Skip to main content

Advertisement

SpringerLink
Log in

Low Birth Weight and Prenatal Exposure to Indoor Pollution from Tobacco Smoke and Wood Fuel Smoke: A Matched Case–Control Study in Gaza Strip

  • Published:
Maternal and Child Health Journal Aims and scope Submit manuscript

Abstract

Maternal exposure to environmental tobacco smoke (ETS) is a major health hazard as it contains lower doses of the toxins that smokers’ inhale. Prenatal exposure to wood fuel smoke has been linked to delivering low birth weight (LBW) infants. The study aims to assess the association between prenatal exposure to ETS and wood fuel smoke and LBW. A case–control study in ratio 1:1 was conducted in two hospitals with obstetric services in Gaza Strip. Subjects were selected during May–June and July–August 2007 from attenders of Mbarak Hospital and Shifa Medical Centre, respectively. 184 (41.2%), and 79 (17.7%) out of 446 participants were exposed to environmental tobacco smoke and wood fuel smoke, respectively. Adjusted maternal exposure to ETS (especially the number of cigarettes smoked, water pipe and wood fuel smoke) was associated with LBW infants. Cigarette smoke exhibits an independent dose–response risk of LBW after adjusting for confounders. Prenatal exposure to cigarette smoke indoors is related to a reduction in birth weight of infants of −237 g (95% CI: −415, −58) for pregnant women exposed to 1–20 cigarettes per day and −391 g (95% CI: −642, −140) for exposure to more than 20 cigarettes per day. Exposure to wood fuel smoke exhibits a reduction of infants’ adjusted mean birth weight by −186 g (95% CI: −354, −19). Prenatal exposure to passive smoking and wood fuel smoke are independently associated with LBW. Both these factors are modifiable exposures that could possibly lead to a reduction of delivering LBW infants.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1

Similar content being viewed by others

Abbreviations

LBW:

Low birth weight

NBW:

Normal birth weight

ETS:

Environmental tobacco smoke

SHTS:

Second-hand tobacco smoke

WPS:

Water pipe smoke

CI:

Confidence interval

mOR:

Matched odds ratio

BMI:

Body mass index

References

  1. United Nations Children’s Fund and World Health Organization. (2004). Low birth weight: country, regional and global estimates. New York: UNICEF. Available at URL: http://www.unicef.org/publications/index_24840.html. Accessed 05 Jan 2009.

  2. ACC/SCN. (2000). Low birth weight: Report of a meeting in Dhaka, Bangladesh on 14–17 June 1999. In J. Pojda & L. Kelley (Eds.), Nutrition Policy Paper No 18. ACC/SCN in collaboration with ICDDR. Geneva.

  3. World Health Organization. (2007). Indoor air pollution from solid fuels and risk of low birth weight and stillbirth. Report from a symposium held at ISEE Annual Conference, September 2005, Johannesburg, South Africa, WHO.

  4. Kramer, M. S., Seguin, L., Lydon, J., et al. (2000). Socio-economic disparities in pregnancy outcome: Why do the poor fare so poorly? Paediatric and Perinatal Epidemiology, 14, 194–210.

    Article  PubMed  CAS  Google Scholar 

  5. Hofhuis, W., de Jongste, J. C., & Merkus, P. J. (2003). Adverse health effects of prenatal and postnatal tobacco smoke exposure on children. Archives of Disease in Childhood, 88, 1086–1090.

    Article  PubMed  CAS  Google Scholar 

  6. Chan, A., Keane, R. J., & Robinson, J. S. (2001). The contribution of maternal smoking to preterm birth, small for gestational age and low birth weight among Aboriginal and non-Aboriginal births in South Australia. Medical Journal of Australia, 174, 389–393.

    PubMed  CAS  Google Scholar 

  7. Salmasi, G., Grady, R., Jones, J., et al. (2010). Environmental tobacco smoke exposure and perinatal outcomes: A systematic review and meta-analyses. Acta Obstetricia et Gynecologica Scandinavica, 89, 423–441.

    Article  PubMed  Google Scholar 

  8. Tobacco Advisory Group of the Royal College of Physicians. (2005). Passive smoking: What it is and why it is harmful. In: Going smoke-free: The case for clean air in the home, at work and in public places. Royal College of Physicians of London. London, pp. 6–9.

  9. Ward, C., Lewis, S., & Coleman, T. (2007). Prevalence of maternal smoking and environmental tobacco smoke exposure during pregnancy and impact on birth weight: Retrospective study using millennium Cohort. BMC Public Health, 7, 81.

    Article  PubMed  Google Scholar 

  10. Fielding, J. E., & Phenow, K. J. (1988). Health effects of involuntary smoking. The New England Journal of Medicine, 319, 1452–1460.

    Article  PubMed  CAS  Google Scholar 

  11. Sastry, B. V. (1991). Placental toxicology: Tobacco smoke, abused drugs, multiple chemical interactions, and placental function. Reproduction, Fertility, and Development, 3(4), 355–372.

    Article  PubMed  CAS  Google Scholar 

  12. Von Kries, R., Toschke, A., Koletzko, B., et al. (2002). Maternal smoking during pregnancy and childhood obesity. American Journal of Epidemiology, 156, 954–961.

    Article  Google Scholar 

  13. Chiolero, A., Bovet, P., & Paccaud, F. (2005). Association between maternal smoking and low birth weight in Switzerland: The EDEN study. Swiss Medicine Weekly, 135, 525–530.

    Google Scholar 

  14. Windham, G. C., Hopkins, B., Fenster, L., et al. (2000). Prenatal active or passive tobacco smoke exposure and the risk of preterm delivery or low birth weight. Epidemiology, 11, 427–433.

    Article  PubMed  CAS  Google Scholar 

  15. US Department of Health and Human Services. (2004). Chapter 5. Reproductive effects. In The health consequences of smoking: A report of the surgeon general. US Department of Health and Human Services, Centers for Disease Control and Prevention, National Center for Chronic Disease Prevention and Health Promotion, Office on Smoking and Health. Atlanta, GA, 5770-600. Available at URL: http://www.cdc.gov/tobacco/data_statistics/sgr/sgr_2004/index.html. Accessed Mar 2009.

  16. Montgomery, S., & Ekbom, A. (2002). Smoking during pregnancy and diabetes mellitus in a British longitudinal birth cohort. BMJ, 324, 26–27.

    Article  PubMed  Google Scholar 

  17. Goel, P., Radotra, A., Singh, I., et al. (2004). Effects of passive smoking on outcome in pregnancy. Journal of Postgraduate Medicine, 50, 12–16.

    PubMed  CAS  Google Scholar 

  18. Chaouachi, K. (2009). Hookah (Shisha, Narghile) smoking and environmental tobacco smoke (ETS). A critical review of the relevant literature and the public health consequences. International Journal of Environmental Research and Public Health, 6, 798–843.

    Article  PubMed  Google Scholar 

  19. Nuwayhid, I. A., Yamout, B., Azar, G., et al. (1998). Narghile (hubble-bubble) smoking, low birth weight, and other pregnancy outcomes. American Journal of Epidemiology, 148, 375–383.

    Article  PubMed  CAS  Google Scholar 

  20. Li, N., Sioutas, C., Cho, A., et al. (2003). Ultrafine particulate pollutants induce oxidative stress and mitochondrial damage. Environmental Health Perspectives, 111, 455–460.

    Article  PubMed  CAS  Google Scholar 

  21. Pope, D. P., Mishra, V., Thompson, L., et al. (2010). Risk of low birth weight and stillbirth associated with indoor air pollution from solid fuel use in developing countries. Epidemiologic Reviews, 32, 70–81.

    Article  PubMed  Google Scholar 

  22. Tielsch, J. M., Katz, J., Thulasiraj, R. D., et al. (2009). Exposure to indoor biomass fuel and tobacco smoke and risk of adverse reproductive outcomes, mortality, respiratory morbidity and growth among newborn infants in south India. International Journal of Epidemiology, 38, 1351–1363.

    Article  PubMed  Google Scholar 

  23. Siddiqui, A. R., Gold, E. B., Yang, X., et al. (2008). Prenatal exposure to wood fuel smoke and low birth weight. Environmental Health Perspectives, 116(4), 543–549.

    Article  PubMed  Google Scholar 

  24. SPSS 16.0 for Windows. (2005). S. Wacker drive. Chicago, IL: SPSS Inc.

  25. Kleinbaum, D. G. (1994). Chapter 8. Analysis of matched data using logistic regression. In D. G. Kleinbaum (Ed.), Logistic regression: A self-learning text (pp. 227–252). New York: Springer.

    Google Scholar 

  26. Parodi, S., & Bottarelli, E. (2005). Controlling for confounding in case-control studies. Ann Fac Medic Vet di Parma, 25, 19–46.

    Google Scholar 

  27. Hosmer, D. W., & Lemeshow, S. (1989). Applied logistic regression. Model-building strategies. Series QA278 2.H67. USA: Wiley.

    Google Scholar 

  28. Peduzzi, P., Concato, J., Kemper, E., et al. (1996). A simulation study of the number of events per variable in logistic regression analysis. Journal of Clinical Epidemiology, 49, 1373–1379.

    Article  PubMed  CAS  Google Scholar 

  29. Palestinian National Authority (PNA). (1998). Palestinian women status in Gaza. Palestine: Women Health Development Health Directorate, MOH.

    Google Scholar 

  30. Bloch, M., Tong, V. T., Novotny, T. E., et al. (2010). Tobacco use and secondhand smoke exposure among pregnant women in low- and middle-income countries: A call to action. Acta Obstetricia et Gynecologica Scandinavica, 89, 418–422.

    Article  PubMed  Google Scholar 

  31. Mirahmadizadeh, A., & Nakhaee, N. (2008). Prevalence of water pipe smoking among rural pregnant women in southern Iran. Medical Principles and Practice, 17, 435–439.

    Article  PubMed  Google Scholar 

  32. Kadir, M. M., McClure, E. M., Goudar, S. S., et al. (2010). Exposure of pregnant women to indoor air pollution: A study from nine low and middle income countries. Acta Obstetricia et Gynecologica Scandinavica, 89, 540–548.

    Article  PubMed  CAS  Google Scholar 

  33. Torres-Arreola, L. P., Constantino-Casas, P., Flores-Hernandez, S., Villa-Barragan, J. P., & Rendon-Macias, E. (2005). Socioeconomic factors and low birth weight in Mexico. BMC Public Health, 5, 20.

    Article  PubMed  Google Scholar 

  34. Mavalankar, D. V., Gray, R. H., & Trivedi, C. R. (1992). Risk factors for preterm and term low birth weight in Ahmedabad, India. International Journal of Epidemiology, 21, 263–272.

    Article  PubMed  CAS  Google Scholar 

  35. Wipfli, H., Avila-Tang, E., Navas-Acien, A., et al. (2008). Secondhand smoke exposure among women and children: Evidence from 31 Countries. American Journal of Public Health, 98, 672–679.

    Article  PubMed  Google Scholar 

  36. Coutinho, P. R., Cecatti, J. G., Surita, F.G., etal. (2011). Perinatal outcomes associated with low birth weight in a historical cohort. Reproductive Health, 8(1):18 (Epub ahead of print).

    Google Scholar 

  37. Ministry of Health-PHIC (MOH-PHIC). (2006). The status of health in Palestine. Annual report 2005. MOH. Palestine.

Download references

Acknowledgments

Authors would like to gratefully acknowledge all medical personnel in the participating hospitals, particularly staff nurses. This work was not funded but was implemented as part of a PhD dissertation in Hygiene and Social Medicine, in the Aristotle University of Thessaloniki.

Conflict of interest

The authors declare that they have no competing interest.

Author information

Authors and Affiliations

  1. Department of Hygiene and Social Medicine, Medical School, Aristotle University of Thessaloniki, PO box: 1689, 54006, Thessaloniki, Greece

    Akram Abusalah, Magda Gavana, Anna-Bettina Haidich, Emmanouil Smyrnakis, Nikos Papadakis & Alexis Benos

  2. 1st Gynaecology and Obstetrics Department, Medical School, Aristotle University of Thessaloniki, Thessaloniki, Greece

    Alexis Papanikolaou

Authors
  1. Akram Abusalah
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Magda Gavana
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Anna-Bettina Haidich
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Emmanouil Smyrnakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Nikos Papadakis
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Alexis Papanikolaou
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Alexis Benos
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Magda Gavana.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Abusalah, A., Gavana, M., Haidich, AB. et al. Low Birth Weight and Prenatal Exposure to Indoor Pollution from Tobacco Smoke and Wood Fuel Smoke: A Matched Case–Control Study in Gaza Strip. Matern Child Health J 16, 1718–1727 (2012). https://doi.org/10.1007/s10995-011-0851-4

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10995-011-0851-4

Keywords

Search

Navigation