Household cooking fuel use and risk of adverse birth outcomes: a prospective follow-up study in eastern Ethiopia.

Evidence indicates that pregnant women's exposure to polluted air adversely affects the growing fetus leading to adverse birth outcomes including preterm birth, low birth weight, and stillbirth. There is a lack of evidence on the effects of air pollution and adverse birth outcomes in Ethiopia. This study examined the relationship between cooking fuel use and adverse pregnancy-related outcomes. The paper used data from pregnancy surveillance in Child Health and Mortality Prevention Surveillance in eastern Ethiopia form July 2021 to June 2023. A total of 15,778 women whose pregnancy outcomes were known were included in this analysis. Data were collected using Research Data Capture (Redcap) and analyzed using STATA 17. Self-reported fuel use for cooking was classified as "clean" (petroleum, biogas, and electricity) and "polluting (firewood, charcoal, crop residue, sawdust, and straw/shrubs/grass). A modified Poisson regression model was used to examine the association between adverse birth outcomes (preterm birth, stillbirth, low birth weight) and cooking fuel use. Women using polluting cooking fuel had higher rates of stillbirth (3.1%), preterm delivery (6.1%), and low birth weight (10.5%) compared to those using clean fuel (1.9%, 2.8%, and 8.3%, respectively). Utilization of polluting fuel had a significant effect on the occurrence of preterm birth Adjusted risk ratio (ARR): 2.16, 95% Confidence Intervals (CI): 1.16, 2.89), stillbirth (ARR: 1.50, 95% CI: 1.09, 2.06), and low birth weight (ARR: 1.23, 95% CI: 1.06, 1.43) respectively. The findings indicated that using polluting fuel during pregnancy has a strong association with adverse pregnancy outcomes. It is essential to provide education during ANC regarding the dangers of using polluting fuels and methods to reduce excessive exposure to them.