Impact of biomass fuels on pregnancy outcomes in central East India

Environmental Health

Research

Lora Sabin¹  Kojo Yeboah-Antwi¹  William B MacLeod²  Davidson H Hamer³  Brent A Coull⁴  Darby Jack⁵  Blair J Wylie⁶  Mrigendra P Singh⁷  Neeru Singh⁸ 

[1] Center for Global Health and Development, Boston University, Boston, MA, USA;Center for Global Health and Development, Boston University, Boston, MA, USA;Department of International Health, Boston University of School of Public Health, Boston, MA, USA;Center for Global Health and Development, Boston University, Boston, MA, USA;Department of International Health, Boston University of School of Public Health, Boston, MA, USA;Department of Medicine, Section of Infectious Diseases, Boston University School of Medicine, Boston, MA, USA;Zambia Centre for Applied Health Research and Development (ZCAHRD), Lusaka, Zambia;Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA;Departments of Biostatistics, Harvard School of Public Health, Boston, MA, USA;Department of Environmental Health, Mailman School of Public Health, Columbia University, New York, NY, USA;Division of Maternal-Fetal Medicine, Vincent Department of Obstetrics and Gynecology, Massachusetts General Hospital and Harvard Medical School, 55 Fruit Street, Boston, MA, USA;Center for Global Health and Development, Boston University, Boston, MA, USA;Department of International Health, Boston University of School of Public Health, Boston, MA, USA;Department of Environmental Health, Harvard School of Public Health, Boston, MA, USA;National Institute for Malaria Research Field Station, Jabalpur, Madhya Pradesh, India;Regional Medical Research Centre for Tribals (Indian Council for Medical Research), Jabalpur, Madhya Pradesh, India;

关键词: Indoor air pollution;    Household air pollution;    Birth weight;    Stillbirth;    Preterm birth;    Preterm delivery;    Pregnancy outcome;    Biofuel;    Biomass;    India;   

DOI  :  10.1186/1476-069X-13-1

 received in 2013-10-24, accepted in 2014-01-02,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundSmoke from biomass burning has been linked to reduced birth weight; association with other birth outcomes is poorly understood. Our objective was to evaluate effects of exposure to biomass smoke on birth weight, preterm birth and stillbirth.MethodsInformation on household cooking fuel was available for secondary analysis from two cohorts of pregnant women enrolled at delivery in India (n = 1744). Birth weight was measured and the modified Ballard performed to assess gestational age. Linear and logistic regression models were used to explore associations between fuel and birth outcomes. Effect sizes were adjusted in multivariate models for socio-demographic characteristics using propensity score techniques and for medical/obstetric covariates.ResultsCompared to women who use gas (n = 265), women cooking with wood (n = 1306) delivered infants that were on average 112 grams lighter (95% CI -170.1, -54.6) and more likely to be preterm (OR 3.11, 95% CI 2.12, 4.59). Stillbirths were also more common in the wood group (4% versus 0%, p < 0.001). In adjusted models, the association between wood use and birth weight was no longer significant (14 g reduction; 95% CI -93, 66); however, the increased odds for preterm birth persisted (aOR 2.29; 95% CI 1.24, 4.21). Wood fuel use did not increase the risk of delivering either a low birth weight or small for gestational age infant.ConclusionsThe association between wood fuel use and reduced birth weight was insignificant in multivariate models using propensity score techniques to account for socio-demographic differences. In contrast, we demonstrated a persistent adverse impact of wood fuel use on preterm delivery. If prematurity is confirmed as a consequence of antenatal exposure to household air pollution, perinatal morbidity and mortality from household air pollution may be higher than previously appreciated.

【 授权许可】

CC BY   
© Wylie et al.; licensee BioMed Central Ltd. 2014