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Low birth weight is a key public health problem in many developing countries, including Sri Lanka. Indoor air pollution from tobacco smoke and kitchen-fuel smoke are among the major contributors to low birth weight, factors of which there are little awareness of in Sri Lanka. We evaluated the effect of passive smoking and kitchen-fuel smoke exposure on birth weight. Seventy-six pregnant women were included in the study. Data were collected by questionnaire, and exposure assessment was conducted using a breath carbon monoxide monitor. Women exposed to second-hand tobacco smoke daily had a significantly lower mean gestational age at delivery (mean ± standard error [SE]: 38.0 ± 0.5 weeks) than women who were exposed to second-hand tobacco smoke only once a week (mean ± SE: 39.3 ± 0.3 weeks) ( p  < 0.05). Women who were exposed to tobacco smoke every day delivered neonates with significantly lower mean birth weight (mean ± SE: 2703 ± 135 g) than women who were only exposed once a week (mean ± SE: 3125 ± 147 g) ( p  < 0.05). A one-minute increase in cooking time in a kitchen without a chimney increased women’s expired air carbon monoxide concentration by 0.038 ppm ( p  = 0.006). Long-term exposure to wood-fuel smoke in a kitchen without a chimney can increase the risk of inhaling high concentrations of carbon monoxide.

Effects of Prenatal Tobacco and Wood-Fuel Smoke Exposure on Birth Weight in Sri Lanka