Indoor air pollution from solid fuels and risk of low birth weight and stillbirth
Report from a symposium held at the Annual Conference of the International Society for Environmental Epidemiology (ISEE), September 2005, Johannesburg
Around half of the world's population still relies on solid fuels, which are typically used indoors, leading to very high levels of exposure to smoke. Most heavily exposed are women of child-bearing age and young children. Women usually continue with their domestic and cooking role throughout pregnancy, so the developing foetus is also indirectly exposed. This report summarizes the evidence linking such exposure to low birth weight (LBW) and stillbirth, as reviewed in a symposium held at ISEE 2005 in Johannesburg. Five studies on low birth weight summarized in this report found a lower birth weight in children of mothers with higher exposure. Three studies on pregnancy outcomes found a higher odds ratio for stillbirths.
In summary, this review reports consistent impacts of solid fuel smoke exposure on both LBW and stillbirth. Since high proportions of pregnant women are exposed to solid fuel smoke in developing countries, and the prevalence of both LBW and stillbirth is high, the population attributable risk associated with this exposure is likely to be substantial. The ISEE symposium concluded that a modest number of additional, high quality studies of adverse pregnancy outcomes are required, paying particular attention to assessment of exposure and gestational age.