Effect of Biomass Fuel Exposure on Pregnancy Outcomes in Rural Bangladesh

Abstract

Low birth weight is a major cause of infant morbidity and mortality in low-income countries like Bangladesh. Emerging data suggest that exposure to biomass fuel(BMF) smoke, common during cooking with BMF, might affect birth weight. Here we investigated whether exposure to BMF smoke is associated with pregnancy outcomes in rural Bangladesh.As part of the Cook Stove Study of Bangladesh(CSSB) we recruited 903 pregnant women within 6-18 weeks of pregnancy. Detailed sociodemographic, health, diet, and pertinent exposure data (type of fuel used, duration of cooking, kitchen type and others) were collected by trained interviewers. Anthropometric measurements of the newborns(N=797) were done by field personnel within 24-72 hours of delivery. This analysis was restricted to newborns born within 37-42 weeks of gestation(N=736). Participants who used coal, wood, leaves, agricultural residues, or cow dung were categorized as solid fuel users(n=602). We fitted a multivariable linear regression model to assess the effect of exposures of interest on birth weight, length and head circumference after adjusting for gestational age, and maternal age, BMI, diabetes status and hypertension.The mean(±SD) birthweight of the newborns was 2736 gm(±370gm). Almost 82% of the women used solid fuel for cooking and spent on average 3.32hrs(±1.8hrs ) for cooking. We observed a statistically significant interaction for the use of solid fuel and duration of cooking on birth weight(p =0.03) and marginally significant interaction on birth length (p =0.1). Based on hour model coefficients, 3.32 hours of cooking with solid fuel can lead to a 145gm reduction in birthweight, compared to a woman who does not cook or spend time in the kitchen during cooking. Exposure of pregnant women to solid fuel smoke during cooking has a detrimental effect on birth weight of the newborn.