Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia
Air pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are current...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-06-01
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| Series: | Environment International |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S0160412022001775 |
| _version_ | 1811338931017351168 |
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| author | Erin Flanagan Anna Oudin John Walles Asmamaw Abera Kristoffer Mattisson Christina Isaxon Ebba Malmqvist |
| author_facet | Erin Flanagan Anna Oudin John Walles Asmamaw Abera Kristoffer Mattisson Christina Isaxon Ebba Malmqvist |
| author_sort | Erin Flanagan |
| collection | DOAJ |
| description | Air pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are currently lacking. This study explores the association between ambient air pollution (NOX and NO2) and indoor air pollution (cooking fuel type) and fetal and neonatal death in Adama, Ethiopia. A prospective cohort of mothers and their babies was used, into which pregnant women were recruited at their first antenatal visit (n = 2085) from November 2015 to February 2018. Previously developed land-use regression models were utilized to assess ambient concentrations of NOX and NO2 at the residential address, whereas data on cooking fuel type was derived from questionnaires. Birth outcome data was obtained from self-reported questionnaire responses during the participant's postnatal visit or by phone if an in-person meeting was not possible. Binary logistic regression was employed to assess associations within the final study population (n = 1616) using both univariate and multivariate models; the latter of which adjusted for age, education, parity, and HIV status. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were reported. Within the cohort, 69 instances of fetal death (n = 16 miscarriages; n = 53 stillbirths) and 16 cases of neonatal death were identified. The findings suggest a tendency towards an association between ambient NOX and NO2 exposure during pregnancy and an increased risk of fetal death overall as well as stillbirth, specifically. However, statistical significance was not observed. Results for indoor air pollution and neonatal death were inconclusive. As limited evidence on the effects of exposure to ambient air pollution on adverse birth outcomes exists in Sub-Saharan Africa and Ethiopia, additional studies with larger study populations should be conducted. |
| first_indexed | 2024-04-13T18:18:04Z |
| format | Article |
| id | doaj.art-72d7af80b56d4d12b7b50bcd53e57e87 |
| institution | Directory Open Access Journal |
| issn | 0160-4120 |
| language | English |
| last_indexed | 2024-04-13T18:18:04Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Environment International |
| spelling | doaj.art-72d7af80b56d4d12b7b50bcd53e57e872022-12-22T02:35:36ZengElsevierEnvironment International0160-41202022-06-01164107251Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, EthiopiaErin Flanagan0Anna Oudin1John Walles2Asmamaw Abera3Kristoffer Mattisson4Christina Isaxon5Ebba Malmqvist6Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, Sweden; Corresponding author.Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, SwedenClinical Infection Medicine, Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, SwedenEthiopia Institute of Water Resources, Addis Ababa University, Addis Ababa, EthiopiaDivision of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, SwedenDivision of Ergonomics and Aerosol Technology, Department of Design Sciences, Faculty of Engineering, LTH, Lund University, Lund, SwedenDivision of Occupational and Environmental Medicine, Department of Laboratory Medicine, Faculty of Medicine, Lund University, Lund, SwedenAir pollution poses a threat to human health, with pregnant women and their developing fetuses being particularly vulnerable. A high dual burden of ambient and indoor air pollution exposure has been identified in Ethiopia, but studies investigating their effects on adverse birth outcomes are currently lacking. This study explores the association between ambient air pollution (NOX and NO2) and indoor air pollution (cooking fuel type) and fetal and neonatal death in Adama, Ethiopia. A prospective cohort of mothers and their babies was used, into which pregnant women were recruited at their first antenatal visit (n = 2085) from November 2015 to February 2018. Previously developed land-use regression models were utilized to assess ambient concentrations of NOX and NO2 at the residential address, whereas data on cooking fuel type was derived from questionnaires. Birth outcome data was obtained from self-reported questionnaire responses during the participant's postnatal visit or by phone if an in-person meeting was not possible. Binary logistic regression was employed to assess associations within the final study population (n = 1616) using both univariate and multivariate models; the latter of which adjusted for age, education, parity, and HIV status. Odds ratios (OR) and their corresponding 95% confidence intervals (CI) were reported. Within the cohort, 69 instances of fetal death (n = 16 miscarriages; n = 53 stillbirths) and 16 cases of neonatal death were identified. The findings suggest a tendency towards an association between ambient NOX and NO2 exposure during pregnancy and an increased risk of fetal death overall as well as stillbirth, specifically. However, statistical significance was not observed. Results for indoor air pollution and neonatal death were inconclusive. As limited evidence on the effects of exposure to ambient air pollution on adverse birth outcomes exists in Sub-Saharan Africa and Ethiopia, additional studies with larger study populations should be conducted.http://www.sciencedirect.com/science/article/pii/S0160412022001775Ambient air pollutionIndoor air pollutionCooking fuelBirth outcomesFetal deathNeonatal death |
| spellingShingle | Erin Flanagan Anna Oudin John Walles Asmamaw Abera Kristoffer Mattisson Christina Isaxon Ebba Malmqvist Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia Environment International Ambient air pollution Indoor air pollution Cooking fuel Birth outcomes Fetal death Neonatal death |
| title | Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia |
| title_full | Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia |
| title_fullStr | Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia |
| title_full_unstemmed | Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia |
| title_short | Ambient and indoor air pollution exposure and adverse birth outcomes in Adama, Ethiopia |
| title_sort | ambient and indoor air pollution exposure and adverse birth outcomes in adama ethiopia |
| topic | Ambient air pollution Indoor air pollution Cooking fuel Birth outcomes Fetal death Neonatal death |
| url | http://www.sciencedirect.com/science/article/pii/S0160412022001775 |
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