A feasibility study of the use of UmbiFlow™ to assess the impact of heat stress on fetoplacental blood flow in field studies

Ana Bonell; Valerie Vannevel; Bakary Sonko; Nuredin Mohammed; Ana Vicedo-Cabrera; Andy Haines; Neil Maxwell; Jane Hirst; Andrew Prentice

doi:10.1002/ijgo.14480

A feasibility study of the use of UmbiFlow™ to assess the impact of heat stress on fetoplacental blood flow in field studies

Ana Bonell, Valerie Vannevel, Bakary Sonko, Nuredin Mohammed, Ana Vicedo-Cabrera, Andy Haines, Neil Maxwell, Jane Hirst, Andrew Prentice

School of Sport and Health Sciences

Research output: Contribution to journal › Article › peer-review

Abstract

Objective: To evaluate the use of UmbiFlow™ in field settings to assess the impact of heat stress on umbilical artery resistance index (RI). Methods: This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal. Results: A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature. Conclusions: The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.

Original language	English
Pages (from-to)	430-436
Number of pages	7
Journal	International Journal of Gynecology & Obstetrics
Volume	160
Issue number	2
DOIs	https://doi.org/10.1002/ijgo.14480
Publication status	Published - 27 Sept 2022

Bibliographical note

Funding Information:
This project was funded by the Wellcome Trust through the Wellcome Trust Global Health PhD Fellowship awarded to AB (216336/Z/19/Z). The funders had no role in study design, data collection, analysis, manuscript writing, or decision to submit.

Publisher Copyright:
© 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.

Keywords

heat
pregnancy
fetoplacental circulation
climate change
Africa
General Medicine
Obstetrics and Gynecology

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https://obgyn.onlinelibrary.wiley.com/doi/10.1002/ijgo.14480

Cite this

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title = "A feasibility study of the use of UmbiFlow{\texttrademark} to assess the impact of heat stress on fetoplacental blood flow in field studies",

abstract = "Objective: To evaluate the use of UmbiFlow{\texttrademark} in field settings to assess the impact of heat stress on umbilical artery resistance index (RI). Methods: This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal. Results: A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature. Conclusions: The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.",

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author = "Ana Bonell and Valerie Vannevel and Bakary Sonko and Nuredin Mohammed and Ana Vicedo-Cabrera and Andy Haines and Neil Maxwell and Jane Hirst and Andrew Prentice",

note = "Funding Information: This project was funded by the Wellcome Trust through the Wellcome Trust Global Health PhD Fellowship awarded to AB (216336/Z/19/Z). The funders had no role in study design, data collection, analysis, manuscript writing, or decision to submit. Publisher Copyright: {\textcopyright} 2022 The Authors. International Journal of Gynecology & Obstetrics published by John Wiley & Sons Ltd on behalf of International Federation of Gynecology and Obstetrics.",

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AU - Sonko, Bakary

AU - Mohammed, Nuredin

AU - Vicedo-Cabrera, Ana

AU - Haines, Andy

AU - Maxwell, Neil

AU - Hirst, Jane

AU - Prentice, Andrew

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PY - 2022/9/27

Y1 - 2022/9/27

N2 - Objective: To evaluate the use of UmbiFlow™ in field settings to assess the impact of heat stress on umbilical artery resistance index (RI). Methods: This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal. Results: A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature. Conclusions: The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.

AB - Objective: To evaluate the use of UmbiFlow™ in field settings to assess the impact of heat stress on umbilical artery resistance index (RI). Methods: This feasibility study was conducted in West Kiang, The Gambia, West Africa; a rural area with increasing exposure to extreme heat. We recruited women with singleton fetuses who performed manual tasks (such as farming) during pregnancy to an observational cohort study. The umbilical artery RI was measured at rest, and during and at the end of a typical working shift in women at 28 weeks or more of pregnancy. Adverse pregnancy outcomes (APO) were classified as stillbirth, preterm birth, low birth weight, or small for gestational age, and all other outcomes as normal. Results: A total of 40 participants were included; 23 normal births and 17 APO. Umbilical artery RI demonstrated a nonlinear relationship to heat stress, with indication of a potential threshold value for placental insufficiency at 32°C by universal thermal climate index and 30°C by wet bulb globe temperature. Conclusions: The Umbiflow device proved to be an effective field method for assessing placental function. Dynamic changes in RI may begin to explain the association between extreme heat and APO with an identified threshold of effect.

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KW - fetoplacental circulation

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A feasibility study of the use of UmbiFlow™ to assess the impact of heat stress on fetoplacental blood flow in field studies

Abstract

Bibliographical note

Keywords

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