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MAIN RESEARCH ARTICLES

Exposure of pregnant women to indoor air pollution: a study from nine low and middle income countries

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Pages 540-548 | Received 26 Oct 2009, Accepted 06 Nov 2009, Published online: 04 Dec 2009
 

Abstract

Objective. We studied exposure to solid fuel and second-hand tobacco smoke among pregnant women in south Asia, Africa and Latin America. Design. Prospective cross-sectional survey. Setting. Antenatal clinics in Argentina, Brazil, Ecuador, Guatemala, Uruguay, Democratic Republic of Congo, Zambia, India and Pakistan. Sample. A total of 7,961 pregnant women in ten sites in nine countries were interviewed between October 2004 and September 2005. Methods. A standardized questionnaire on exposure to indoor air pollution (IAP) and second-hand smoke was administered to pregnant women during antenatal care. Main outcome measures. Exposure to IAP and second-hand tobacco smoke. Results. South Asian pregnant women commonly reported use of wood (49.1–89.7%), crop residue and animal dung as cooking and heating fuel. African pregnant women reported higher use of charcoal (85.4–93.5%). Latin American pregnant women had greater use of petroleum gas. Among south Asian women, solid fuel use and cooking on an open flame inside the home were common. There was a significant association between solid fuel use and allowing smoking within the home at the Asian sites and in Zambia (p < 0.05). Conclusions. Pregnant women from low/middle income countries were commonly exposed to IAP secondary to use of solid fuels. Among these populations, exposure to second-hand tobacco smoke was also common. This combination of exposures likely increases the risk of poor pregnancy outcomes among the most vulnerable women. Our study highlights the importance of further research on the combined impact of IAP and second-hand tobacco smoke exposures on adverse maternal and perinatal outcomes.

Acknowledgements

This study was funded by grants from the U.S. Eunice Shriver National Institute of Child Health and Human Development and the U.S. National Cancer Institute.

*Global Network Tobacco Study Group: Argentina – Fernando Althabe and Jose M. Belizan (Institute for Clinical Effectiveness and Health Policy); Democratic Republic of Congo – Antoinette Tshefu (Kinshasa School of Public Health); Guatemala – Ana Garces (San Carlos University); India – Sailajanandan Parida (Sriramchandra Bhanja Medical College); Shivaprasad S. Goudar and Bhalchandra S. Kodkany (Jawaharlal Nehru Medical College); Pakistan – Omrana Pasha (Aga Khan University); Zambia – Elwyn Chomba (University of Zambia); USA – Jeffrey Murray (University of Iowa); Waldemar A. Carlo (University of Alabama at Birmingham); Nancy Krebs and Michael Hambidge (University of Colorado); Robert L. Goldenberg (Drexel University); Pinaki Panigrahi (University of Maryland Baltimore); Richard J. Derman (University of Missouri, Kansas City); Carl Bose (University of North Carolina at Chapel Hill); Pierre Buekens (Tulane School of Public Health and Tropical Medicine); Joseph Spinnato (University of Cincinnati); Linda L. Wright (Eunice Kennedy Shriver National Institute of Child Health and Human Development); Elizabeth M. McClure, Norman Goco, Janet Moore, Jutta Thornberry, and Ty Hartwell (Research Triangle Institute).

Disclosure of interest: There are no conflicts of interests.

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