Birth weight and environmental heat load: a between-population analysis.

Low birth weight, a major cause of infant morbidity and mortality, is caused by different factors in Western and developing-country populations. In addition to differing in terms of ethnicity, maternal size, maternal nutritional status, and disease load, developing-country and Western populations are also characterized by different environmental heat loads. Thermodynamic theory predicts that heat stress is mitigated by reduced size of both mother and offspring, and therefore generates the hypothesis that reduced birth weight may be an adaptation to environmental heat load. The aim of this study was to test the hypothesis that environmental heat load is associated with between-population variability in birth weight. Data on birth weight and thermal environment were obtained from the literature for 140 populations. Further data on several physical, social, and biological confounders were also collated. After adjusting for confounding factors, of which only maternal height and per capita gross domestic product were statistically significant, heat stress showed a significant inverse relationship with birth weight in 108 populations, accounting for an additional 9.6% of the between-population variance. Though based on data collected from more than one source, these results are consistent with the hypothesis that heat stress is inversely associated with birth weight, as previously reported for within-population studies. Further studies are needed to establish to what extent heat stress is a determinant of low birth weight in developing countries. Copyright 2002 Wiley-Liss, Inc.