Factors Associated with Impaired Lung Function among Pregnant Women in Selected Rural and Urban Settings of the Copperbelt Province of Zambia

Background Information: Impaired lung function among women in developing countries remains a major public health problem.Factors influencing this important respiratory condition are not well characterized. The objective of our study was to explore factors associated with impaired lungfunction among pregnant women attending antenatal services at selected primary health care facilities in Ndola and Masaiti, Zambia.

Methods: Data on background, prenatal and environmental characteristics including spirometry resultswas obtained in a cross sectional study. A sample size of 1170 was computed and factors associated with impaired lung function among pregnant women were determined in the multivariate logistic regression. Spirome try was determined using a spirometer, MIR Spirobank-G (Italy) with an attached printout of forced vital capacity (FVC), forced expiratory volume in 1 second (FEV1), and FEV1/FVC% ratio. Lung function parameters of interest were categorized as follows: Normal FEV1/FVC%: >70, Normal FEV1%: > 80 and Normal FVC%: > 80. Cooking fuel type was categorized as charcoal, wood, crop residues or electricity.While kitchen type was classified as enclosed, semi-open and open kitchen. Data analysis using SPSS version 16 used to present frequencies and proportions of population characteristics. Determinants of impaired lung function identified in the multivariate analysis.

Results: Out of a total sample of 1210 pregnant women, the study achieved a response rate of 96.7%. Distribution of cooking fuel types was such that charcoal had an overall rate of slightly more than half (52.3%) followed by wood (14.8%). More people used electricity in the urban (15.5%) compared to rural area (2.5%). Our current study only found two factors independently associated with impaired lung function, cooking fuel type and gravidity. Use of crop residues as cooking fuel was 57% less likely [AOR: 0.43, 95% CI (0.24, 0.76)] to cause impaired lung function compared to using electricity. A primigravida was 24% more likely to [AOR: 1.24, 95% CI (1.03, 1.50)] have impaired lung function compared with a multigravida.

Conclusion: Monitoring of respiratory disease using spirometry needs to be included in the primary health care package and interventions to prevent impaired lung functions in women in general should target advocacy for cleaner cooking fuel types for the poor women in developing countries where biomass is the predominant cooking fuel type.

Keywords: Spirometry, biomass, lung function, respiratory symptoms.