TY - JOUR
T1 - Effects of a liquefied petroleum gas stove intervention on stillbirth, congenital anomalies and neonatal mortality
T2 - A multi-country household air pollution intervention network trial
AU - Household Air Pollution Intervention Network (HAPIN) Investigators
AU - Younger, Ashley
AU - Ye, Wenlu
AU - Alkon, Abbey
AU - Harknett, Kristen
AU - Kirby, Miles A.
AU - Elon, Lisa
AU - Lovvorn, Amy E.
AU - Wang, Jiantong
AU - Diaz-Artiga, Anaité
AU - McCracken, John P.
AU - Castañaza Gonzalez, Adly
AU - Alarcon, Libny Monroy
AU - Mukeshimana, Alexie
AU - Rosa, Ghislaine
AU - Chiang, Marilu
AU - Balakrishnan, Kalpana
AU - Garg, Sarada S.
AU - Pillarisetti, Ajay
AU - Piedrahita, Ricardo
AU - Johnson, Michael A.
AU - Craik, Rachel
AU - Papageorghiou, Aris T.
AU - Toenjes, Ashley
AU - Williams, Kendra N.
AU - Underhill, Lindsay J.
AU - Hartinger, Stella M.
AU - Nicolaou, Laura
AU - Chang, Howard H.
AU - Naeher, Luke P.
AU - Rosenthal, Joshua
AU - Checkley, William
AU - Peel, Jennifer L.
AU - Clasen, Thomas F.
AU - Thompson, Lisa M.
N1 - Publisher Copyright:
© 2024
PY - 2024/3/15
Y1 - 2024/3/15
N2 - 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 in an ITT analysis. Higher mean personal exposures to PM2.5, CO and BC during pregnancy were associated with a higher, but statistically non-significant, incidence of adverse outcomes. The LPG stove and fuel intervention did not reduce the risk of these outcomes nor did we find evidence supporting an association between personal exposures to HAP and stillbirth, congenital anomalies and neonatal mortality.
AB - 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 in an ITT analysis. Higher mean personal exposures to PM2.5, CO and BC during pregnancy were associated with a higher, but statistically non-significant, incidence of adverse outcomes. The LPG stove and fuel intervention did not reduce the risk of these outcomes nor did we find evidence supporting an association between personal exposures to HAP and stillbirth, congenital anomalies and neonatal mortality.
KW - Birth outcomes
KW - Congenital anomaly
KW - Cooking fuel
KW - Low- and middle-income countries
KW - Neonatal mortality
KW - Stillbirth
UR - http://www.scopus.com/inward/record.url?scp=85183993806&partnerID=8YFLogxK
U2 - 10.1016/j.envpol.2024.123414
DO - 10.1016/j.envpol.2024.123414
M3 - Article
C2 - 38286258
AN - SCOPUS:85183993806
SN - 0269-7491
VL - 345
JO - Environmental Pollution
JF - Environmental Pollution
M1 - 123414
ER -