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

Abusalah, Akram; Gavana, Magda; Haidich, Anna‐Bettina; Smyrnakis, Emmanouil; Papadakis, N.; Papanikolaou, Athanasios; Benos, Alexis

doi:10.1007/s10995-011-0851-4

Cited by 47 publications

(41 citation statements)

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“…In many countries, pregnant mothers are exposed to wood fuel smoke. The carbon monoxide depresses placental energy-dependent processes and amino-acid transport and exhibits a reduction of infants’ adjusted mean BW by −186 g (110). Variation in genes encoding enzymes modify the associations between maternal smoking and BW, but the contribution of epigenetic mechanisms, rather than genetic, underlie the long-term effects of smoke exposure as shown in aberrant placental metabolism, syncytial knot formation, or markers of placental oxidative damage (111).…”

Section: Resultsmentioning

confidence: 99%

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

2017

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Physiologic adaptations during pregnancy unmask a woman’s predisposition to diseases. Complications are increasingly predicted by first-trimester algorithms, amplify a pre-existing maternal phenotype and accelerate risks for chronic diseases in the offspring up to adulthood (Barker hypothesis). Recent evidence suggests that vice versa, pregnancy diseases also indicate maternal and even grandparent’s risks for chronic diseases (reverse Barker hypothesis). Pub-Med and Embase were reviewed for Mesh terms “fetal programming” and “pregnancy complications combined with maternal disease” until January 2017. Studies linking pregnancy complications to future cardiovascular, metabolic, and thrombotic risks for mother and offspring were reviewed. Women with a history of miscarriage, fetal growth restriction, preeclampsia, preterm delivery, obesity, excessive gestational weight gain, gestational diabetes, subfertility, and thrombophilia more frequently demonstrate with echocardiographic abnormalities, higher fasting insulin, deviating lipids or clotting factors and show defective endothelial function. Thrombophilia hints to thrombotic risks in later life. Pregnancy abnormalities correlate with future cardiovascular and metabolic complications and earlier mortality. Conversely, women with a normal pregnancy have lower rates of subsequent diseases than the general female population creating the term: “Pregnancy as a window for future health.” Although the placenta works as a gatekeeper, many pregnancy complications may lead to sickness and earlier death in later life when the child becomes an adult. The epigenetic mechanisms and the mismatch between pre- and postnatal life have created the term “fetal origin of adult disease.” Up to now, the impact of cardiovascular, metabolic, or thrombotic risk profiles has been investigated separately for mother and child. In this manuscript, we strive to illustrate the consequences for both, fetus and mother within a cohesive perspective and thus try to demonstrate the complex interrelationship of genetics and epigenetics for long-term health of societies and future generations. Maternal–fetal medicine specialists should have a key role in the prevention of non-communicable diseases by implementing a framework for patient consultation and interdisciplinary networks. Health-care providers and policy makers should increasingly invest in a stratified primary prevention and follow-up to reduce the increasing number of manifest cardiovascular and metabolic diseases and to prevent waste of health-care resources.

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Section: Resultsmentioning

confidence: 99%

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

2017

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“…Seven studies, including one RCT (analyzed per protocol) [52] and six observational studies [53-58] reported on the risk of low birth weight (<2500 gm at term), Additional File 3, Table 2. Two studies provided separate, independent estimates for pre-term IUGR and term LBW [54,57].…”

Section: Resultsmentioning

confidence: 99%

Control of household air pollution for child survival: estimates for intervention impacts

et al. 2013

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Background Exposure to household air pollution (HAP) from cooking with solid fuels affects 2.8 billion people in developing countries, including children and pregnant women. The aim of this review is to propose intervention estimates for child survival outcomes linked to HAP. Methods Systematic reviews with meta-analysis were conducted for ages 0-59 months, for child pneumonia, adverse pregnancy outcomes, stunting and all-cause mortality. Evidence for each outcome was assessed against Bradford-Hill viewpoints, and GRADE used for certainty about intervention effect size for which all odds ratios (OR) are presented as protective effects. Results Reviews found evidence linking HAP exposure with child ALRI, low birth weight (LBW), stillbirth, preterm birth, stunting and all-cause mortality. Most studies were observational and rated low/very low in GRADE despite strong causal evidence for some outcomes; only one randomised trial was eligible.Intervention effect (OR) estimates of 0.64 (95% CI: 0.55, 0.75) for ALRI, 0.71 (0.65, 0.79) for LBW and 0.66 (0.54, 0.81) for stillbirth are proposed, specific outcomes for which causal evidence was sufficient. Exposure-response evidence suggests this is a conservative estimate for ALRI risk reduction expected with sustained, low exposure. Statistically significant protective ORs were also found for stunting [OR=0.79 (0.70, 0.89)], and in one study of pre-term birth [OR=0.70 (0.54, 0.90)], indicating these outcomes would also likely be reduced. Five studies of all-cause mortality had an OR of 0.79 (0.70, 0.89), but heterogenity precludes a reliable estimate for mortality impact. Although interventions including clean fuels and improved solid fuel stoves are available and can deliver low exposure levels, significant challenges remain in achieving sustained use at scale among low-income households. Conclusions Reducing exposure to HAP could substantially reduce the risk of several child survival outcomes, including fatal pneumonia, and the proposed effects could be achieved by interventions delivering low exposures. Larger impacts are anticipated if WHO air quality guidelines are met. To achieve these benefits, clean fuels should be adopted where possible, and for other households the most effective solid fuel stoves promoted. To strengthen evidence, new studies with thorough exposure assessment are required, along with evaluation of the longer-term acceptance and impacts of interventions.

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“…Pour évaluer l'impact du tabagisme passif sur la qualité de l'air, les particules respirables en suspension (PM 2,5 ) émises pendant la consommation de cigarettes et de pipes à eau ont été mesurées à l'intérieur et à l'extérieur de 18 lieux publics fumeurs et 5 lieux publics non-fumeurs de la ville de Gaza. Le taux de PM 2,5 moyen à l'intérieur des lieux fumeurs était de 117 µg/m 3 , un taux plus de quatre fois supérieur aux recommandations de l'Organisation mondiale de la Santé pour l'exposition quotidienne aux particules fines (25 µg/m 3 ).…”

Section: Tabagisme Passif Et Qualité De L'air Intérieur Dans Des Lieuunclassified

“…Particulate levels were also measured for 5 minutes outside each venue (immediately before indoor measurements) to account for ambient PM 2. 5 .…”

Section: Data Collectionmentioning

confidence: 99%

“…It has been estimated that SHS exposure contributed to the deaths (lower respiratory infections, asthma and otitis media) of some 32 000 children in the EMR in 2004 [4]. Furthermore, studies conducted in Gaza have found associations between low birth weight and infant mortality and SHS exposure [5,6]. A previous survey revealed that the prevalence of smoking in Palestine was higher among male than female adults (40.7% versus 3.2%), which is consistent with other countries in the Region [7].…”

Section: Introductionmentioning

confidence: 99%

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Second-hand smoke and indoor air quality in public places in Gaza city

Abuelaish

et al. 2013

East Mediterr Health J

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Second-hand smoke is a major cause of preventable disease and death in the Eastern Mediterranean Region. To assess how second-hand smoke impacts air quality, respirable suspended particles (PM 2.5 ), which are emitted during cigarette and waterpipe smoking, were measured inside and outside of 18 smoking and 5 nonsmoking public venues in Gaza city. Median PM 2.5 level inside the smoking venues was 117 µg/m 3 , which exceeds the WHO guidelines for daily PM 2.5 exposure (25 µg/m 3 ) by more than 4-fold. The median level inside the smoking venues (117 µg/m 3 ) was significantly higher than outside the venues (43 µg/m 3 ), and significantly higher than the median level inside non-smoking venues (40 µg/m 3 ). By contrast, particulate levels outside non-smoking venues (35 µg/m 3 ) did not differ from the corresponding levels inside (40 µg/m 3 ). To protect employees and the public from second-hand smoke exposure, policies prohibiting smoking in public places are needed in Gaza city. Tabagisme passif et qualité de l'air intérieur dans des lieux publics de la ville de GazaRÉSUMÉ Le tabagisme passif est une cause majeure de morbi-mortalité évitable dans la Région de la Méditerranée orientale. Pour évaluer l'impact du tabagisme passif sur la qualité de l'air, les particules respirables en suspension (PM 2,5 ) émises pendant la consommation de cigarettes et de pipes à eau ont été mesurées à l'intérieur et à l'extérieur de 18 lieux publics fumeurs et 5 lieux publics non-fumeurs de la ville de Gaza. Le taux de PM 2,5 moyen à l'intérieur des lieux fumeurs était de 117 µg/m 3 , un taux plus de quatre fois supérieur aux recommandations de l'Organisation mondiale de la Santé pour l'exposition quotidienne aux particules fines (25 µg/m 3 ). Le taux intérieur médian des lieux fumeurs (117 µg/m 3 ) était nettement supérieur au taux extérieur (43 µg/m 3 ) et significativement supérieur au taux intérieur médian des lieux non-fumeurs (40 µg/m 3 ). En revanche, les taux de particules à l'extérieur des lieux non-fumeurs (35 µg/m 3 ) et à l'intérieur de ces mêmes lieux (40 µg/m 3 ) étaient similaires. Afin de protéger les employés et le public de l'exposition au tabagisme passif, des politiques interdisant le tabagisme dans les lieux publics sont nécessaires dans la ville de Gaza.

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

Cited by 47 publications

References 24 publications

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

Pregnancy: An Underutilized Window of Opportunity to Improve Long-term Maternal and Infant Health—An Appeal for Continuous Family Care and Interdisciplinary Communication

Control of household air pollution for child survival: estimates for intervention impacts

Second-hand smoke and indoor air quality in public places in Gaza city

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