About this item:

143 Views | 96 Downloads

Author Notes:

Address correspondence to L.M. Thompson, 2 Koret Way, Box 0606, San Francisco, CA, 94143-0606 USA. Telephone: (415) 502-5628. Fax: (415) 753-2161. E-mail: lisa.thompson@nursing.ucsf.edu

We acknowledge J. Balmes, University of California–Berkeley, and J. McCracken, Harvard University. We also acknowledge the following contributors in Guatemala: B. Arana, the Guatemalan Ministry of Health; fieldworkers J. Ramirez, E. Ramirez, A. Morales, D. Velasquez, C. Hernandez, V. Tema, R. Gonzalez, M. Isidro, E. Augustin, and R. Orozco; and participating study families.

The authors declare they have no actual or potential competing financial interests.


Research Funding:

This work was supported by U.S. National Institute of Environmental Health Sciences grant R01ES010178 and by the World Health Organization.


  • Science & Technology
  • Life Sciences & Biomedicine
  • Environmental Sciences
  • Public, Environmental & Occupational Health
  • Toxicology
  • Environmental Sciences & Ecology
  • carbon monoxide
  • household air pollution
  • low birth weight
  • maternal malnutrition
  • RESPIRE trial
  • seasonality

Impact of Reduced Maternal Exposures to Wood Smoke from an Introduced Chimney Stove on Newborn Birth Weight in Rural Guatemala


Journal Title:

Environmental Health Perspectives


Volume 119, Number 10


, Pages 1489-1494

Type of Work:

Article | Final Publisher PDF


Background: A growing body of evidence indicates a relationship between household indoor air pollution from cooking fires and adverse neonatal outcomes, such as low birth weight (LBW), in resource-poor countries. Objective: We examined the effect of reduced wood smoke exposure in pregnancy on LBW of Guatemalan infants in RESPIRE (Randomized Exposure Study of Pollution Indoors and Respiratory Effects). Methods: Pregnant women (n = 266) either received a chimney stove (intervention) or continued to cook over an open fire (control). Between October 2002 and December 2004 we weighed 174 eligible infants (69 to mothers who used a chimney stove and 105 to mothers who used an open fire during pregnancy) within 48 hr of birth. Multivariate linear regression and adjusted odds ratios (ORs) were used to estimate differences in birth weight and LBW (< 2,500 g) associated with chimney- stove versus open-fire use during pregnancy. Results: Pregnant women using chimney stoves had a 39% reduction in mean exposure to carbon monoxide compared with those using open fires. LBW prevalence was high at 22.4%. On average, infants born to mothers who used a stove weighed 89 g more [95% confidence interval (CI), -27 to 204 g] than infants whose mothers used open fires after adjusting for maternal height, diastolic blood pressure, gravidity, and season of birth. The adjusted OR for LBW was 0.74 (95% CI, 0.33-1.66) among infants of stove users compared with open-fire users. Average birth weight was 296 g higher (95% CI, 109-482 g) in infants born during the cold season (after harvest) than in other infants; this unanticipated finding may reflect the role of maternal nutrition on birth weight in an impoverished region. Conclusions: A chimney stove reduced wood smoke exposures and was associated with reduced LBW occurrence. Although not statistically significant, the estimated effect was consistent with previous studies.

Copyright information:

Publication of EHP lies in the public domain and is therefore without copyright. All text from EHP may be reprinted freely.

Export to EndNote