The Effect of High and Low Ambient Temperature on Infant Health: A Systematic Review

Abstract

Children, and particularly infants, have physiological, anatomic, and social factors that increase vulnerability to temperature extremes. We performed a systematic review to explore the association between acute adverse infant outcomes (children 0-1 years) and exposure to high and low ambient temperatures. MEDLINE (Pubmed), Embase, CINAHL Plus, and Global Health were searched alongside the reference lists of key papers. We included published journal papers in English that assessed adverse infant outcomes related to short-term weather-related temperature exposure. Twenty-six studies met our inclusion criteria. Outcomes assessed included: infant mortality (n = 9), sudden infant death syndrome (n = 5), hospital visits or admissions (n = 5), infectious disease outcomes (n = 5), and neonatal conditions such as jaundice (n = 2). Higher temperatures were associated with increased risk of acute infant mortality, hospital admissions, and hand, foot, and mouth disease. Several studies identified low temperature impacts on infant mortality and episodes of respiratory disease. Findings on temperature risks for sudden infant death syndrome were inconsistent. Only five studies were conducted in low- or middle-income countries, and evidence on subpopulations and temperature-sensitive infectious diseases was limited. Public health measures are required to reduce the impacts of heat and cold on infant health.

Keywords: SIDS; ambient temperature; cold exposure; heat exposure; infant health; mortality; neonatal health.

Figure 1

The factors that could increase temperature vulnerability in infants compared to older children and adults [15,16,17,18,19,20].

Figure 2

PRISMA flow diagram that illustrates the study selection process.

Figure 3

A summary of the critical appraisal using a modified OHAT Risk of bias tool [15,17,19,21,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42,44,45,46,47,48,49,50].