title: 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.
  
  
  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.
authors: Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
authors: Muhammad Masood
authors: MM
authors: Kadir
authors: Research Triangle Institute, Durham, NC, USA.
authors: Elizabeth M
authors: EM
authors: McClure
authors: Jawaharlal Nehru Medical College, Belgaum, India.
authors: Shivaprasad S
authors: SS
authors: Goudar
authors: San Carlos University, Guatemala City, Guatemala.
authors: Ana L
authors: AL
authors: Garces
authors: Research Triangle Institute, Durham, NC, USA.
authors: Janet
authors: J
authors: Moore
authors: Kinshasa School of Public Health, University of Kinshasa, Democratic Republic of Congo.
authors: Marie
authors: M
authors: Onyamboko
authors: University Teaching Hospital, Lusaka, Zambia.
authors: Christine
authors: C
authors: Kaseba
authors: Institute of Clinical Effectiveness and Health Policy, Buenos Aires, Argentina.
authors: Fernando
authors: F
authors: Althabe
authors: Estudio Colaborativo Latinoamericano de Malformaciones Congenitas, Rio de Janeiro, Brazil.
authors: Eduardo E
authors: EE
authors: Castilla
authors: Federal University of Pernambuco, Recife, Brazil.
authors: Salvio
authors: S
authors: Freire
authors: S.C.B. Medical College, Orissa, India.
authors: Sailajanandan
authors: S
authors: Parida
authors: Department of Community Health Sciences, Aga Khan University, Karachi, Pakistan.
authors: Sarah
authors: S
authors: Saleem
authors: National Institute of Child Health and Human Development, Bethesda, MD, USA.
authors: Linda L
authors: LL
authors: Wright
authors: Drexel University College of Medicine, Philadelphia, PA, USA.
authors: Robert L
authors: RL
authors: Goldenberg
mesh_terms: 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
chemical_list: D014028:Tobacco Smoke Pollution; D002606:Charcoal