Abstract
Abstract Background The relationship between the solid fuels and the occurrence of pregnancy-induced hypertension (PIH) is inconclusive. Methods A birth cohort study of 10,452 pregnant women without chronic hypertension was conducted from 2010 to 2012 at the Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Multivariable logistic regression models were used to assess the relationship. Results Compared to pregnant women using gas as cooking fuel, pregnant women using coal (OR=2.55, 95% CI: 1.85-3.51)and biomass (OR=3.58, 95% CI: 2.29-5.60) were associated with an increased risk of PIH, gestational hypertension (biomass: OR=3.38, 95% CI: 1.68-6.80), and preeclampsia (coal: OR=2.89, 95% CI: 1.98-4.21; biomass: OR=3.38, 95% CI: 1.95-5.84).The relationship between cooking fuel and PIH is modified by maternal age(p<0.0001), pre-pregnancy BMI (p<0.0001), gestational weigh gain(p<0.0001), parity(p<0.0001), and multiple birth (p<0.0001). Conclusions During pregnancy, exposure to coal or biomass was associated with an increased risk of PIH and preeclampsia.
Highlights
Compared to pregnant women using gas as cooking fuel, pregnant women using coal (OR=2.55, 95% confidence intervals (CI): 1.85-3.51)and biomass (OR=3.58, 95% CI: 2.29-5.60) were associated with an increased risk of pregnancy-induced hypertension (PIH), gestational hypertension, and preeclampsia.The relationship between cooking fuel and PIH is modified by maternal age(p
The associations between types of cooking fuels and the risk of PIH were evaluated in a Chinese population, in which an increased risk of PIH among women who using coal or biomass for cooking compared to use of gas, and the risk varies by PIH subtypes were found
They speculate that this effect may be related to the combustion by-products of biomass fuels, which are quite similar to tobacco and cigarette smoking during pregnancy was associated with a significantly reduced risk for PE (OR=0.51, 95% CI: 0.37-0.63) have been reported in metaanalysis.(Castles et al, 1999) Agrawal S et al(2015) conducted a large-scale cross-sectional nationally representative of adult women in India including 39,657 women (456 preeclampsia/ eclampsia), and suggested that women living in households using biomass and solid fuels were associated with an increased risk of preeclampsia/eclampsia symptoms compared to women living in households using cleaner fuels (OR=2.21, 95% CI: 1.263.87), even after controlling potentially confounding factors
Summary
Solid fuels, such as coal and biomass (wood, crop residues), are widely used for cooking in worldwide, approximately half of the world’s population (International Energy Agency & Organisation for Economic Cooperation and Development, 2004).In China, gas, biomass, solar/electricity, and coal, the main energy fuels for cooking, are used by 44.8%, 32.1%, 11.7% and 11.3% of households, respectively. (Duan et al, 2014) Studies found that indoor PM2.5 concentrations is higher than that in outdoor air due to inefficient combustion of solid fuel, especially in rural areas. (Li et al, 2016; Shen et al, 2010) Indoor air pollution (IAP) is associated with illness and premature deaths and more than 800,000 deaths were caused in 2013 by IAP in China (Institute for Health Metrics and Evaluation, 2016).Cohort studies found that IAP from solid fuels has been proved to be associated with the increases risk of blood pressure,(Baumgartner et al, 2011; Clark et al, 2011) and chronic hypertension (Dutta & Ray, 2012; Lee et al, 2012) in non-pregnant populations. (Li et al, 2016; Shen et al, 2010) Indoor air pollution (IAP) is associated with illness and premature deaths and more than 800,000 deaths were caused in 2013 by IAP in China (Institute for Health Metrics and Evaluation, 2016).Cohort studies found that IAP from solid fuels has been proved to be associated with the increases risk of blood pressure,(Baumgartner et al, 2011; Clark et al, 2011) and chronic hypertension (Dutta & Ray, 2012; Lee et al, 2012) in non-pregnant populations. Results: Compared to pregnant women using gas as cooking fuel, pregnant women using coal (OR=2.55, 95% CI: 1.85-3.51)and biomass (OR=3.58, 95% CI: 2.29-5.60) were associated with an increased risk of PIH, gestational hypertension (biomass: OR=3.38, 95% CI: 1.68-6.80), and preeclampsia (coal: OR=2.89, 95% CI: 1.98-4.21; biomass: OR=3.38, 95% CI: 1.95-5.84).The relationship between cooking fuel and PIH is modified by maternal age(p
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