BACKGROUND Accruing epidemiological evidence suggests that prenatal exposure to emissions from cooking fuel is associated with increased risks of adverse maternal and perinatal outcomes including hypertensive disorders of pregnancy, low birth weight, stillbirth and infant mortality. We aimed to investigate the relationship between cooking fuel use and various pregnancy related outcomes in a cohort of urban women from the Accra region of Ghana. METHODS Self-reported cooking fuel use was divided into "polluting" (wood, charcoal, crop residue and kerosene) and "clean" fuels (liquid petroleum gas and electricity) to examine 12 obstetric outcomes in a prospective cohort of pregnant women (N = 1010) recruited at < 17 weeks of gestation from Accra, Ghana. Logistic and multivariate linear regression analyses adjusted for BMI, maternal age, maternal education and socio-economic status asset index was conducted. RESULTS 34% (n = 279) of 819 women with outcome data available for analysis used polluting fuel as their main cooking fuel. Using polluting cooking fuels was associated with perinatal mortality (aOR: 7.6, 95%CI: 1.67-36.0) and an adverse Apgar score (< 7) at 5 min (aOR:3.83, 95%CI: (1.44-10.11). The other outcomes (miscarriage, post-partum hemorrhage, pre-term birth, low birthweight, caesarian section, hypertensive disorders of pregnancy, small for gestational age, and Apgar score at 1 min) had non-statistically significant findings. CONCLUSIONS We report an increased likelihood of perinatal mortality, and adverse 5-min Apgar scores in association with polluting fuel use. Further research including details on extent of household fuel use exposure is recommended to better quantify the consequences of household fuel use. STUDY REGISTRATION Ghana Service Ethical Review Committee (GHS-ERC #: 07-9-11).

中文翻译：

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加纳队列研究中的家庭燃料使用和不良妊娠结局。

背景技术越来越多的流行病学证据表明，产前暴露于烹饪燃料的排放与孕妇和围产期不良后果的风险增加相关，包括妊娠高血压疾病，低出生体重，死产和婴儿死亡率。我们旨在调查来自加纳阿克拉地区的一批城市妇女的烹饪燃料使用与各种妊娠相关结局之间的关系。方法将自我报告的烹饪燃料的使用分为“污染”（木材，木炭，农作物残渣和煤油）和“清洁”燃料（液化石油气和电力），以检查预期孕妇的12种产科结局（N = （1010）妊娠小于17周从加纳的阿克拉招募。针对BMI进行了逻辑和多元线性回归分析的调整，进行了孕产妇年龄，孕产妇教育和社会经济地位资产指数的调查。结果819名妇女中有34％（n = 279）具有可用于分析的结果数据，使用污染燃料作为其主要烹饪燃料。使用污染性烹饪燃料与围产期死亡率（aOR：7.6，​​95％CI：1.67-36.0）和不良的Apgar评分（5）在5分钟时（aOR：3.83，95％CI：（1.44-10.11）相关。其他结局（流产，产后出血，早产，低出生体重，剖腹产，妊娠高血压疾病，小胎龄和1分钟的Apgar评分）均无统计学意义。围产期死亡的可能性以及与污染的燃料使用相关的不良5分钟Apgar评分。建议进一步研究，包括有关家庭使用燃料的程度，以更好地量化家庭使用燃料的后果。研究注册加纳服务伦理审查委员会（GHS-ERC＃：07-9-11）。