies) that result in
significant medical care burden, including newly diagnosed chronic health conditions, psychological stress
disorders, and amplified risks of maternal deaths. Black women are 2 times more likely to suffer from these life-
threatening pregnancy complications, and the environmental causes of this important disparity are largely
unknown and underexplored.
 An important science gap remains in identifying measures that elucidate climate and maternal health
inequities, particularly for understanding the relationship between climate change and pregnancy risks among
Black women in the South. This project will use a retrospective birth cohort to explore the causal linkages
between the upstream social and environmental stressors and climate-related changes in maternal morbidity.
Our long-term goal is to develop patient and healthcare interventions to reduce the impact of climate change
during pregnancy. The overarching objectives of this exploratory study is to examine climate-sensitivity
in SMM risk and advance understanding of the social-environmental drivers of racial inequalities in
maternal morbidity. We will address this research gap with the following two specific aims: Aim 1. Examine
patterns in SMM rates in response to three climate hazards--extreme heat, hurricanes, and inland flooding for
a Southern birth cohort; Aim 2. Characterize the individual and neighborhood-level social (e.g., poverty,
residential segregation) and environmental (e.g., greenspace) determinants that drive maternal health
disparities in a changing climate. At the completion of this project, our expected outcomes are to 1) understand
how the rate of SMM differs across different climate hazards and 2) elucidate the causal pathways linking
climate change and maternal morbidity. The proposed research is significant because results will extend
beyond identifying disease risks to capturing protective factors, as well as aid in hypothesis generation around
pathways that contribute towards causal inference. This contribution is innovative since proposed results will
provide new knowledge and a necessary first step in furthering understanding of the impacts of climate
change on maternal health, providing the foundation for future...

## Key facts

- **NIH application ID:** 10373675
- **Project number:** 1R03ES031228-01A1
- **Recipient organization:** NORTH CAROLINA STATE UNIVERSITY RALEIGH
- **Principal Investigator:** Jennifer D. Runkle
- **Activity code:** R03 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $83,108
- **Award type:** 1
- **Project period:** 2022-08-23 → 2024-07-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10373675

## Citation

> US National Institutes of Health, RePORTER application 10373675, Climate Change Impacts on Maternal Health in a Southern Birth Cohort: A Causal Analysis (1R03ES031228-01A1). Retrieved via AI Analytics 2026-05-26 from https://api.ai-analytics.org/grant/nih/10373675. Licensed CC0.

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