Cooking fuel and the risk of pregnancy-induced hypertension in Lanzhou, China: A birth cohort study

Abstract Background The relationship between the solid fuels and the occurrence of pregnancy-induced hypertension (PIH) is inconclusive. Methods A birth cohort study of 10,452 pregnant women without chronic hypertension was conducted from 2010 to 2012 at the Gansu Provincial Maternity and Child Care Hospital in Lanzhou, China. Multivariable logistic regression models were used to assess the relationship. Results Compared to pregnant women using gas as cooking fuel, pregnant women using coal (OR=2.55, 95% CI: 1.85-3.51)and biomass (OR=3.58, 95% CI: 2.29-5.60) were associated with an increased risk of PIH, gestational hypertension (biomass: OR=3.38, 95% CI: 1.68-6.80), and preeclampsia (coal: OR=2.89, 95% CI: 1.98-4.21; biomass: OR=3.38, 95% CI: 1.95-5.84).The relationship between cooking fuel and PIH is modified by maternal age(p<0.0001), pre-pregnancy BMI (p<0.0001), gestational weigh gain(p<0.0001), parity(p<0.0001), and multiple birth (p<0.0001). Conclusions During pregnancy, exposure to coal or biomass was associated with an increased risk of PIH and preeclampsia.

【背景】固体燃料与妊娠高血压综合征（pregnancy-induced hypertension, PIH）发生风险之间的关联尚未明确。
【研究方法】本研究于2010至2012年在中国兰州甘肃省妇幼保健院开展，纳入10452名无慢性高血压病史的孕妇，采用出生队列研究设计，通过多因素logistic回归模型分析二者间的关联。
【研究结果】与以燃气作为烹饪燃料的孕妇相比，使用煤炭（比值比Odds Ratio, OR=2.55，95%置信区间Confidence Interval, CI：1.85~3.51）与生物质燃料（OR=3.58，95%CI：2.29~5.60）的孕妇发生妊娠高血压综合征、妊娠高血压（生物质燃料组：OR=3.38，95%CI：1.68~6.80）及子痫前期（煤炭组：OR=2.89，95%CI：1.98~4.21；生物质燃料组：OR=3.38，95%CI：1.95~5.84）的风险显著升高。烹饪燃料与妊娠高血压综合征之间的关联受产妇年龄（p<0.0001）、孕前体重指数（Body Mass Index, BMI）、孕期体重增长（p<0.0001）、产次（p<0.0001）及多胎妊娠（p<0.0001）的调节。
【研究结论】孕期暴露于煤炭或生物质燃料，与妊娠高血压综合征及子痫前期的发病风险升高显著相关。