文章基本信息

标题：Prenatal household air pollutant exposure is associated with reduced size and gestational age at birth among a cohort of Ghanaian infants
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作者：Ashlinn K. Quinn ; Irene Apewe Adjei ; Kenneth Ayuurebobi Ae-Ngibise 等
期刊名称：Environment International
印刷版ISSN：0160-4120
电子版ISSN：1873-6750
出版年度：2021
卷号：155
页码：106659
DOI：10.1016/j.envint.2021.106659
出版社：Pergamon
摘要：Background Low birth weight and prematurity are important risk factors for death and disability, and may be affected by prenatal exposure to household air pollution (HAP). Methods We investigate associations between maternal exposure to carbon monoxide (CO) during pregnancy and birth outcomes (birth weight, birth length, head circumference, gestational age, low birth weight, small for gestational age, and preterm birth) among 1288 live-born infants in the Ghana Randomized Air Pollution and Health Study (GRAPHS). We evaluate whether evidence of malaria during pregnancy, as determined by placental histopathology, modifies these associations. Results We observed effects of CO on birth weight, birth length, and gestational age that were modified by placental malarial status. Among infants from pregnancies without evidence of placental malaria, each 1 ppm increase in CO was associated with reduced birth weight (−53.4 g [95% CI: −84.8, −21.9 g]), birth length (−0.3 cm [−0.6, −0.1 cm]), gestational age (−1.0 days [−1.8, −0.2 days]), and weight-for-age Z score (−0.08 standard deviations [−0.16, −0.01 standard deviations]). These associations were not observed in pregnancies with evidence of placental malaria. Each 1 ppm increase in maternal exposure to CO was associated with elevated odds of low birth weight (LBW, OR 1.14 [0.97, 1.33]) and small for gestational age (SGA, OR 1.14 [0.98, 1.32]) among all infants. Conclusions Even modest reductions in exposure to HAP among pregnant women could yield substantial public health benefits, underscoring a need for interventions to effectively reduce exposure. Adverse associations with HAP were discernible only among those without evidence of placental malaria, a key driver of impaired fetal growth in this malaria-endemic area.
关键词：Household air pollution ; Carbon monoxide ; Birth weight ; Placental malaria ; Particulate matter ; Pregnancy