{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T20:35:05Z","timestamp":1785789305770,"version":"3.56.0"},"reference-count":27,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,10,10]],"date-time":"2022-10-10T00:00:00Z","timestamp":1665360000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["216336\/Z\/19\/Z"],"award-info":[{"award-number":["216336\/Z\/19\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["obgyn.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Intl J Gynecology &amp; Obste"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To evaluate the use of UmbiFlow\u2122 in field settings to assess the impact of heat stress on umbilical artery resistance index (RI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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\u2009weeks 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u00b0C by universal thermal climate index and 30\u00b0C by wet bulb globe temperature.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ijgo.14480","type":"journal-article","created":{"date-parts":[[2022,9,27]],"date-time":"2022-09-27T08:54:46Z","timestamp":1664268886000},"page":"430-436","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["A feasibility study of the use of\n                    <scp>UmbiFlow<\/scp>\n                    \u2122 to assess the impact of heat stress on fetoplacental blood flow in field studies"],"prefix":"10.1002","volume":"160","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5981-762X","authenticated-orcid":false,"given":"Ana","family":"Bonell","sequence":"first","affiliation":[{"name":"Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine  Banjul The Gambia"},{"name":"Centre on Climate Change and Planetary Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie","family":"Vannevel","sequence":"additional","affiliation":[{"name":"Maternal and Infant Healthcare Strategies Unit, SAMRC  Pretoria South Africa"},{"name":"Department of Obstetrics and Gynaecology University of Pretoria  Pretoria South Africa"},{"name":"Research Centre for Maternal, Fetal, Newborn &amp; Child Healthcare strategies University of Pretoria  Pretoria South Africa"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bakary","family":"Sonko","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine  Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuredin","family":"Mohammed","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine  Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ana M.","family":"Vicedo\u2010Cabrera","sequence":"additional","affiliation":[{"name":"Institute of Social and Preventive Medicine, University of Bern  Bern Switzerland"},{"name":"Oeschger Center for Climate Change Research University of Bern  Bern Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andy","family":"Haines","sequence":"additional","affiliation":[{"name":"Centre on Climate Change and Planetary Health London School of Hygiene and Tropical Medicine  London UK"},{"name":"Department of Public Health, Environment and Society, Department of Population Health London School of Hygiene and Tropical Medicine  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neil S.","family":"Maxwell","sequence":"additional","affiliation":[{"name":"Environmental Extremes Laboratory University of Brighton  Eastbourne UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Hirst","sequence":"additional","affiliation":[{"name":"Nuffield Department of Women's and Reproductive Health and the George Institute for Global Health University of Oxford  Oxford UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew M.","family":"Prentice","sequence":"additional","affiliation":[{"name":"Medical Research Council Unit The Gambia at London School of Hygiene and Tropical Medicine  Banjul The Gambia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,10,10]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1038\/nclimate3322"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2542-5196(18)30240-7"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30451-0"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(18)30385-1"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.8243"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.m3811"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12978-022-01344-7"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1080\/0265673021000039628"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwq170"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwr404"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.12688\/wellcomeopenres.15731.1"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(21)01208-3"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1986.60.5.1759"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0035-1570379"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.placenta.2009.10.010"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.eclinm.2021.100792"},{"issue":"1","key":"e_1_2_9_18_1","first-page":"62","article-title":"Comparison between a newly developed PC\u2010based doppler umbilical artery waveform analyser and a commercial unit","volume":"95","author":"Theron GB","year":"2005","journal-title":"S Afr Med J"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40814-019-0499-1"},{"key":"e_1_2_9_20_1","doi-asserted-by":"crossref","unstructured":"BonellA SonkoB BadjieJ et al.Assessing the effect of environmental heat stress on maternal physiology and fetal blood flow in pregnant subsistence farmers in West Africa. 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