Effect of homemade peanut oil consumption during pregnancy on low birth weight and preterm birth outcomes: a cohort study in Southwestern China

BackgroundHomemade peanut oil is widely consumed in rural areas of Southwestern China, which is easily contaminated by aflatoxins (AFs) and associated with adverse birth outcomes.ObjectiveTo identify the effect of exposure to homemade peanut oil consumption on low birth weight (LBW), preterm birth (PB) and other associated factors.MethodsA prospective cohort study was conducted among pregnant women in Guangxi province, Southwestern China. Information of all eligible women on homemade peanut oil consumption and potential factors associated with LBW and PB was collected, and all were followed up until delivery. The effect of homemade peanut oil exposure was analyzed using multiple logistic regression models using the directed acyclic graph (DAG) approach.ResultsOf 1611 pregnant women, 1316 (81.7%) had consumed homemade peanut oil, and the rates of LBW and PB were 9.7% and 10.0%, respectively. Increased risks of LBW and PB in women with homemade peanut oil consumption were found with aORs of 1.9 (95% CI 1.1-3.2) and 1.8 (95% CI 1.1-3.0), respectively. Women with a history of PB or LBW were 3-5 times more likely to have higher rates of LBW or PB compared with those without this type of history. The odds of PB were approximately double in those taking medicine during pregnancy. Advanced maternal age, lack of physical exercise during pregnancy, passive smoking, or pregnancy complications were also more likely to have a higher risk of LBW.ConclusionsHomemade peanut oil consumption was a potential risk factor for both LBW and PB, of which health authorities who are responsible for food safety of the country should pay more attention to providing recommendation for oil consumption during pregnancy. Main findings: Homemade peanut oil consumption was associated with increased risk of low birth weight and preterm birth, in addition to advanced age, adverse obstetric histories, and health risk behaviors during pregnancy in a county in Southwestern China.Added knowledge: This study identifies the direct and total effects of homemade peanut oil consumption on low birth weight and preterm birth and explains the factors associated with low birth weight and preterm birth in a county in Southwestern China.Global health impact for policy and action: Evidence of associated risk factors for low birth weight and preterm birth should be informed to the community, and precautionary policies for the protection of aflatoxin exposure during pregnancy are needed.