Background: Smoke from the burning of biomass fuels has been linked with adverse pregnancy outcomes such as low birth weight, stillbirth, and prematurity.
Objective: To identify potential underlying mechanisms of adverse perinatal outcomes, we explored the association of placental pathology with household air pollution in pregnant women from urban/periurban Tanzania who cook predominantly with charcoal.
Methods: Between 2011 and 2013, we measured personal exposures to fine particulate matter (PM2.5) and carbon monoxide (CO) over 72 hr among a cohort of Tanzanian pregnant women. Placentas were collected after delivery for examination. Placental pathologies of inflammatory, hypoxic, ischemic/hypertensive, infectious and thrombotic etiologies were diagnosed, blinded to exposure levels. Using multiple logistic regression, we explored the association of PM2.5 and CO exposure with placental pathology.
Results: One hundred sixteen women had personal air exposure measurements and placental histopathology available for analysis. PM2.5 and CO exposures were moderate [geometric means (GSD) were 40.5 μg/m3 (17.3) and 2.21 ppm (1.47) respectively]; 88.6% of PM2.5 measurements exceeded World Health Organization air quality guidelines. We observed an increase in the odds (per 1-unit increase in exposure on the ln-scale) of fetal thrombotic vasculopathy (FTV) both with increasing PM2.5 [adjusted odds ratio (aOR) = 5.5; 95% CI: 1.1, 26.8] and CO measurements (aOR = 2.5; 95% CI: 1.0, 6.4) in adjusted models only. FTV also was more common among pregnancies complicated by stillbirth or low birth weight.
Conclusions: Fetal thrombosis may contribute to the adverse outcomes associated with household air pollution from cook stoves during pregnancy. Larger studies are necessary for confirmation.
1Department of Obstetrics/Gynecology, Massachusetts General Hospital, Boston, Massachusetts, USA; 2Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; 3Harvard Medical School, Boston, Massachusetts, USA; 4African Academy for Public Health, Dar es Salaam, Tanzania; 5Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania; 6Department of Global Health and Population, 7Department of Biostatistics, and 8Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA; 9MRC-PHE Centre for Environment and Health, School of Public Health, Imperial College London, London, United Kingdom; 10Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts, USA
Recommended Citation:
Blair J. Wylie,1,2,et al. Placental Pathology Associated with Household Air Pollution in a Cohort of Pregnant Women from Dar es Salaam, Tanzania[J]. Environmental Health Perspectives,2017-01-01,Volume 125(Issue 1):134