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The study by Mi-Sun Lee and colleagues1 has investigated the risk of adverse outcomes in offspring on perinatal exposure to cooking biomass fuels in Bangladeshi women, particularly crop residue and wood-fuel, and reported an increased odds of low birth weight and a significant reduction in the gestational age and head circumference of offspring on exposure to smoke from crop residue burning. While it is an insightful effort carried out among a considerable cohort of 1137 participants, the quantification of exposure using only a questionnaire tool may have potentially obscured the estimation of the actual exposure and the overall effect size. Despite several epidemiological factors are accounted for, no information pertaining to the quality of antenatal care, including diet or nutrition during gestation and pre-existing and/or pregnancy-associated comorbid conditions of the participating women have been recorded or included in the analyses such as hypertension, preeclampsia, diabetes and other metabolic conditions, which are most important and could possibly confound the association. Moreover, besides the information on the type of cooking fuel and secondhand …
Contributors AMD conceptualised, collected and interpreted data, designed, drafted and edited the manuscript. RJ participated in data interpretation and editing the manuscript. All authors reviewed, revised and approved the final manuscript.
Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.
Competing interests None declared.
Provenance and peer review Not commissioned; internally peer reviewed.