Assessing the impact of heat stress on growth faltering in the first 1000 days of life in rural Gambia

Abstract The intersecting crises of climate change, crop failure, food security and under-nutrition are disproportionately impacting children living in the Global South. Understanding the relationship between heat stress exposure and child growth is needed considering current and projected increasing temperatures. We used multilevel, multivariate linear regression models of 60-day heat stress exposure on child growth. Heat stress was defined by Universal Thermal Climate Index (UTCI), and outcomes as: prenatal weight-for-age (WAZ); postnatally to 2 years weight-for-age (WAZ), weight-for-height (WHZ) and height-for-age (HAZ) z-scores, in The Gambia, West Africa. Postnatal WAZ and WHZ reduced with increasing heat stress exposure. Mean UTCI exposure of 30°C versus 20°C was associated with 0.34 (95%CI -0.49;-0.20) reduction in WHZ between 0–2 years. In contrast, HAZ increased with increasing UTCI, to 29°C, beyond which HAZ plateaued/decreased. Our results suggest that rising global temperatures may impact child growth in vulnerable areas with long-term implications for morbidity and mortality.