Abstract
The adverse health effects of exposure to environmental tobacco smoke (ETS) on children are well-documented, and yet, gender difference in low birthweight among newborns whose mothers were exposed to ETS during pregnancy still remains contentious. We therefore explored the association between ETS exposure and risk of low birthweight, and further determined the gender difference in the association between exposure to ETS during pregnancy and birth weight in Africa. The Demographic Health Surveys of 23 African countries with information on 208,027 newborns were used. The associations between exposure to ETS and birth weight was estimated using multiple logistic regression models. Exposure to ETS increased the risk of low birthweight in Africa (adjusted odds ratio (OR) = 1.06; 95% Confidence Interval (CI): 1.02–1.10). A stratified analysis, by gender, revealed that male newborns whose mothers were exposed to ETS were 1.08 (95% CI: 1.02–1.14) times more likely to be low in birthweight than those whose mothers were not exposed, with those exposed weekly (adjusted OR = 1.17; 95% CI: 1.01–1.35) and daily (adjusted OR = 1.06; 95% CI: 1.01–1.12) being more likely to have low birthweight. Exposure to ETS is significantly associated with low birthweight in Africa, mainly among male newborns. Gender could possibly be a modifier, and hence, research on biological plausibility is necessary. Moreover, a public health promotion on behavioral changes is likely to have a positive impact on newborns’ health.
Highlights
Even though active and passive exposure to environmental tobacco smoke (ETS) during pregnancy has been associated with a wide-range of health risks, including still birth, prematurity, and miscarriage [1,2,3], many women in Sub-Saharan Africa (SSA) are still exposed to cigarette smoke in the household during pregnancy
All the indicators were statistically significant at p < 0.05, except for gender, which was not different in exposure to ETS
We determined the association between exposure to ETS and low birthweight in Africa and subsequently explored gender differences and the likelihood of low birthweight, finding that exposure to ETS in the household during pregnancy increases the risk of low birth weight, especially among male newborns, who were 8% more likely to have low birthweight if their mothers were exposed to ETS in the household when compared to babies whose mothers were not
Summary
Even though active and passive exposure to environmental tobacco smoke (ETS) during pregnancy has been associated with a wide-range of health risks, including still birth, prematurity, and miscarriage [1,2,3], many women in Sub-Saharan Africa (SSA) are still exposed to cigarette smoke in the household during pregnancy. Over 33% of the population is frequently exposed to cigarette smoke actively or passively, and, of all female non-smokers, about 35% were exposed to secondhand tobacco smoke (STS) [4]. In SSA as recently as 2015, adult daily smoking prevalence varied greatly between countries, with some countries estimated to be as low as 3% (i.e., Ethiopia) with others. Res. Public Health 2018, 15, 1409; doi:10.3390/ijerph15071409 www.mdpi.com/journal/ijerph
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