Sergiu Gladun, Director of the Mother and Child Institute: “Pregnant women and newborns are the most vulnerable to climate change”

Their physiological capacity to adapt is limited, and extreme temperatures have direct and often dangerous effects. We discussed with Sergiu Gladun, Director of the Mother and Child Institute (IMC), how climate change affects the health of pregnant mothers, the intrauterine life of the fetus, and the first days of a newborn’s life.

Mr. Gladun, could you please describe the specific risks that climate change poses to the health of mothers and newborns?

Pregnant women and newborns are the most vulnerable to climate change due to their physiological fragility and limited adaptive capacity. Our responsibility is to provide them with a safe, balanced, and healthy environment, regardless of weather or season.

During periods of intense heat, pregnant women are at risk of dehydration and premature contractions, which can affect placental circulation and fetal development. Newborns, who do not yet have an efficient thermoregulation system, are particularly sensitive to:

• overheating, which can cause hyperthermia, rapid dehydration, apnea episodes, or neurological disturbances;
• sudden cooling in low-temperature conditions.

It is essential that the surrounding air temperature for children is comfortable and adapted to their physiological needs.

Another risk posed by climate change and its consequences (drought, floods, displacement) is chronic maternal stress. Maternal anxiety and depression are often exacerbated by sudden climate changes, which are associated with:

— alterations in fetal brain development;

— increased risk of attention-deficit/hyperactivity disorder (ADHD), language and emotional disorders in children; chronic prenatal stress also raises maternal cortisol levels, which can affect the fetus's central nervous system.

Considering the risks you mentioned, how is your institution prepared to address these challenges?

The Mother and Child Institute has integrated climate change adaptation into its 2022–2026 Institutional Development Plan, focusing on three key areas: infrastructure resilience, thermal safety, and air quality.

Renovation works target the Maternity Block and IMC Polyclinic, including thermal insulation of walls, replacement of old windows, modernization of lighting with LED technology, and upgrading heating and ventilation systems. Photovoltaic panels will also be installed to generate electricity, reducing energy consumption and heat emissions, contributing to a more sustainable environment.

The Department of Pediatric Surgery and Pediatrics underwent a complete overhaul of water, sewage, and heating systems. Old sewer lines were replaced with sealed PVC-U pipes, reducing humidity and eliminating unpleasant odors and mold growth.

Soviet-era heating systems were replaced with modern flat-panel steel radiators, equipped with thermostatic heads for individual control. Each room now has a thermostat that maintains temperatures between 22 and 24°C, a safe and comfortable range for children and newborns.

Through these measures, IMC provides a safe and stable medical environment, protected from the effects of climate fluctuations, ensuring the health and comfort of mothers and children, regardless of season or external weather conditions.

In your opinion, what are the biggest challenges the medical system faces in maintaining optimal temperatures in all maternity hospitals across the country?

Our biggest challenge is the legacy of outdated infrastructure, which was not designed for today’s climatic and technological realities. Many maternity hospitals in the country were built decades ago under different conditions, and today we aim to make these spaces truly safe—warm in winter and cool in summer—for mothers and newborns.

The costs of modernization are high, and implementing energy-efficient solutions requires time, planning, and resources. But behind every project and repair is the genuine care of medical teams and the support of partners who believe in our mission. With the help of the Ministry of Health, development partners, and international donors, we are gradually transforming these spaces into greener, more human-centered, and safer places.

Can you describe trends among patients affected by climate change in recent years, and what projections exist for the future?

Currently, we do not have official statistics fully reflecting the impact of climate change on maternal and child health. However, we observe correlations, such as respiratory conditions during winter and heat-related complications in extremely hot summers, including dehydration, premature births, and heat exhaustion.

These trends highlight the need for a more detailed monitoring system and protocols adapted to new climate realities. We approach this challenge responsibly and with hope because, once we better understand the link between climate and health, we can more effectively protect what matters most: children’s lives and family well-being.

Considering climate variations throughout the year (milder winters, late snowfalls in spring, extreme summer temperatures, sudden autumn chills), how do these phenomena affect pregnancy in each season?

Each season leaves its mark on pregnancy. Nature no longer follows past patterns, and a pregnant woman’s body feels these changes acutely.

Milder winters prolong exposure to allergens and respiratory infections, while late winters with snow and difficult road access can limit pregnant women’s access to consultations or emergency care.

Extreme summer temperatures are perhaps the greatest challenge—the pregnant body is under extra stress, increasing the risk of dehydration, exhaustion, and premature births. Autumns with sudden temperature drops also bring risks of respiratory infections and maternal fatigue.

All these factors remind us of the importance of personalized medical supervision of pregnancy, carefully adapted to the climate context. Essentially, it is double care: for the mother and for the environment around her.

How does IMC respond to hospitalizations of pregnant women related to weather conditions or climate change effects?

At the Mother and Child Institute, we have understood that caring for a mother’s health begins with caring for the environment in which she is treated. Climate change has shown us the importance of ensuring stable thermal comfort, regardless of season.

Through investments made in recent years, we have managed to maintain a consistent microclimate in wards and delivery rooms, so patients feel safe and protected even when outdoor temperatures fluctuate dramatically. Modern ventilation and air-conditioning systems are not just technical equipment—they are part of our daily care, preventing complications caused by temperature variations and providing mothers with a warm, calm, and balanced environment.

Adapting to new climatic conditions ultimately means adapting to the real needs of women and children. For us, this is not just an investment in technology, but an investment in safety, health, and life.

A review conducted by UNFPA with the support of the UK Government, in the context of the UN campaign “Climate Change Adaptation is No Longer Optional in Moldova,” organized on the occasion of the UN Climate Change Conference COP30, Brazil, 2025.