Solid fuel use and adverse pregnancy outcomes in a Ghanaian Cohort

Abstract

PDS 74: Pregnancy outcomes, Exhibition Hall (PDS), Ground floor, August 26, 2019, 1:30 PM - 3:00 PM Background/Aim: Domestic solid fuel use (wood, coal etc.), and its associated air pollution is linked with multiple adverse health outcomes that disproportionately affects women and children in low-middle income countries. Accruing evidence suggests that prenatal exposure to household air pollution is associated with low birth weight and stillbirth. This study aimed to investigate the relationship between solid fuel use and various pregnancy-related outcomes in a cohort of Ghanaian women. Methods: A secondary analysis was conducted on a prospective cohort of pregnant mothers (N=1010) recruited <17 weeks gestation from Accra, Ghana. Solid fuel use was self-reported use of charcoal, coal or crop residue as main cooking fuel and was compared to gas, kerosene, or electricity as primary cooking fuels. Logistic and multivariate linear regression analyses were conducted to examine the association between solid fuel use and multiple pregnancy-related outcomes adjusted for BMI, maternal age, maternal education, and SES. Results: Of the 819 women included in the analysis, 33% (n=270) used solid fuel as their main cooking fuel. Self-reported use of solid fuels was associated with an increased likelihood of perinatal death (OR: 8.88, 95%CI 1.88, 43.32) and an adverse Apgar score (<7) after 5 minutes (OR: 3.35, 95%CI: 1.22, 9.05). Elevated (but non-significant) ORs were observed for post-partum hemorrhage (OR: 2.00, 95%CI: 0.59, 6.74), preterm birth (OR: 1.09, 95%CI: 0.51, 2.30), and low birthweight (<2500g; OR: 1.14, 95%CI 0.61, 2.12). Conclusion: In this exploratory analysis of 12 obstetric outcomes we report an increased likelihood of perinatal death and low Apgar scores with solid fuel use and potential increased risks of other pregnancy outcomes. As solid fuel use is a modifiable risk factor, further investigation is required to better quantify the consequences and possible alternatives to solid fuel use to effectively ease future transition up the energy ladder.