Climate Change and Maternal Health in Urban Nigeria: Heat, Flood Risk, Mental Health, and Health System Adaptation Gaps

Abstract: Urban Nigeria is experiencing increasing exposure to climate-related hazards, including extreme heat, recurrent flooding, and environmental degradation, which pose significant risks to maternal health. Pregnancy represents a physiologically sensitive period, during which elevated temperatures, disrupted access to care, infectious exposures, and psychosocial stress can contribute to adverse maternal, perinatal, and mental health outcomes. Despite growing global evidence, research specific to Sub-Saharan Africa—and Nigeria in particular—remains limited. This narrative review synthesizes existing literature on the pathways linking climate hazards to maternal health outcomes in urban Nigeria. Heat exposure is associated with dehydration, preterm birth, hypertensive disorders, and stillbirth, whereas flooding contributes to infection risk, malaria exposure, disrupted antenatal care, and nutritional insecurity. Climate-related stressors also affect maternal mental health, manifesting as anxiety, climate grief, economic stress, amplified domestic tension, and increased postpartum depression risk. Urban health system vulnerabilities—including flood-damaged facilities, limited emergency obstetric transport, weak climate adaptation planning, and fragmented surveillance systems—further exacerbate these risks. Policy analysis reveals a disconnect between Nigeria’s climate adaptation frameworks and maternal health strategies. Neither domain sufficiently integrates climate-specific maternal risk assessments, heat-response guidance, or climate-informed antenatal care protocols. Research gaps include the need for localized heat exposure metrics linked to pregnancy outcomes, flood-displacement mental health tracking, urban vulnerability mapping, mixed-method investigations, and integrated climate-sensitive maternal health surveillance. This review highlights the urgent need for interdisciplinary research and policy integration to support climate-resilient maternal health systems in Nigeria’s rapidly urbanizing contexts. Strengthening evidence, surveillance, and health system preparedness is essential to protect pregnant women from the immediate and escalating impacts of climate change.