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. 2024 Sep 3;30(11):3106–3113. doi: 10.1038/s41591-024-03245-7

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© The Author(s) 2024

Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.

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Fig. 1 — Direct effects of heat may include placental changes and embryogenic/fetal impacts. These may lead to epigenetic changes, imprinting and other molecular effects. In the second and third trimester, these changes may lead to physiological effects, such as fetal growth restriction, resulting in stillbirth and neonatal deaths. In addition, indirect impacts may have an effect through health system responsiveness or through psychological factors, including stress and nutrition.