Work as a street vendor and risk of adverse pregnancy outcomes in Accra, Ghana

摘要

Background: Street vending is a dominant occupation in urban areas of developing countries due to the massive influx of rural dwellers into urban environment in search of better livelihood. Although it is widely known that street vending exposes individuals to several environmental pollutants very few studies have investigated the health effects of these exposures among street vendors. The relationship of street vending with pregnancy outcomes has not been examined. Aims: To assess the outdoor air pollution exposure experiences of women street vendors in Accra, Ghana and examine it effects on birth weight and gestational duration. Methods: A cross-sectional study was conducted among 105 street vendors and a reference group of 281 mothers accessing postnatal services at the Korle Bu Teaching Hospital in Accra, Ghana in 2010. Results: Multivariate linear regression analysis adjusting for age, social class, marital status and gravidity of mothers, sex of neonate, and indoor air pollution, resulted in 177g (95% CI: 324, 31) reduction in birth weight among street vendors. Sensitivity analysis performed by restricting the analysis to term births resulted in further reductions in birth weight. Generalized linear models adjusting for confounders indicated a 35% (RR=1.35; 95% CI: 0.87, 2.12) increased risk of low birth weight (LBW). The effect measure increased in the sensitivity analysis but was not statistically significant. Upon applying the ordinal scale exposure parameter, moderate exposure was associated with a statistically significant 95% (RR=1.95; 95% 0:1.03, 3.70) increased risk of LBW. The risk of preterm birth was not associated with street vending (RR=1.03; 95% CI: 0.67,1.58). Conclusions: Street vending during pregnancy is a determinant of average fetal growth and risk of LBW. More research is required to further quantify their effects on pregnancy outcomes and provide the evidence base for interventions to safeguard maternal and perinatal health in developing countries.