BackgroundExposure to air pollution, especially indoor air pollution, was associated with an increased risk of childhood stunting. However, few longitudinal studies have explored the long-term impacts of indoor air pollution from household solid fuel use on child growth. We aimed to investigate the association between household air pollution (HAP) from solid fuel use and childhood stunting in Chinese children.MethodThe longitudinal data from the Chinese Family Panel Study over 2010–2018 were included in this study with a total of 6,013 children aged 0–15 years enrolled at baseline. Exposure to HAP was measured as solid fuel use for cooking, while solid fuel was defined as coal and firewood/straw according to the questionnaire survey. Stunting was defined as−2SD below the height-for-age z-score (HAZ) of the reference children. Logistic regression and Cox proportional hazards models with time-varying exposures were employed to estimate the association between childhood stunting and HAP exposure.ResultsAt baseline, children with exposure to HAP from combusting solid fuels had a relatively higher risk of stunting [OR (95%CI): 1.42 (1.24–1.63)]. Among children without stunning at baseline, those living in households with solid fuel use had a higher stunting risk over an 8-year follow-up [HR (95%CI): 2.05 (1.64–2.57)]. The risk of childhood stunting was increased for those with HAP exposure from firewood/straw combustion or with longer exposure duration [HR (95%CI): 2.21 (1.74–2.79) and 3.01 (2.23–4.08), respectively]. Meanwhile, this risk was significantly decreased among children from households switching from solid fuels to clean fuels [HR (95%CI): 0.53 (0.39–0.70)]. Solid fuel use was suggested to be a mediator of the relationship between poor socioeconomic factors (i.e., household income and parental education level) and childhood stunning, with a mediation effect ranging from 11.25 to 14.26%.ConclusionsHAP exposure from solid fuel use was associated with childhood stunting. Poor parental education and low household income might be socioeconomic factors contributing to solid fuel use. Therefore, household energy policies to facilitate access to clean fuels are urgently needed, especially for low-income and low-educated households.
Backgrounds
A few studies have focused on the effect of thalassemia and different Hb levels on pregnancy outcomes recently. However, to our knowledge, there are no studies on the effects of different levels of hemoglobin(Hb) on pregnancy outcomes in Chinese women with thalassemia minor. In the present research, we aimed to clarify the effect of different Hb levels on pregnancy outcomes and to further explore the association of different Hb levels and gestational diabetes mellitus (GDM) in pregnant women with thalassemia minor in Chinese populations.
Methods
A retrospective controlled study was conducted on 723 pregnant women who were followed up for delivery in our hospital from 2017 to 2021. They were grouped into thalassemia minor and control group. The two groups were further divided into three subgroups, including anmia, normal and high Hb subgroups. Pregnant complications were studied in two main groups and their three subgroups. All statistical analyses were performed using R version 4.1.0 and contributed packages.
Results
There were no significant differences regarding neonatal and maternal pregnancy outcomes in women with and without thalassemia except for postpartum anemia. Furthermore, in the thalassemia group, the prevalence of GDM in the high Hb subgroup was significantly higher than the other two subgroups. However, in the control group, no significant statistical differences were found among the three subgroups. Moreover, in the high Hb subgroup, the fetuses of women with thalassemia were more likely to develop jaundice after birth. In the normal Hb subgroup, the proportion of macrosomia in the thalassemia group was significantly higher than the control group, while the proportion of low birth weight infants was on the contrary. Lastly, in anemia subgroups, we found less pregnant women with thalassemia suffered from cesarean compared to pregnant women without thalassemia.
Conclusion
We concluded that high Hb concentration might be a trigger for GDM in Chinese pregnant women with thalassemia minor. Maternal iron and Hb levels should be monitored during antenatal care and pregnancy management, as iron supplementation may lead to adverse pregnancy outcomes in women with thalassemia minor with normal or particularly high Hb concentrations.
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