Association of adverse birth outcomes with exposure to fuel type use: A prospective cohort study in the northern region of Ghana.

We aimed to investigate the potential associations between exposure to fuel types for cooking and birth outcomes in Northern Region of Ghana. Third trimester pregnant women were recruited during antenatal visit to the hospital and followed-up till delivery. Three questionnaires were administered covering baseline information, exposure to fuel types, and birth outcomes. Adjusting for potential confounding factors, log binomial regression model was applied to investigate the association between low birth weights (LBW), preterm birth and perinatal deaths in mothers and fuel types. Of the 1626 participants recruited at baseline, about 1323 women in the delivery period completed the study. At delivery period, maternal mean (SD) age was 27.3 (5.2) years. Mothers who used charcoal and firewood for cooking had 1.47 times (95% CI 1.04-2.05) and 1.18 times (95% CI 0.83-1.69) increased in risk of preterm birth respectively after controlling for potential confounding variables. Although, non-significant, mothers who used charcoal had 1.34 times (95% CI 0.45-3.97) increased risk in LBW, while those who used firewood had 1.23 times (95% CI 0.41-3.71) risk in LBW. Similarly, babies of mothers who used charcoal and those who used firewood respectively had 1.72 times (95% CI 0.52-5.65) and 1.70 times (95% CI 0.49-5.92) risk in small for gestational age after controlling for maternal BMI at first visit and anemia. Lastly, mothers who used charcoal and those who used firewood respectively had 1.87 times (95% CI 0.29-11.64) and 2.02 times (95% CI 0.31-13.04) increased risk in perinatal mortality after controlling for potential confounding variables. We observed a significant association between charcoal and preterm birth. Also, we observed a non-significant association between charcoal and firewood users and LBW, SGA and perinatal mortality respectively, compared to those using gas or electricity. This suggests cooking with charcoal and firewood could have health consequences on the outcome of pregnancy.