Air pollution has been recognized as a pressing sustainability concern seeing that it is directly mentioned in two SDG targets: SDG 3.9 (substantial reduction of health impacts from hazardous substances) and SDG 11.6 (reduction of adverse impacts of cities on people) (Rafaj et al., 2018). Air pollution, both ambient and indoor, is known to contribute significantly to the global burden of disease, contributing to a majority of non-communicable disease-related deaths in low to middle-income countries in Africa and Asia (WHO, 2016). In 2018, air pollution was attributed to 28,000 deaths in Ghana (Odonkor and Mahami, 2020).
Air pollution, which comprises ambient air pollution and household air pollution (HAP), is one of the largest environmental risk factors and contributes to about 7 million deaths worldwide. 1 In 2016, HAP resulted in an estimated 3.8 million premature deaths, equivalent to 6.7% of global mortality and is greater than deaths due to malaria, tuberculosis, and HIV/AIDS combined. 2 HAP is predominantly generated from the use of solid fuels, such as wood, coal and charcoal for cooking, heating and lightning. In some settings, burning of garbage is another important source of HAP. 3 Currently, about 41% of households globally rely on solid fuels as their primary cooking fuel
Background
Disorders of pregnancy such as hypertensive disorders of pregnancy (HDP) and gestational diabetes mellitus (GDM) have been associated with adverse birth outcomes. However, to date, no study has explored the ameliorating role of maternal nutrition in the relationship between disorders of pregnancy and adverse birth outcomes. We investigated the relationship between HDP and GDM, and adverse birth outcomes in a Ghanaian population and evaluated the ameliorating role of fruit and vegetable consumption in the relationship.
Methods
We conducted a cross-sectional study among 799 mothers who had recently delivered singletons in the Cape Coast Metropolis, Ghana. Information on HDP and GDM, and birth outcomes were retrieved from the maternal health book of the mothers. A food frequency questionnaire was used to assess fruit and vegetable intake during pregnancy. Multivariable binary logistic regression was used to investigate the association between pregnancy disorders, and preterm birth (PTB) and low birth weight (LBW)
Results
These disorders of pregnancy were associated with increased odds of PTB (AOR = 6.53; 95% CI: 4.33, 9.83) and LBW (AOR = 8.41; 95% CI: 4.16, 17.01). In the stratified analysis, the odds of both PTB and LBW decreased with increasing fruits and vegetables consumption. The interaction p values were 0.0006 and 0.3985 for PTB and LBW, respectively.
Conclusions
We found mother’s experience of GDM and HDP to be associated with PTB and LBW in this Ghanaian population and further provide evidence of the ameliorating role of fruits and vegetables consumption in the observed relationship. Mothers diagnosed of GDM and HDP should be advised during their antenatal visits to increase intake of fruits and vegetable consumption to help safeguard their health and that of the developing foetus.
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