Julius Global Health, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
Institute for Risk Assessment Science (IRAS), Division of Environmental Epidemiology (EEPI), Utrecht University, Utrecht, The Netherlands.
Reprod Health. 2020 Feb 22;17(1):29. doi: 10.1186/s12978-020-0878-3.
Accruing epidemiological evidence suggests that prenatal exposure to emissions from cooking fuel is associated with increased risks of adverse maternal and perinatal outcomes including hypertensive disorders of pregnancy, low birth weight, stillbirth and infant mortality. We aimed to investigate the relationship between cooking fuel use and various pregnancy related outcomes in a cohort of urban women from the Accra region of Ghana.
Self-reported cooking fuel use was divided into "polluting" (wood, charcoal, crop residue and kerosene) and "clean" fuels (liquid petroleum gas and electricity) to examine 12 obstetric outcomes in a prospective cohort of pregnant women (N = 1010) recruited at < 17 weeks of gestation from Accra, Ghana. Logistic and multivariate linear regression analyses adjusted for BMI, maternal age, maternal education and socio-economic status asset index was conducted.
34% (n = 279) of 819 women with outcome data available for analysis used polluting fuel as their main cooking fuel. Using polluting cooking fuels was associated with perinatal mortality (aOR: 7.6, 95%CI: 1.67-36.0) and an adverse Apgar score (< 7) at 5 min (aOR:3.83, 95%CI: (1.44-10.11). The other outcomes (miscarriage, post-partum hemorrhage, pre-term birth, low birthweight, caesarian section, hypertensive disorders of pregnancy, small for gestational age, and Apgar score at 1 min) had non-statistically significant findings.
We report an increased likelihood of perinatal mortality, and adverse 5-min Apgar scores in association with polluting fuel use. Further research including details on extent of household fuel use exposure is recommended to better quantify the consequences of household fuel use.
Ghana Service Ethical Review Committee (GHS-ERC #: 07-9-11).
越来越多的流行病学证据表明，孕妇在孕期接触烹饪燃料排放物会增加妊娠不良结局和围产儿不良结局的风险，包括妊娠高血压疾病、低出生体重儿、死胎和婴儿死亡率。我们旨在调查加纳阿克拉地区城市女性队列中使用烹饪燃料与各种妊娠相关结局之间的关系。
自我报告的烹饪燃料使用分为“污染”（木材、木炭、农作物残余物和煤油）和“清洁”燃料（液化石油气和电），以检查在阿克拉招募的孕妇前瞻性队列中 12 项产科结局（N=1010），在妊娠<17 周时进行。对 BMI、产妇年龄、产妇教育和社会经济地位资产指数进行了逻辑和多元线性回归分析。
819 名有可用结局数据进行分析的妇女中，有 34%（n=279）使用污染燃料作为主要烹饪燃料。使用污染性烹饪燃料与围产儿死亡率相关（优势比：7.6，95%置信区间：1.67-36.0），5 分钟时不良 Apgar 评分（<7）（优势比：3.83，95%置信区间：（1.44-10.11）。其他结局（流产、产后出血、早产、低出生体重、剖宫产、妊娠高血压疾病、小于胎龄儿和 1 分钟时 Apgar 评分）无统计学意义。
我们报告了与污染性燃料使用相关的围产儿死亡率增加和 5 分钟时 Apgar 评分不良的可能性增加。建议进行进一步的研究，包括家庭燃料使用暴露程度的详细信息，以更好地量化家庭燃料使用的后果。
加纳服务伦理审查委员会（GHS-ERC #: 07-9-11）。
