Exposure of pregnant women to indoor air pollution: a study from nine low and middle income countries.
OBJECTIVE
We studied exposure to solid fuel and second-hand tobacco smoke among pregnant women in south Asia, Africa and Latin America.


METHODS
Prospective cross-sectional survey.


METHODS
Antenatal clinics in Argentina, Brazil, Ecuador, Guatemala, Uruguay, Democratic Republic of Congo, Zambia, India and Pakistan.


METHODS
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.


METHODS
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.
Kadir
Muhammad Masood
MM
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
McClure
Elizabeth M
EM
Research Triangle Institute, Durham, NC, USA.
Goudar
Shivaprasad S
SS
Jawaharlal Nehru Medical College, Belgaum, India.
Garces
Ana L
AL
San Carlos University, Guatemala City, Guatemala.
Moore
Janet
J
Research Triangle Institute, Durham, NC, USA.
Onyamboko
Marie
M
Kinshasa School of Public Health, University of Kinshasa, Democratic Republic of Congo.
Kaseba
Christine
C
University Teaching Hospital, Lusaka, Zambia.
Althabe
Fernando
F
Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
Castilla
Eduardo E
EE
Estudio Colaborativo Latinoamericano de Malformaciones Congenitas, Rio de Janeiro, Brazil.
Freire
Salvio
S
Federal University of Pernambuco, Recife, Brazil.
Parida
Sailajanandan
S
S.C.B. Medical College, Orissa, India.
Saleem
Sarah
S
Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
Wright
Linda L
LL
National Institute of Child Health and Human Development, Bethesda, MD, USA.
Goldenberg
Robert L
RL
Drexel University College of Medicine, Philadelphia, PA, USA.
D000328:Adult; D000349:Africa / Q000453:epidemiology; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000706:statistics & numerical data*; D001208:Asia / Q000453:epidemiology; D002606:Charcoal; D003296:Cooking; D003430:Cross-Sectional Studies; D003906:Developing Countries; D005260:Female; D005390:Fires; D006361:Heating; D006801:Humans; D007843:Latin America / Q000453:epidemiology; D018811:Maternal Exposure / Q000706:statistics & numerical data*; D011247:Pregnancy; D011446:Prospective Studies; D014028:Tobacco Smoke Pollution / Q000706:statistics & numerical data; D014934:Wood
D014028:Tobacco Smoke Pollution; D002606:Charcoal