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Carbon Monoxide Detector Presence among Reproductive-Age Women in South Carolina: A 2011 Behavioral Risk Factor Surveillance System Analysis

Posted By Chelsea Lynes and Harley T. Davis, Friday, August 19, 2016
Updated: Wednesday, August 3, 2016

Carbon monoxide (CO) is a colorless, odorless gas that can be detected by a CO detector in the home. Acute CO poisoning in pregnancy has been associated with increased maternal (18-24%) and fetal (36-67%) mortality [1]. Accidental household exposure to CO is the most frequent cause of poisoning in pregnancy [1]. From 2012-2013, 53.7% of women in South Carolina (SC) reported their pregnancy was unintended (29.0% mistimed; 8.4% unwanted; 16.3% unsure) [2]. Due to the high fetal mortality rate associated with CO exposure and high incidence of unintended pregnancy in SC, we investigated associations between CO detector presence in the residence and demographic characteristics of reproductive aged (18-44 years old) women in SC using data from the Behavioral Risk Factor Surveillance System (BRFSS).

SC BRFSS data were obtained from 2011 (n=12,948). The study sample was restricted to reproductive aged women who were not currently pregnant and who gave a valid response to the question, “Do you have a CO detector in your home?”. The final sample was comprised of 1,160 women. We utilized survey logistic regression procedures in SAS 9.2 [3]. Significance of bivariate associations between demographic characteristics and CO detector presence were evaluated via odds ratios and 95% confidence intervals.

Results are displayed in Figure 1.

Figure 1
Figure 1: Odds ratios and 95% confidence intervals measuring association between
CO detector presence in home and covariates of interest (SC BRFSS 2011)

In conclusion, non-pregnant women of reproductive age with lower odds of having a CO detector in the home: reported lower educational attainment and income level; had never been married; rented their home; were not Non-Hispanic White. We found the same associations in the general population of SC. Family planning was not associated with the presence of CO detectors. Regardless, it may be important to focus educational efforts, i.e. CO sources and detector placement, on reproductive age women in SC due to high incidence of unintended pregnancy. We plan to add the CO detector question to future iterations of SC BRFSS to monitor the prevalence of use of this important safety device in the home.


[1] Friedman P, Guo XM, Stiller RJ, Laifer SA. Carbon monoxide exposure during pregnancy. Obstet Gynecol Surv. 2015 Nov;70(11):705-12.

[2] South Carolina Pregnancy Risk Assessment Monitoring System. 2012-2013 data.

[3] SAS 9.2. SAS Institute, Inc. Cary, NC.


Chelsea Lynes, MSPH and Harley T. Davis, MSPH, PhD are epidemiologists at the South Carolina Department of Health and Environmental Control, Public Health Statistics and Information Services, Division of Surveillance. Join the CSTE Maternal and Child Health Subcommittee to learn more about public health topics regarding pregnancy.

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