Division of Public Health, School of Population, Community and Behavioural Sciences, University of Liverpool, Whelan Building, Quadrangle, Liverpool L69 3GB, United Kingdom.
Epidemiol Rev. 2010;32:70-81. doi: 10.1093/epirev/mxq005. Epub 2010 Apr 8.
Exposure to indoor air pollution from solid fuel use (IAP) has been linked to approximately 1.5 million annual deaths (World Health Organization (http://www.who.int/indoorair/publications/fuelforlife/en/index.html)) due to acute lower respiratory infections in children <5 years of age and chronic obstructive lung disease and lung cancer in adults. Emerging evidence suggests that IAP increases the risk of other conditions, including adverse pregnancy outcomes. To establish the relation of IAP with birth weight and stillbirth, systematic reviews with meta-analyses were conducted. Studies reporting outcomes of mean birth weight, percentage of low birth weight (LBW; <2,500 g), and/or stillbirth and assessing IAP were identified. Five LBW studies (of 982) and 3 stillbirth studies (of 171) met inclusion criteria for the reviews. Fixed-effect meta-analyses (I(2) = 0%) found that IAP was associated with increased risk of percentage LBW (odds ratio = 1.38, 95% confidence interval: 1.25, 1.52) and stillbirth (odds ratio = 1.51, 95% confidence interval: 1.23, 1.85) and reduced mean birth weight (-95.6 g, 95% confidence interval: -68.5, -124.7). Evidence from secondhand smoke, ambient air pollution, and animal studies--and suggested plausible mechanisms--substantiate these associations. Because a majority of pregnant women in developing countries, where rates of LBW and stillbirth are high, are heavily exposed to IAP, increased relative risk translates into substantial population attributable risks of 21% (LBW) and 26% (stillbirth).
室内空气污染（IAP）来自固体燃料的使用，与每年约 150 万例 5 岁以下儿童急性下呼吸道感染、成年人慢性阻塞性肺病和肺癌死亡有关（世界卫生组织（http://www.who.int/indoorair/publications/fuelforlife/en/index.html））。新出现的证据表明，IAP 增加了其他疾病的风险，包括不良妊娠结局。为了确定 IAP 与出生体重和死产的关系，进行了系统评价和荟萃分析。确定了报告平均出生体重、低出生体重（LBW；<2500g）百分比和/或死产结果并评估 IAP 的研究。五项 LBW 研究（982 项中的 5 项）和 3 项死产研究（171 项中的 3 项）符合综述纳入标准。固定效应荟萃分析（I²=0%）发现，IAP 与 LBW 百分比增加的风险相关（比值比=1.38，95%置信区间：1.25，1.52）和死产（比值比=1.51，95%置信区间：1.23，1.85）以及降低的平均出生体重（-95.6g，95%置信区间：-68.5，-124.7）。二手烟、环境空气污染和动物研究的证据——以及提出的合理机制——证实了这些关联。由于发展中国家大多数孕妇，LBW 和死产发生率高，大量接触 IAP，相对风险增加转化为 21%（LBW）和 26%（死产）的人群归因风险。
