This scoping review provides an overview of the published literature, identifies research gaps, and summarises the current evidence of the association between elevated ambient temperature exposure during pregnancy and adverse maternal, foetal, and neonatal outcomes. Following the PRISMA extension for scoping reviews reporting guidelines, a systematic search was conducted on CINAHL, PubMed, and Embase and included original articles published in the English language from 2015 to 2020 with no geographical limitations. A total of seventy-five studies were included, conducted across twenty-four countries, with a majority in the USA (n = 23) and China (n = 13). Study designs, temperature metrics, and exposure windows varied considerably across studies. Of the eighteen heat-associated adverse maternal, foetal, and neonatal outcomes identified, pre-term birth was the most common outcome (n = 30), followed by low birth weight (n = 11), stillbirth (n = 9), and gestational diabetes mellitus (n = 8). Overall, papers reported an increased risk with elevated temperature exposures. Less attention has been paid to relationships between heat and the diverse range of other adverse outcomes such as congenital anomalies and neonatal mortality. Further research on these less-reported outcomes is needed to improve understanding and the effect size of these relationships with elevated temperatures, which we know will be exacerbated by climate change.

Heat-Health Action Plans (HHAPs) are essential public health interventions to reduce heat-related mortality and morbidity, yet how heat-related health risks have changed following their implementation remains scarce. This study aimed to examine the temporal changes in heat-related mortality in relation to the implementation of the HHAPs across five major cities of Australia, including Melbourne, Sydney, Brisbane, Adelaide, and Perth. Daily mortality and temperature data from 1999 to 2019 were analysed using distributed lag non-linear models to compare the heat-related mortality attributable fractions (AF%) between pre- and post-HHAP periods. The results showed an overall reduction in heat-related mortality after HHAP implementation, with a notable 0.12 % (95 % CI: -0.28 - 0.04) decrease in mortality attributable to extreme heat across five cities. The reduction was more evident in individuals aged 75 and older (-0.18 %, 95 % CI: -0.35 - 0.01), while the 0-74 age group saw slight increases (+0.13 %, 95 % CI: -0.13 - 0.39). Heatwave-related mortality showed general reductions or slight increases across cities, with AF differences in period 2 and 1 ranging from -0.20 % to +0.01 %. Brisbane, Perth, Sydney, and Adelaide witnessed notable AF decreases or minimal increases in period 2 across different definitions of heatwaves (-1.38 % to -0.01 % in Brisbane, -2.01 % to +0.05 % in Perth, -0.19 %-0.00 % in Sydney, and -0.71 %-0.17 % in Adelaide). In Melbourne, AF increased notably in period 2 for low-intensity heatwaves (≥2 days + 90th/92th percentile) by +0.25 % and +0.38 %, primarily due to the increase among those aged 0-74. Meanwhile, Sydney showed AF increases by +0.08 % to +0.43 % among the elderly during low-intensity heatwaves despite overall AF reductions. These findings suggest that HHAPs have reduced heat-related mortality in Australia's major cities, particularly during extreme heat days. However, extreme heat continues to pose significant health risks, highlighting the need for enhanced heat-health strategies.

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This study aimed to investigate the potential impact of an excise tax on sugar sweetened beverages (SSBs) in Egypt—specifically, a tax intended to raise consumer prices by 20%—on health outcomes and healthcare expenditure. Epidemiologic-economic modelling study. We used a proportional multi-state life table model to project the health of the current Egyptian population over their remaining lifespan, using data from both Egyptian and international sources. A tax that increases consumer prices of SSBs by 20%, in line with World Health Organization recommendations, could yield substantial health improvements for the people of Egypt. Over 25 years, it could prevent 350,000 (95% uncertainty interval: 320,000 – 390,000) cases of obesity, 250,000 (196,000 – 324,000) cases of T2DM, 56,000 (43,000 – 72,000) cases of heart disease, 39,000 (32,000 – 46,000) cases of stroke, 2700 (2000 – 3300) new cases of cancer, and 30.9 (19.7 – 42.8) million instances of tooth decay. Over the lifetime of the 2019 population, the tax could result in an additional 1.6 million health-adjusted life years (1.3–1.9 million). Over the first 25 years, healthcare cost savings are estimated at USD 1.8 billion (EGP 30 billion). The most significant impact of the tax on body mass would be observed among younger Egyptians, with women benefiting slightly more than men. This study demonstrates that taxing SSBs could produce significant health benefits and healthcare cost savings in Egypt.

The association between high ambient temperatures and adverse birth outcomes (ABOs) is gaining global attention; however, evidence from Queensland, Australia, is limited and inconsistent. This study examined the associations between average maximum temperatures (AMTs) and ABOs, including preterm birth (PTB), low birth weight (LBW), stillbirth, congenital anomalies, and neonatal deaths, across 82 statistical areas level 3 (SA3) in Queensland. The study further investigates whether sociodemographic and economic factors modify these relationships. Using multivariable binary logistic regression and random-effects meta-analysis, the study estimated SA3-specific and pooled effects. Meta-regression explored the influence of sociodemographic and economic factors. Greater AMT-ABO risk observed in remote and regional SA3s than urban SA3s. A 1 °C increase in AMT was associated with higher odds of PTB (0.6 % [95 %CI: 0.2-0.9]) during the 0-8 weeks of gestation, LBW during weeks 13-26 (0.7 % [95 % CI, 0.2-1.1]) and final week (0.4 % [95 % CI, 0.0-0.7]). AMT was also linked with congenital anomalies in the last four weeks (0.5 % [95 % CI, 0.2-0.7]) and the final week (0.6 % [95 % CI, 0.2-0.9]), and neonatal deaths from 27 weeks until birth (3.4 % [95 % CI, 0.0-6.8]). No significant association was found for stillbirth. The association between AMT-congenital anomalies was stronger in lower income communities, while the association with stillbirth was more pronounced in communities with higher Indigenous population. No other sociodemographic or economic factors had significant modifying effects. Our findings highlight the urgent need to implement targeted heat-health interventions to protect Queensland mothers and newborns from high temperatures.