Exposure to Household Air Pollution Is Associated With Stillbirth and Child Mortality but Not Low Birth Weight in Ghana
Abstract
Household air pollution (HAP) has been hypothesized to increase premature deaths and poor health outcomes. Yet, fewer studies have examined the mechanism through which this happens particularly with pregnancy and birth outcomes in sub-Saharan Africa.Therefore, this study examined the association between exposure to household air pollution and stillbirth, child mortality, and low birth weight in Ghana.
Data were drawn from the 2017 Ghana Maternal Health survey, a nationally representative survey that collected information on pregnancy outcomes, livebirths, miscarriages, cooking fuel used, and sociodemographic factors. Following descriptive and bivariate analysis, we used generalized linear models in a binomial distribution with a negative log-log link function to examine the association between exposure to HAP and lifetime stillbirths, child mortality, and low birthweight. We adjusted for pregnancy history and sociodemographic factors.
In the bivariate models, exposure to HAP was associated with low birth weight (OR=1.10, p=0.04; for use of biomass), lifetime stillbirth (OR=1.08, p=0.03; for use of mix fuels; OR=1.13, p=0.000; use of biomass), and child mortality (OR=1.09, p=0.03; for use of mix fuel; OR=1.15, p=0.000; use of biomass). In the multivariable model, exposure to HAP was significantly associated with stillbirth (AOR=1.17, 95%CI: 1.02, 1.34; via use of biomass) and child mortality (AOR=1.10, 95%CI: 1.02, 1.20; via the use of mix fuel), but not low birthweight. Other significant factors that mediated these relationships included parity, gravidity and age.
These data show that exposure to household air pollution either by the use of mix fuel or biomass has deleterious consequences for pregnancy and birth outcomes.
