The impact of anti-tobacco legislation on birth weight in Peru

Background:Tobacco exposure remains a significant issue for public health,especially for pregnant women.It increases the risk for premature labor,low birth weight and small for gestational age(SGA),among other effects.To reduce these risks,many countries have enacted public policies to curb tobacco exposure.Peru enacted anti-tobacco laws that forbid smoking in public places,require prevention text and images in products and publicity,along with restriction of sales to adults.We evaluated the effect of the implementation of this law on newborn outcomes:birth weight,prematurity and SGA.Methods:This was a quasi-experimental study that utilized data from the Peruvian Live Birth Registry.Children born to mothers from urban areas were the intervention group,while children born to mothers from rural areas were considered the control group.Only singletons with information on birth weight and gestational age,born to mothers aged 12 to 49 years were included in the study.In addition,newborns with birth weights greater than+4 standard deviations(SD)or less than−4 SD from the gestational age-specific mean were excluded.To measure the effect of legislation on birth weight we performed a difference in differences analysis.Results:A total of 2,029,975 births were included in the analysis.After adjusting for characteristics of the mother and the child,and contextual variables,the anti-tobacco law in Peru reduced the incidence of prematurity by 30 cases per 10,000 live births(95%CI:19 to 42).Conclusions:The reform had negligible effects on overall birth weights and on the incidence of SGA.This modest result suggests the need for a more aggressive fight against tobacco,prohibiting all types of advertising and promotion of tobacco products,among others measures.

Spatio-temporal co-occurrence of hotspots of tuberculosis, poverty and air pollution in Lima, Peru

Growing evidence suggests pollution and other environmental factors have a role in the development of tuberculosis(TB),however,such studies have never been conducted in Peru.Considering the association between air pollution and specific geographic areas,our objective was to determine the spatial distribution and clustering of TB incident cases in Lima and their co-occurrence with clusters of fine particulate matter(PM2.5)and poverty.We found co-occurrences of clusters of elevated concentrations of air pollutants such as PM2.5,high poverty indexes,and high TB incidence in Lima.These findings suggest an interplay of socio-economic and environmental in driving TB incidence.