Prenatal and early childhood exposure to biothermal stress and developmental vulnerability at school entry in Western Australia: a population-based cohort study

Date

2025

Authors

Atalell, K.A.
Pereira, G.
Duko, B.
Nyadanu, S.D.
O’donnell, M.
Tessema, G.A.

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Environment International, 2025; 202:109642-1-109642-8

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Kendalem Asmare Atalell, Gavin Pereira, Bereket Duko, Sylvester Dodzi Nyadanu, Melissa O'Donnell, Gizachew A. Tessema

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Abstract

Backgrounds: Rising global temperatures, including in Australia, increase biothermal stress. However, the impact of prenatal and childhood exposure to extreme biothermal stress, measured by the Universal Thermal Climate Index (UTCI), on early childhood developmental vulnerability remains unclear. This study aimed to examine the association between prenatal and early childhood exposure to biothermal stress and early childhood developmental vulnerability at school entry in Western Australia. Methods: A population-based retrospective cohort study of 59,771 children from the 2009–2015 Australian Early Development Census (AEDC) was conducted. UTCI was spatiotemporally linked to maternal residential addresses at the time of birth at the Statistical Area 1 (SA1) level. The average UTCI exposure from conception to AEDC assessment was calculated for each child, with separate analyses for prenatal (conception to birth) and postnatal (birth to AEDC assessment) exposure. Mixed-effect logistic regression models were used to examine the association between childhood developmental vulnerability and biothermal stress. Result: The mean UTCI exposure from conception to AEDC assessment was 14.4 ± 2.5 °C. After adjusting for potential confounders, children exposed to heat stress during this period had 29 % higher odds of DV1 (developmentally vulnerable in one or more AEDC domain(s)) than those exposed to optimal thermal conditions (9–26 °C) (OR: 1.29; 95 % CI: 1.05–1.58). Prenatal exposure to heat stress was associated with 34 % higher odds of DV1 (OR: 1.34; 95 % CI: 1.10–1.65). Conclusion: Exposure to heat stress from conception to the AEDC assessment date increases developmental vulnerability, with the strongest effect observed during the prenatal period. Policymakers might integrate heat exposure considerations into maternal and child health strategies to mitigate risks for vulnerable populations.

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© 2025 Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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