Adverse birth outcomes associated with household air pollution from unclean cooking fuels in low- and middle-income countries: A systematic review
Open accessAbstract
Approximately 3.8 billion people in low- and middle-income countries use unclean fuels as a source of primary cooking fuel as well as for heating. For pregnant women, the toxic chemicals produced by combustion of unclean fuels not only affect women's health directly, but particulate matter and carbon monoxide are absorbed in maternal blood and cross the placental barrier impairing fetal tissue growth. PRISMA 2009 guidelines were used for this systematic review. The inclusion criteria were quantitative, peer reviewed journal articles published within a date range of May 1, 2013-June 12, 2021 examining birth outcomes related to household air pollution from type of cooking fuel in low- and middle-income countries. The quality of available evidence was evaluated using the Office of Health Assessment and Translation (OHAT) risk of bias rating tool. Of the 553 studies screened, 23 satisfied the inclusion criteria. Of the studies that met the inclusion criteria, 14 were cross-sectional, 5 cohort, 1 case-control and 3 randomized control trials conducted across 15 different countries. A range of birth outcomes are reported across studies including birthweight (19), small for gestational age (6), spontaneous abortion (3), preterm birth (6), stillbirth (7) and neonatal mortality (6). The reviewed studies presented evidence for an increased risk of low birth weight (LBW), preterm birth (PTB), small for gestational age (SGA), stillbirth, neonatal mortality and reduction in birthweight with solid fuel and kerosene use compared to cleaner fuels like gas and LPG. Systematically reviewing the evidence and risk of bias ratings illuminated several gaps in the current literature related to exposure assessment, outcome measurement and adequacy of adjustment for confounding.
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Women who were exposed to household air pollution during pregnancy had a higher risk of still and preterm birth and infants of low birthweight or who were small for gestational age.
“women who were exposed to household air pollution during pregnancy had a higher risk of still and preterm birth and infants of low birthweight or who were small for gestational age (180).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [180]
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- Authors
- Younger, A., Alkon, A., Harknett, K., Jean Louis, R., & Thompson, L. M.
- Affiliations
- University of California, San Francisco (US)
- Emory University (US)
- Corresponding author
- Younger, Ashley
- Venue
- Environmental Research
- Publisher
- Elsevier BV
- Published
- 2022-03
- Volume
- 204
- Issue
- Pt C
- Pages
- 112274
- ISSN
- 0013-9351 (ISSN-L)
- OpenAlex
- W3209418432
- Cited by
- 104
- References
- 57
- Citations by year
- 2026: 19 · 2025: 22 · 2024: 21 · 2023: 24 · 2022: 17 · 2020: 1
- FWCI
- 0.75
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Environmental Research (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Physical Sciences › Environmental Science › Health, Toxicology and Mutagenesis › Air Quality and Health Impacts
- Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Global Maternal and Child Health
- Keywords
- household air pollution, cooking fuel, solid fuels, kerosene, low birth weight, preterm birth, small for gestational age, stillbirth, neonatal mortality, miscarriage, pregnancy, low- and middle-income countries, clean cooking fuels, liquefied petroleum gas, gas stoves, particulate matter, carbon monoxide, placental transfer
- MeSH terms
- Air Pollution, Cooking, Developing Countries, Female, Humans, Infant, Newborn, Placenta, Pregnancy, Pregnancy Complications, Air Pollution, Indoor, Premature Birth
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