Impact of biomass fuels on pregnancy outcomes in central East India

Abstract

BackgroundSmoke from biomass burning has been linked to reduced birth weight; association with other birth outcomes is poorly understood. Our objective was to evaluate effects of exposure to biomass smoke on birth weight, preterm birth and stillbirth.MethodsInformation on household cooking fuel was available for secondary analysis from two cohorts of pregnant women enrolled at delivery in India (n = 1744). Birth weight was measured and the modified Ballard performed to assess gestational age. Linear and logistic regression models were used to explore associations between fuel and birth outcomes. Effect sizes were adjusted in multivariate models for socio-demographic characteristics using propensity score techniques and for medical/obstetric covariates.ResultsCompared to women who use gas (n = 265), women cooking with wood (n = 1306) delivered infants that were on average 112 grams lighter (95% CI -170.1, -54.6) and more likely to be preterm (OR 3.11, 95% CI 2.12, 4.59). Stillbirths were also more common in the wood group (4% versus 0%, p < 0.001). In adjusted models, the association between wood use and birth weight was no longer significant (14 g reduction; 95% CI -93, 66); however, the increased odds for preterm birth persisted (aOR 2.29; 95% CI 1.24, 4.21). Wood fuel use did not increase the risk of delivering either a low birth weight or small for gestational age infant.ConclusionsThe association between wood fuel use and reduced birth weight was insignificant in multivariate models using propensity score techniques to account for socio-demographic differences. In contrast, we demonstrated a persistent adverse impact of wood fuel use on preterm delivery. If prematurity is confirmed as a consequence of antenatal exposure to household air pollution, perinatal morbidity and mortality from household air pollution may be higher than previously appreciated.

Platelet hyperactivity, neurobehavioral symptoms and depression among Indian women chronically exposed to low level of arsenic

“…Poverty and use of biomass fuel for cooking have been linked with adverse pregnancy outcomes in rural India (Wylie et al, 2014). However, the family income and the practice of cooking with biomass were similar in As-exposed and control women of this study.…”

Cardiovascular and Cerebrovascular Emergency Department Visits Associated With Wildfire Smoke Exposure in California in 2015

“…Elsewhere, heart failure‐related ED visits were elevated in the context of peat bog fires in North Carolina in 2008, but the association was not significant when repeated for fires in 2011 and only suggestive among wildfires in 1 study from California 15, 16, 26, 43, 45. Other cardiovascular outcomes, such as cardiac dysrhythmia, or pulmonary embolism, have not been found to have a clear association with wildfire‐PM 2.5 , although some suggestive effects have been found for dysrhythmia 26, 43, 46. This investigation contributes to those significant findings of dysrhythmia and pulmonary embolism, but no association was found with peripheral arterial disease, potentially because of a small number of related ED visits.…”

“…This study is one of the few to explicitly investigate cerebrovascular outcomes and to find significant associations with smoke density defined by wildfire‐PM 2.5 . Of 3 studies that described this association, only 1 found elevated impacts 43, 46, 47. Another study of 1 wildfire season in New Mexico found statistically significant elevated rates among adults aged 20 to 64 years (1.69 [1.03–2.77]) during the fire period 20…”

Association between wood cooking fuel and maternal hypertension at delivery in central East India

“…5–12 We have also reported an increased risk of preterm birth among Indian women cooking with wood during pregnancy compared to those cooking with gas. 13 …”

“…An identified association between cooking fuel and hypertension could therefore be biased by these socioeconomic factors as has been suggested in our previous work with regards to low birth weight and other birth outcomes. 13 We employed propensity score techniques to address this concern and to increase the statistical power to simultaneously adjust for multiple confounders. 33 …”