# A prospective study of heat exposure and miscarriage

> **NIH NIH R21** · BOSTON UNIVERSITY MEDICAL CAMPUS · 2022 · $252,079

## Abstract

ABSTRACT
Given the scientific consensus regarding the role of climate change in causing increased temperatures and
higher frequency of extreme weather events in the coming decades, it is crucial to clarify the effects of climate
change on human reproduction. A substantial body of research has documented that exposure to heat is
associated with adverse pregnancy and neonatal outcomes, including preeclampsia, gestational hypertension,
low birth weight, and preterm birth. However, there has been limited assessment of the association between
ambient heat and spontaneous abortion (SAB), defined as a pregnancy loss before 20 weeks’ gestation. SAB
is a particularly challenging reproductive event to measure because many SABs occur early in gestation, often
before pregnancy recognition. The ideal study design for accurately measuring SAB is a preconception cohort
where early reproductive events are closely monitored. In addition, most research on the health effects of heat
have measured ambient rather than personal temperature exposure, despite the fact that ambient temperature
does not sufficiently represent the environmental conditions individuals experience as they move throughout
time and space. In the present proposal, we will utilize the infrastructure of an ongoing preconception cohort
study, Pregnancy Study Online (PRESTO), to explore the role of ambient and personal heat exposure in the
etiology of SAB. PRESTO has successfully enrolled a geographically, racially, and socioeconomically diverse
cohort of couples trying to conceive from across the United States and Canada, and using these data, we have
prospectively identified SAB, including early SAB (<6 weeks’ gestation), and assessed risk factors for SAB.
Specifically, in the present proposal, we aim to 1) examine the association between ambient heat and SAB risk
and measure the extent to which select geospatial features mediate or modify this association, and 2) deploy
wearable personal temperature monitors for one week among 400 newly-enrolled female PRESTO participants
and use monitoring data to identify geospatial, neighborhood, and individual-level predictors of heat exposure.
The proposed study will have a large and sustained impact on the fields of reproductive epidemiology and
climate health. This will be the first study to measure personal exposure to heat in pregnant women, a
population with underlying physiologic susceptibility to heat. Our predictive models of heat exposure have vast
applications in fields of environmental exposure assessment. The ability to measure personal heat exposure
using questionnaire and geospatial data, rather than relying on personal monitoring, could revolutionize the
study of the health effects of extreme temperatures. In addition, this study could provide critical information on
the etiology of SAB, inform specific interventions to reduce SAB risk, and challenge current clinical practice
guidelines for advising women early in pregnancy that focus on lifes...

## Key facts

- **NIH application ID:** 10452143
- **Project number:** 1R21HD106357-01A1
- **Recipient organization:** BOSTON UNIVERSITY MEDICAL CAMPUS
- **Principal Investigator:** Amelia Kent Wesselink
- **Activity code:** R21 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $252,079
- **Award type:** 1
- **Project period:** 2022-09-10 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10452143

## Citation

> US National Institutes of Health, RePORTER application 10452143, A prospective study of heat exposure and miscarriage (1R21HD106357-01A1). Retrieved via AI Analytics 2026-06-05 from https://api.ai-analytics.org/grant/nih/10452143. Licensed CC0.

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