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

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. ; Fil: Kadir, Muhammad Masood. The Aga Khan University; Pakistán ; Fil: McClure, Elizabeth M. Research Triangle Institute; Reino Unido ; Fil: Goudar, Shivaprasad S. Jawaharlal Nehru Medical College Belgaum; India ; Fil: Garces, Ana L. Universidad de San Carlos; Guatemala ; Fil: Moore, Janet. Research Triangle Institute; Reino Unido ; Fil: Onyamboko, Marie. University of Kinshasa; República Democrática del Congo ; Fil: Kaseba, Christine. University Teaching Hospital; Zambia ; Fil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. CEMIC-CONICET. Centro de Educaciones Médicas e Investigaciones Clínicas "Norberto Quirno". CEMIC-CONICET.; Argentina ; Fil: Castilla, Eduardo Enrique. Estudio Colaborativo Latinoamericano de Malformaciones Congenitas; Brasil ; Fil: Freire, Salvio. Universidade Federal de Pernambuco; Brasil ; Fil: Parida, Sailajanandan. S.C.B. Medical College; India ; Fil: Saleem, Sarah. The Aga Khan University; Pakistán ; Fil: Wright, Linda L. National Institute of Child Health and Human Development; Estados Unidos ; Fil: Goldenberg, Robert L. Drexel University. College of Medicine; Estados Unidos ; Fil: Global Network Tobacco Study Group. No especifica;