Climate Change has severe and wide-ranging health impacts, especially for vulnerable groups. Despite growing evidence of heat-associated adverse maternal and neonatal health outcomes, there remains a lack of synthesis quantifying associations and identifying specific risk periods. We systematically reviewed the literature on heat impacts on maternal, fetal, and neonatal health, and quantified impacts through meta-analyses. We found 198 studies across66 countries, predominantly high income (63.3%) and temperature climate zones (40.1%), and 23 outcomes. Results showed increased odds of preterm birth of 1.04 (95%CI = 1.03, 1.06; n = 12) per 1°C increase in heat exposure and 1.26 (95%CI = 1.08, 1.47; n = 10) during heatwaves. Similarly high heat exposure increased the risk for stillbirths (OR = 1.13 (95%CI=0.95, 1.34; n = 9)), congenital anomalies (OR=1.48 (95%CI = 1.16, 1.88; n = 6)), and gestational diabetes mellitus (OR = 1.28 (95%CI = 1.05, 1.74; n = 4)). The odds of any obstetric complication increased by 1.25 (95%CI = 1.09, 1.42; n = 11) during heatwaves. Patterns in susceptibility windows varied by condition. The findings were limited by heterogeneity in exposure metrics and study designs. The systematic review demonstrated that escalating heat exposure poses a major threat to maternal and neonatal health, highlighting research priorities, guiding the selection and monitoring of heat-health indicators, and emphasising the need to prioritise maternal and neonatal health in national climate-health programmes.

气候变化对健康产生严重而广泛的影响，尤其是对弱势群体而言。尽管越来越多的证据表明与热相关的不良孕产妇和新生儿健康结局，但仍然缺乏量化关联和确定特定风险期的综合。我们系统回顾了有关高温对孕产妇、胎儿和新生儿健康影响的文献，并通过 meta 分析量化了影响。我们发现了 66 个国家的 198 项研究，主要是高收入 （63.3%） 和温度气候区 （40.1%），以及 23 个结局。结果显示，热暴露每增加 1°C，早产几率增加 1.04 （95%CI = 1.03， 1.06;n = 12），热浪期间早产几率增加 1.26 （95%CI = 1.08， 1.47;n = 10）。同样，高温暴露会增加死产 （OR = 1.13 （95%CI = 0.95， 1.34;n = 9））、先天性异常 （OR=1.48 （95%CI = 1.16， 1.88;n = 6）） 和妊娠糖尿病 （OR = 1.28 （95%CI = 1.05， 1.74;n = 4）） 的风险。在热浪期间，任何产科并发症的几率增加了 1.25 （95%CI = 1.09， 1.42;n = 11）。易感性窗口的模式因条件而异。研究结果受到暴露指标和研究设计的异质性的限制。系统评价表明，不断升级的热暴露对孕产妇和新生儿健康构成重大威胁，强调了研究重点，指导了热健康指标的选择和监测，并强调了在国家气候健康计划中优先考虑孕产妇和新生儿健康的必要性。