BACKGROUND AND AIM: To date only two studies conducted in India have investigated the association of household air pollution (HAP) exposure from cooking with pregnancy disorders. The role of garbage burning at home, an important contributor to HAP has never been investigated. The ameliorating role of diet and nutrition in the association of HAP with pregnancy disorders also remains unexplored. We investigated the association of HAP with hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM), and examined the effect modifying role of vitamin D (vitD) intake. METHODS: We conducted a population-based cross-sectional study among 799 nursing mothers in Cape Coast Metropolis, Ghana. We assessed HAP exposure from cooking and garbage burning at home using a structured questionnaire through the collection of several types of information. A semi-quantitative food frequency questionnaire was used to assess vitD intake. Double-selection lasso logit regression was used to investigate the association between HAP exposure and pregnancy disorders. We performed stratification analysis according to quartiles of vitD intake. RESULTS:HAP exposure due to cooking and garbage burning was associated with 74% (OR=1.74; 95% CI: 0.99, 3.07) and 287% (OR=3.87; 95% CI: 1.86, 8.04) increased odds of GDM and HDP, respectively. Mothers exposed to both HAP exposures had 256% (OR=4.56; 95%: 1.49, 8.49) increased odds of pregnancy disorders compared to mothers cooking with clean fuels. In the stratified analysis, mothers classified in the fourth quartile of vitD intake had reduced odds of pregnancy disorders compared to their counterparts classified in the first to third quartile. All the interaction p values were greater than 0.05. CONCLUSIONS:We provide the first evidence on the ameliorating role of vitD intake on the effect of HAP exposure on pregnancy disorders. The study findings will help to better tailor intervention strategies for addressing the burden of pregnancy disorders in developing countries. KEYWORDS: Vitamin D, Household air pollution, Gestational diabetes mellitus, Hypertensive disorders of pregnancy, Ghana
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