Effects of Prenatal Tobacco and Wood-Fuel Smoke Exposure on Birth Weight in Sri Lanka
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethics
2.2. Data Analyis
3. Results
3.1. Characteristics of Participants
3.2. Relationship between Maternal Parameters and Birth Weight
3.3. Exposure Response
3.4. Time Spent Cooking and CO and COHb Measurements
4. Discussion
Limitations
5. Conclusions
Acknowledgments
Author Contributions
Conflicts of Interest
References
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Variable | All (n = 76) | Exposed to Second Hand Tobacco Smoke | Wood Fuel Smoke Exposure | |||
---|---|---|---|---|---|---|
Exposed (n = 73) | Not Exposed a n = 3 | |||||
Yes (n = 26, 34.2%) | No (n = 50, 65.8%) | In a Kitchen with a Chimney (n = 64, 87.7%) | In a Kitchen without a Chimney (n = 9, 12.3%) | |||
Age (years) † | 29.3 ± 5.7 | 27.8 ± 6.4 | 30.0 ± 5.3 | 29.7 ± 5.7 | 26.8 ± 5.3 | 27.3 ± 6.5 |
Pre-pregnancy BMI (kg/m2) † | 22.7 ± 4.3 | 22.3 ± 4.5 | 22.9 ± 4.2 | 22.8 ± 4.3 | 22.7 ± 4.6 | 20.0 ± 2.3 |
Education level, n (%) | ||||||
Up to primary | 9 (12.0%) | 4 (16.0%) | 5 (10.0%) | 8 (12.7%) | 1 (11.1%) | - |
Secondary/higher | 66 (88.0%) | 21 (84.0%) | 45 (90.0%) | 55 (87.3%) | 8 (88.9%) | 3 (100.0%) |
Monthly household income, n (%) | ||||||
Up to 14,000 LKR | 15 (20.0%) | 4 (16.0%) | 11 (22.0%) | 12 (19.0%) | 3 (33.3%) | - |
14,000 to 32,000 LKR | 51 (68.0%) | 18 (72.0%) | 33 (66.0%) | 43 (68.2%) | 6 (66.7%) | 2 (66.7%) |
≥32,000 LKR | 9 (12.0%) | 3 (12.0%) | 6 (12.0%) | 8 (12.7%) | - | 1 (33.3%) |
Residential area, n (%) | ||||||
Urban | 7 (9.3%) | 3 (12.0%) | 4 (8.0%) | 7 (11.1%) | - | - |
Sub-urban | 35(46.7%) | 11 (44.0%) | 24 (48.0%) | 30 (47.6%) | 4 (44.4%) | 1 (33.3%) |
Rural | 33 (44.0%) | 11 (44.0%) | 22 (44.0%) | 26 (41.3%) | 5 (55.6%) | 2 (66.7%) |
Parity, n (%) | ||||||
Primiparous | 23 (30.3%) | 7 (26.9%) | 16 (32.0%) | 15 (23.4%) | 5 (55.6%) | 3 (100.0%) |
Multiparous | 53 (69.7%) | 19 (73.1%) | 34 (68.0%) | 49 (76.6%) | 4 (44.4%) | - |
Previous history of LBW, n (%) | ||||||
Yes | 14 (18.4%) | 6 (23.1%) | 8 (16.0%) | 12 (18.8%) | 2 (22.2%) | - |
No | 62 (81.6%) | 20 (76.9%) | 42 (84.0%) | 52 (81.2%) | 7 (77.8%) | 3 (100.0%) |
History of miscarriage and/or abortion, n (%) | ||||||
Yes | 20 (26.3%) | 6 (23.1%) | 14 (28.0%) | 18 (28.1%) | 2 (22.2%) | - |
No | 56 (73.7%) | 20 (76.9%) | 36 (72.0%) | 46 (71.9%) | 7 (77.8%) | 3 (100.0%) |
Gestational age, weeks b,† | 39.1 ± 1.4 | 38.5 ± 1.8 | 39.2 ± 1.1 | 39.1 ± 1.2 | 38.2 ± 2.4 | 39.0 ± 1.1 |
Birth weight, n (%) | ||||||
<2500 g | 13 (17.1%) | 5 (19.2%) | 8 (16.0%) | 10 (15.6%) | 2 (22.2%) | 1 (33.3%) |
≥2500 g | 63 (82.9%) | 21 (80.8%) | 42 (84.0%) | 54 (84.4%) | 7 (77.8%) | 2 (66.7%) |
Hemoglobin levels at booking visit (g/dL) † (n = 70) | 11.5 ± 1.3 | 11.4 ± 1.3 | 11.5 ± 1.2 | 11.5 ± 1.2 | 10.8 ± 1.8 | 11.6 ± 0.4 |
Anemic at booking visit c, n (%) | 19 (27.1%) | 5 (22.7%) | 14 (29.2%) | 17 (28.3%) | 2 (28.6%) | - |
Non-anemic at booking visit d, n (%) | 51 (72.9%) | 17 (77.3%) | 34 (70.8%) | 43 (71.7%) | 5 (71.4%) | 3 (100.0%) |
Hemoglobin levels at third trimester (g/dL) † (n = 52) | 10.9 ± 1.1 | 10.9 ± 1.1 | 10.9 ± 1.1 | 11.0 ± 1.0 | 10.1 ± 1.4 | No data |
Anemic at third trimester c, n (%) | 25 (48.1%) | 8 (47.1%) | 17 (48.6%) | 20 (44.4%) | 5 (71.4%) | No data |
Non-anemic at third trimester d, n (%) | 27 (51.9%) | 9 (52.9%) | 18 (51.4%) | 25 (55.6%) | 2 (28.6%) | No data |
Term | Coefficient | 95% CI | t-Value | p-Value |
---|---|---|---|---|
Constant | −2239 | −5558–−1080 | −1.35 | 0.183 |
Continuous variables | ||||
Pre-pregnancy BMI | 11.6 | −14.0–−37.2 | 0.91 | 0.368 |
Gestational age at delivery | 107.3 | 28.3–186.4 | 2.71 | 0.009 ** |
Categorical variables | ||||
Area of residence (urban)-reference level | ||||
Area of residence (sub-urban) | −50 | −436–−335 | −0.26 | 0.795 |
Area of residence (rural) | 241 | −145–−627 | 1.25 | 0.217 |
Monthly household income (up to 14,000 LKR)-reference level | ||||
Monthly household income (14,000-32,000 LKR) | 204 | −75–−483 | 1.46 | 0.148 |
Monthly household income (32,000 LKR) | 520 | 115–926 | 2.56 | 0.013 ** |
Previous history of LBW (yes)-reference level | ||||
Previous history of LBW (no) | 311 | 24–597 | 2.17 | 0.034 ** |
Parity (primiparous)-reference level | ||||
Parity (multiparous) | 258 | 6–510 | 2.05 | 0.045 ** |
n | CO Conc. (ppm) | p-Value | COHb (%) | p-Value | Cooking Time (min) | p-Value | GA (Weeks) | p-Value | Birth Weight (g) | p-Value | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Second-hand tobacco smoke exposure | Yes | All a | 26 | 1.885 (0.178) | 0.104 a,h 0.205 b,e 0.099 c,d 0.102 c,f 0.633 d,f | 0.969 (0.049) | 0.445 a,h 0.099 b,e 0.109 c,d 0.109 c,f 0.798 d,f | 108 (14) | 0.054 a,h 0.666 b,e 0.721 c,d 0.721 c,f 0.488 d,f | 38.5 (0.4) | 0.078 a,h 0.045 b,e,** 0.523 c,d 0.523 c,f 0.367 d,f | 2865 (107) | 0.408 a,h 0.046 b,e,** 0.857 c,d 0.028 c,f,** 0.381 d,f | |
Daily | All b | 16 | 2.063 (0.232) | 1.025 (0.073) | 113 (21) | 38.0 (0.5) | 2703 (135) | |||||||
With kitchen chimney c | 13 | 2.231 (0.257) | 1.061 (0.086) | 111(25) | 38.4 (0.4) | 2722 (135) | ||||||||
Without kitchen chimney d | 3 | 1.330 (0.333) | 0.867 (0.067) | 123 (20) | 36.6 (2.3) | 2617 (497) | ||||||||
Once a week | All e | 10 | 1.600 (0.267) | 0.880 (0.041) | 101 (18) | 39.3 (0.3) | 3125 (147) | |||||||
With kitchen chimney f | 9 | 1.556 (0.294) | 0.889 (0.045) | 102 (20) | 39.3 (0.3) | 3194 (145) | ||||||||
Without kitchen chimney g | 1 | 2.000 | 0.800 | 90 | 38.9 | 2500 | ||||||||
No | All h | 50 | 2.340 (0.207) | 1.015 (0.033) | 144 (12) | 39.2 (0.1) | 2972 (71) | |||||||
Wood-fuel smoke exposure | With kitchen chimney | All i | 64 | 2.078 (0.129) | 0.379 i,l 0.476 j,k 0.323 j,l 0.244 j,m 0.111 k,m 0.262 k,n 0.158 m,n | 0.989 (0.026) | 0.614 i,l 0.991 j,k 0.638 j,l 0.086 j,m 0.071 k,m 0.359 k,n 0.190 m,n | 130 (10) | 0.717 i,l 0.104 j,k 0.236 j,l 0.741 j,m 0.235 k,m 0.688 k,n 0.281 m,n | 39.1 (0.2) | 0.301 i,l 0.103 j,k 0.498 j,l 0.434 j,m 0.610 k,m 0.102 k,n 0.409 m,n | 2968 (65) | 0.268 i,l 0.559 j,k 0.426 j,l 0.441 j,m 0.342 k,m 0.554 k,n 0.538 m,n | |
Exposed to second-hand tobacco smoke j | 22 | 1.955 (0.203) | 0.991 (0.057) | 107 (17) | 38.8 (0.3) | 2915 (109) | ||||||||
Not exposed to second-hand tobacco smoke k | 42 | 2.143 (0.165) | 0.988 (0.264) | 142 (13) | 38.2 (0.2) | 2995 (81) | ||||||||
Without kitchen chimney | All l | 9 | 2.899 (0.873) | 1.067 (0.146) | 138 (19) | 38.2 (0.8) | 2739 (184) | |||||||
Exposed to second-hand tobacco smoke m | 4 | 1.500 (0.289) | 0.850 (0.050) | 115 (17) | 37.2 (1.7) | 2588 (353) | ||||||||
Not exposed to second-hand tobacco smoke n | 5 | 4.000 (1.410) | 1.240 (0.242) | 156 (31) | 38.9 (0.3) | 2860 (197) |
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Pathirathna, M.L.; Abeywickrama, H.M.; Sekijima, K.; Sadakata, M.; Fujiwara, N.; Muramatsu, Y.; Wimalasiri, K.M.S.; Jayawardene, U.; De Silva, D.; Dematawewa, C.M.B. Effects of Prenatal Tobacco and Wood-Fuel Smoke Exposure on Birth Weight in Sri Lanka. Healthcare 2017, 5, 64. https://doi.org/10.3390/healthcare5040064
Pathirathna ML, Abeywickrama HM, Sekijima K, Sadakata M, Fujiwara N, Muramatsu Y, Wimalasiri KMS, Jayawardene U, De Silva D, Dematawewa CMB. Effects of Prenatal Tobacco and Wood-Fuel Smoke Exposure on Birth Weight in Sri Lanka. Healthcare. 2017; 5(4):64. https://doi.org/10.3390/healthcare5040064
Chicago/Turabian StylePathirathna, Malshani L., Hansani M. Abeywickrama, Kayoko Sekijima, Mieko Sadakata, Naoshi Fujiwara, Yoshiyuki Muramatsu, Kuruppu M. S. Wimalasiri, Upali Jayawardene, Darshana De Silva, and Chandraratne M. B. Dematawewa. 2017. "Effects of Prenatal Tobacco and Wood-Fuel Smoke Exposure on Birth Weight in Sri Lanka" Healthcare 5, no. 4: 64. https://doi.org/10.3390/healthcare5040064