Effects of a liquefied petroleum gas stove intervention on stillbirth, congenital anomalies and neonatal mortality: A multi-country household air pollution intervention network trial

作者：Ashley Younger, Wenlu Ye, Abbey Alkon, Kristen Harknett, Miles A. Kirby, Lisa Elon, Amy Lovvorn, Jiantong Wang, Anaité Díaz-Artiga, John P. McCracken, Adly Castañaza Gonzalez, Libny Monroy Alarcon, Alexie Mukeshimana, Ghislaine Rosa, Marilú Chiang, Kalpana Balakrishnan, Sarada S. Garg, Ajay Pillarisetti, Ricardo Piedrahita, Michael Johnson, Rachel Craik, Aris T. Papageorghiou, Ashley Toenjes, Kendra N. Williams, Lindsay J. Underhill, Stella M. Hartinger, Laura Nicolaou, Howard H. Chang, Luke P. Naeher, Joshua P. Rosenthal, William Checkley, Jennifer L. Peel, Thomas Clasen, Lisa M. Thompson · 发表于：Environmental Pollution · 年份：2024 · DOI：10.1016/j.envpol.2024.123414 · 被引用次数：7 · 研究领域：Energy and Environment Impacts、Air Quality and Health Impacts、Climate Change and Health Impacts

Household air pollution (HAP) from cooking with solid fuels used during pregnancy has been associated with adverse pregnancy outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial that assessed the impact of a liquefied petroleum gas (LPG) stove and fuel intervention on health in Guatemala, India, Peru, and Rwanda. Here we investigated the effects of the LPG stove and fuel intervention on stillbirth, congenital anomalies and neonatal mortality and characterized exposure-response relationships between personal exposures to fine particulate matter (PM2.5), black carbon (BC) and carbon monoxide (CO) and these outcomes. Pregnant women (18 to <35 years of age; gestation confirmed by ultrasound at 9 to <20 weeks) were randomly assigned to intervention or control arms. We monitored these fetal and neonatal outcomes and personal exposure to PM2.5, BC and CO three times during pregnancy, we conducted intention-to-treat (ITT) and exposure-response (E-R) analyses to determine if the HAPIN intervention and corresponding HAP exposure was associated with the risk of fetal/neonatal outcomes. A total of 3200 women (mean age 25.4 ± 4.4 years, mean gestational age at randomization 15.4 ± 3.1 weeks) were included in this analysis. Relative risks for stillbirth, congenital anomaly and neonatal mortality were 0.99 (0.60, 1.66), 0.92 (95% CI 0.52, 1.61), and 0.99 (0.54, 1.85), respectively, among women in the intervention arm compared to controls...