Association between household cooking fuel type usage, air ventilation and birth defects: a cross sectional study in Nepal

Background Birth defects are a significant cause of neonatal mortality and morbidity globally. Environmental and genetic factors may be the risk factors for birth defects. Thus, this study aims to evaluate the association between the type of household cooking fuel and birth defects in Nepal, as well as investigate whether air ventilation usage had a modifying effect on the possible association. Methods This cross-sectional study used secondary data from Nepal Perinatal Quality Improvement Projectfrom 2017 to 2018. The study sample was 66,713 women with a newborn, whose information was available in hospital records and exit interviews. The association between cooking fuel type usage and birth defects was investigated with adjusted multivariable logistic regression. To investigate the air ventilation usage, a stratified multivariable logistic regression analysis was performed. Results This study found a significant association between cooking fuel type usage and birth defects. Mothers using polluted fuels had higher odds (aOR 1.48 [95% CI 1.15-1.90]) of having a child with a birth defect compared to mothers using clean fuels. Women not using air ventilation while cooking had even higher odds of having a child with birth defects (aOR 1.56 [95% CI 1.20-2.03]), whereas the association was not significant among women using air ventilation. Conclusion The usage of polluted cooking fuels is an important factor related to birth defects. Air ventilation in turn may be important in decreasing its effects. Hence, future studies and interventions are needed to reduce neonatal mortality and life-long morbidity