Impact of biomass fuels on pregnancy outcomes in central East India.
Impact of biomass fuels on pregnancy outcomes in central East India.
复制标题
DOI：
10.1186/1476-069x-13-1
复制
发表时间：
2014-01-09
期刊：
影响因子：
--
通讯作者：
MacLeod WB
中科院分区：
文献类型：
--
作者：
Wylie BJ;Coull BA;Hamer DH;Singh MP;Jack D;Yeboah-Antwi K;Sabin L;Singh N;MacLeod WB
生物质燃烧产生的烟雾与出生体重减轻有关；与其他出生结果的关联尚不清楚。我们的目标是评估暴露于生物质烟雾对出生体重、早产和死产的影响。有关家庭烹饪燃料的信息可用于对印度两组分娩孕妇 (n = 1744) 的二次分析。测量出生体重并采用改良巴拉德法评估胎龄。使用线性和逻辑回归模型来探索燃料和出生结果之间的关联。使用倾向评分技术和医学/产科协变量在多变量模型中根据社会人口特征调整效应大小。与使用煤气的女性 (n = 265) 相比，用木头做饭的女性 (n = 1306) 生下的婴儿平均轻 112 克 (95% CI -170.1, -54.6)，并且更有可能早产 (OR 3.11, 95% CI 2.12, 4.59)。死产在木材组中也更常见（4% 与 0%，p<0.001）。在调整后的模型中，木材使用与出生体重之间的关联不再显着（减少 14 克；95% CI -93, 66）；然而，早产几率持续增加（aOR 2.29；95% CI 1.24，4.21）。使用木材燃料并不会增加出生体重过低或小于胎龄儿的风险。在使用倾向评分技术来解释社会人口差异的多变量模型中，木材燃料的使用与出生体重降低之间的关联并不显着。相比之下，我们证明了木材燃料的使用对早产具有持续的不利影响。如果早产被证实是由于产前暴露于家庭空气污染造成的，那么家庭空气污染造成的围产期发病率和死亡率可能会高于之前的估计。
Smoke 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. Information 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. Compared 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. The 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.