社会不平等影响家庭空气污染对出生结果的影响。
Social inequality influences the impact of household air pollution on birth outcomes.
机构信息
Department of Population and Public Health Sciences, University of Southern California, USA.
Department of Population and Public Health Sciences, University of Southern California, USA; Department of Psychiatry, Kern Medical, Bakersfield, CA, USA.
出版信息
Sci Total Environ. 2022 May 20;822:153405. doi: 10.1016/j.scitotenv.2022.153405. Epub 2022 Jan 29.
BACKGROUND
Studies demonstrated associations between maternal exposure to household air pollution from cooking and increased risk of adverse birth outcomes in offspring; however, the modifying effect of socioeconomic status (SES) on this association has not been explored.
OBJECTIVES
In a cohort of pregnant women with 800 single live births between 2016 and 2017 in rural and semi urban areas of Bangladesh, we tested the hypotheses that kitchen location and cooking fuel type affect birth outcomes (birth weight, low birth weight [LBW] and small for gestational age [SGA]) and these associations vary by SES.
METHODS
Demographic characteristics including SES, kitchen location and fuel type were assessed in prenatal visits. Neonatal anthropometric measurements were recorded within 72 h of births. We performed multivariable linear and logistic regressions adjusting for potential confounders to test the study hypotheses.
RESULTS
For newborns from households with indoor kitchens, adjusted mean birth weight was 65.13 g (95% confidence interval [CI]: -118.37, -11.90) lower and the odds of LBW and SGA were 58% (odds ratio [OR]:1.58, 95% CI: 1.12, 2.24) and 41% (OR: 1.41, 95% CI: 1.05, 1.92) higher compared to those born in households with outdoor kitchens. We found SES significantly modified the associations between kitchen location and birth outcomes in households using biomass fuels. Newborns from low SES households with indoor kitchens had 89 g lower birth weight and a higher odds of being born with LBW (OR: 2.08, 95% CI 1.23, 3.58), and SGA (OR: 1.70, 95% CI 1.06, 2.76) than those born in high SES households using outdoor kitchens.
CONCLUSIONS
In areas with poor access or affordability to clean fuel such as in our study population, cooking in an outdoor kitchen can reduce the burden of LBW and SGA, particularly for low SES households. Promoting outdoor kitchens is a possible intervention strategy to mitigate adverse birth outcomes.
背景
研究表明，母亲在烹饪过程中暴露于家庭空气污染与后代不良出生结局的风险增加之间存在关联；然而，社会经济地位（SES）对此关联的调节作用尚未得到探索。
目的
在孟加拉国农村和半城市地区，于 2016 年至 2017 年期间对 800 例单胎活产孕妇进行的一项队列研究中，我们检验了以下假设，即厨房位置和烹饪燃料类型会影响出生结局（出生体重、低出生体重[LBW]和小于胎龄儿[SGA]），并且这些关联因 SES 而异。
方法
在产前检查中评估了人口统计学特征，包括 SES、厨房位置和燃料类型。在出生后 72 小时内记录新生儿的人体测量学指标。我们进行了多变量线性和逻辑回归，以调整潜在混杂因素，以检验研究假设。
结果
对于来自室内厨房家庭的新生儿，调整后的平均出生体重低 65.13 克（95%置信区间[CI]：-118.37，-11.90），LBW 和 SGA 的几率分别高 58%（比值比[OR]：1.58，95%CI：1.12，2.24）和 41%（OR：1.41，95%CI：1.05，1.92）。我们发现 SES 显著改变了使用生物质燃料的家庭中厨房位置与出生结局之间的关联。来自 SES 较低家庭的室内厨房新生儿出生体重低 89 克，LBW（OR：2.08，95%CI 1.23，3.58）和 SGA（OR：1.70，95%CI 1.06，2.76）的几率更高，而 SES 较高家庭的新生儿使用户外厨房。
结论
在本研究人群所在地区，由于清洁燃料的获取或负担能力较差，在户外厨房烹饪可以减轻 LBW 和 SGA 的负担，特别是对 SES 较低的家庭而言。促进户外厨房可能是减轻不良出生结局的一种干预策略。
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