Médecine interne: libre accès
Libre accès

Abstrait

Pregnancy Outcomes Associated with Chronic Indoor Air PollutionRelated Maternal Respiratory III Health in Ndola and Masaiti, Zambia

Mulenga D, Nyirenda HT, Chileshe-Chibangula M, Mwila P and Siziya S

Introduction: Adverse pregnancy outcomes have been associated with impaired lung function and increased respiratory symptoms among women using biomass for cooking/heating houses. We investigated the association between maternal respiratory health and pregnancy outcomes among pregnant women predominantly using biomass for cooking/heating in Masaiti and Ndola, Zambia.
Methods: A cross-sectional study involved collection of information from 1,170 consenting pregnant women using a standard questionnaire and Spirometry conducted simultaneously. Data was analyzed using Stata Version 13 and association between maternal respiratory health and birth outcomes determined after adjusting for potential confounders using multivariate logistic regression analysis.
Results: The mean differences of lung function were statistically significant between mothers of LBW and those of normal weight; FEV₁/FVC (p value 0.023) and FVC (p value 0.0176). The mean differences were statistically significant between mothers of SGA babies and those of normal; FEV₁/FVC (p value < 0.0001) and FEV₁ (p value 0.0134). There was a statistically significant association between FEV₁/FVC and preterm in the urban (p value<0.0001) and small for gestational age (p value<0.0001) in the rural area for all the three trimesters. In the urban area, LBW was statistically associated with recurrent nasal symptoms OR [1.69 (95% C.I; 1.0-2.8)] and prolonged secretion of phlegm OR [0.58 (95% C.I; 0.3-1.0)]. In the multivariate analysis, there was a significant association between FVC and LBW in the rural area OR [0.09 (99% C.I; 0.0-0.4)]. Preterm delivery was statistically significantly associated with FVC OR [0.39 (99% C.I; 0.2-0.8)] in the entire study population.
Conclusion: Our results demonstrated substantial increased risk of several adverse pregnancy outcomes for pregnant women with poor respiratory health. These findings suggest the need for cleaner fuels for cooking and better ventilated cooking environment for the poor women who are the main victims in this health hazard. The respiratory health of pregnant women needs to be constantly monitored using Spirometry.