title: Maternal exposure to carbon monoxide and fine particulate matter during pregnancy in an urban Tanzanian cohort.
abstract: Low birthweight contributes to as many as 60% of all neonatal deaths; exposure during pregnancy to household air pollution has been implicated as a risk factor. Between 2011 and 2013, we measured personal exposures to carbon monoxide (CO) and fine particulate matter (PM2.5) in 239 pregnant women in Dar es Salaam, Tanzania. CO and PM2.5exposures during pregnancy were moderately high (geometric means 2.0 ppm and 40.5 μg/m3); 87% of PM2.5measurements exceeded WHO air quality guidelines. Median and high (75th centile) CO exposures were increased for those cooking with charcoal and kerosene versus kerosene alone in quantile regression. High PM2.5exposures were increased with charcoal use. Outdoor cooking reduced median PM2.5exposures. For PM2.5, we observed a 0.15 kg reduction in birthweight per interquartile increase in exposure (23.0 μg/m3) in multivariable linear regression; this finding was of borderline statistical significance (95% confidence interval 0.30, 0.00 kg; P = 0.05). PM2.5was not significantly associated with birth length or head circumference nor were CO exposures associated with newborn anthropometrics. Our findings contribute to the evidence that exposure to household air pollution, and specifically fine particulate matter, may adversely affect birthweight.
authors.affiliation: Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Massachusetts General Hospital, Boston, MA, USA.|Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: B J
authors.initials: BJ
authors.lastname: Wylie
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Y
authors.initials: Y
authors.lastname: Kishashu
authors.affiliation: Africa Academy of Public Health, Mikocheni, Dar es Salaam, Tanzania.
authors.forename: E
authors.initials: E
authors.lastname: Matechi
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: Z
authors.initials: Z
authors.lastname: Zhou
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: B
authors.initials: B
authors.lastname: Coull
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: A I
authors.initials: AI
authors.lastname: Abioye
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.|Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: K L
authors.initials: KL
authors.lastname: Dionisio
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: F
authors.initials: F
authors.lastname: Mugusi
authors.affiliation: Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania.
authors.forename: Z
authors.initials: Z
authors.lastname: Premji
authors.affiliation: Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: W
authors.initials: W
authors.lastname: Fawzi
authors.affiliation: Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
authors.forename: R
authors.initials: R
authors.lastname: Hauser
authors.affiliation: MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, Norfolk Place, London, UK.
authors.forename: M
authors.initials: M
authors.lastname: Ezzati
mesh_terms: D000293:Adolescent; D000328:Adult; D016902:Air Pollution, Indoor / Q000009:adverse effects / Q000032:analysis*; D001724:Birth Weight; D002248:Carbon Monoxide / Q000032:analysis*; D003296:Cooking / Q000379:methods; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D016014:Linear Models; D008297:Male; D018811:Maternal Exposure / Q000009:adverse effects / Q000706:statistics & numerical data*; D015999:Multivariate Analysis; D052638:Particulate Matter / Q000032:analysis*; D011247:Pregnancy; D011446:Prospective Studies; D013636:Tanzania; D014505:Urban Population / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D052638:Particulate Matter; D002248:Carbon Monoxide
keywords: Birth outcome; Carbon monoxide; Household air pollution; Particulate matter; Personal exposure