Prenatal exposure to particulate matter (PM2.5) and low birth weight in a Sri Lankan birth cohort

Abstract

Background: About 74% of the Sri Lankan population use biomass in the form of unprocessed wood as the primary cooking fuel. A growing body of evidence from meta-analyses and individual studies although limited by few prospective studies, report that prenatal exposure to particulate matter of size 2.5 µm (PM_2.5) emissions from biomass fuel burning may be associated with low birth weight (LBW) (50% wood use) was significantly associated with birth weight as compared to LPG users (β, −0.13; SE, 0.06; p, 0.0331). In logistic regression models, a 10-unit increase in PM_2.5 was associated with increased odds for LBW (OR, 1.26; 95%CI, 1.02-1.55; p, 0.0355), while the prevalence of LBW was highest among >50% wood users (OR, 2.82; 95%CI, 1.18-6.73; p, 0.0124), as compared to those using >50% LPG with wood and only LPG users. The association between HAP exposure and birth weight/LBW were consistent among term births (n=486).Conclusions: The finding of a significant association between prenatal PM_2.5 exposure and LBW in a low-middle income country (LMIC) setting where competing risk factors are minimal fills a gap in the body of evidence linking HAP from biomass smoke to LBW. These results underscore the crucial need to implement prevention and reduction of HAP exposure in LMICs where the HAP burden is high.