Recorded presentation

Vinod Mishra, PhD, MPH¹, Robert D. Retherford, PhD¹, and Kirk R. Smith, PhD, MPH². (1) Population and Health Studies, East-West Center, 1601 East-West Road, Honolulu, HI 96848, 808-944-7403, retherfr@ewc.hawaii.edu, (2) School of Public Health, Environmental Health Sciences, University of California, Berkeley, 140 Warren Hall, Berkeley, CA 94720

Numerous studies have linked tobacco smoke (both active smoking by mother and environmental tobacco smoke) and ambient air pollution to adverse pregnancy outcomes. Although smoke from biomass combustion for cooking and heating produces some of the same pollutants found in tobacco smoke and ambient air, only one study to date has linked cooking with biomass fuels during pregnancy to stillbirths, and only two recent studies, one in Zimbabwe and another in rural Guatemala, have linked it to reduced birth weight. The primary mechanisms are believed to be through exposure to CO and particulates in biomass smoke. To examine the relationship further, we designed a study using data on 19,189 ever-married women age 40-49 included in India’s 1998-99 National Family Health Survey. We estimate effects of cooking smoke, measured by type of cooking fuel, and tobacco smoke (both active and passive) on the likelihood of having a stillbirth, using binary and multinomial logit regression after controlling for several potentially confounding factors. Results indicate that, with other factors controlled, women who cook with wood, dung, or crop residues are significantly more likely to have experienced a stillbirth than those who cook with LPG, biogas, or electricity (OR=1.44; 95%CI: 1.04, 1.97). Results also indicate that women who cook with biomass fuels are twice as likely to have experienced two or more stillbirths as those who cook with cleaner fuels (OR=2.01; 95%CI: 1.11, 3.62). The effect of active tobacco smoking on the risk of stillbirth is also positive (OR=1.23) but not statistically significant.

Learning Objectives: At the conclusion of this session, the participants will be able to

• recognize indoor air pollution from cooking with unprocessed biomass fuels as a risk factor for adverse pregnancy outcomes;
• articulate the mechanisms by which cooking smoke can cause stillbirths and other adverse pregnancy outcomes.

Keywords: Air Pollutants, Perinatal Outcomes

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: East-West Center, National Institute of Child Health and Human Development (NICHD)
I have a significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.
Relationship: NICHD Grant (# 1 R03 HD043929-01)

Recorded presentation