Effects of a liquefied petroleum gas stove and fuel intervention on head circumference and length at birth: A multi-country household air pollution intervention network (HAPIN) trial

IF 10.3 1区环境科学与生态学 Q1 ENVIRONMENTAL SCIENCES

Environment International Pub Date : 2025-01-01 DOI:10.1016/j.envint.2024.109211

Hina Raheel , Sheela Sinharoy , Anaité Diaz-Artiga , Sarada S. Garg , Ajay Pillarisetti , Kalpana Balakrishnan , Marilu Chiang , Amy Lovvorn , Miles Kirby , Usha Ramakrishnan , Shirin Jabbarzadeh , Alexie Mukeshimana , Michael Johnson , John P. McCracken , Luke P. Naeher , Ghislaine Rosa , Jiantong Wang , Joshua Rosenthal , William Checkley , Thomas F. Clasen , Lisa M. Thompson

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引用次数: 0

Abstract

Background

Air pollution may impair child growth and cognitive development, with potential markers including birth length and head circumference.

Methods

The Household Air Pollution Intervention Network (HAPIN) trial was an open label multi-country-randomized controlled trial, with 3200 pregnant women aged 18–34 years (9–19 weeks of gestation) randomly assigned in a 1:1 ratio to receive liquefied petroleum gas (LPG) stove intervention compared to women continuing to cook with solid fuels for 18 months. Particulate matter ≤ 2.5 μm (PM2.5), black carbon (BC) and carbon monoxide (CO) 24-hour personal exposures were measured three times during pregnancy. Head circumference and length were measured < 24 h of birth. We conducted intention-to-treat and exposure–response analyses to determine the intervention effects and associations between household air pollution (HAP) exposure during pregnancy and head circumference, head circumference-for-gestational age Z-score, length, and length-for-gestational age Z-scores at birth. ClinicalTrials.gov.

Results

Between May 2018, and Feb 2020, 3200 pregnant women were randomly assigned to intervention (n = 1593) and control groups (n = 1607) with 3060 births included in the analysis. There was a 71.9 % reduction in PM2.5 in the intervention group with similar reductions for BC and CO. Intention-to-treat analysis showed that the intervention did not affect head circumference (β = -0.01 cm, 95 %CI −0.11, 0.09), head circumference-for-gestational age Z-score (β = -0.01, 95 %CI −0.08, 0.07), or birth length (β = 0.14 cm, 95 %CI −0.01, 0.29) but did increase birth length-for-gestational age Z-score (β = 0.09, 95 %CI 0.01, 0.16). After covariate adjustment, exposure–response analysis revealed that each log-unit increase in BC was associated with a decrease in birth length-for-gestational age Z-score (β = -0.07, 95 %CI −0.13, −0.005). There was no evidence of hypothesized associations with PM2.5 or CO.

Conclusion

An LPG intervention reduced HAP exposure during pregnancy but had minor effects on birth length-for-gestational age Z-score. Birth length-for-gestational age was only associated with BC.

Clinical Trial Registration: The study has been registered with ClinicalTrials.gov (Identifier NCT02944682).

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液化石油气炉和燃料干预对出生时头围和长度的影响：多国家庭空气污染干预网络（HAPIN）试验

空气污染可能损害儿童的生长和认知发展，潜在的标志包括出生长度和头围。家庭空气污染干预网络（HAPIN）试验是一项开放标签的多国家随机对照试验，3200名年龄在18 - 34 岁（9-19 孕周）的孕妇按1:1的比例随机分配接受液化石油气（LPG）炉干预，与继续使用固体燃料烹饪18 个月的妇女相比。测量妊娠期间3次个人24小时接触颗粒物 ≤ 2.5 μm （PM2.5）、黑碳（BC）和一氧化碳（CO）。出生后测量头围和头长 <； 24 h。我们进行了意向治疗和暴露-反应分析，以确定怀孕期间家庭空气污染（HAP）暴露与出生时头围、头围胎龄z评分、身长和身长胎龄z评分之间的干预效果和关系。该研究已在ClinicalTrials.gov注册（标识符NCT02944682）。结果在2018年5月至2020年2月期间，3200名孕妇被随机分配到干预组（n = 1593）和对照组（n = 1607），其中3060名新生儿被纳入分析。有一个71.9 %减少PM2.5在公元前干预组与类似的削减和有限公司意向处理分析表明,干预并不影响头围(β =  -0.01厘米,95 % CI−0.11,0.09),头circumference-for-gestational年龄z分数(β = -0.01,95 % CI−0.08,0.07),或出生长度(β =  0.14厘米,95 % CI−0.01,0.29)但并增加出生length-for-gestational年龄z分数(β = 0.09,95 % CI 0.01, 0.16)。协变量调整后，暴露-反应分析显示，BC每增加一个对数单位，出生长度/胎龄z评分就会降低（β = -0.07,95 %CI - 0.13, - 0.005）。结论LPG干预减少了妊娠期HAP暴露，但对出生长度与胎龄的z评分影响较小。出生体长胎龄仅与BC相关。临床试验注册：该研究已在ClinicalTrials.gov（标识符NCT02944682）注册。

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来源期刊

Environment International 环境科学-环境科学

CiteScore

21.90

自引率

3.40%

发文量

734

审稿时长

2.8 months

期刊介绍： Environmental Health publishes manuscripts focusing on critical aspects of environmental and occupational medicine, including studies in toxicology and epidemiology, to illuminate the human health implications of exposure to environmental hazards. The journal adopts an open-access model and practices open peer review. It caters to scientists and practitioners across all environmental science domains, directly or indirectly impacting human health and well-being. With a commitment to enhancing the prevention of environmentally-related health risks, Environmental Health serves as a public health journal for the community and scientists engaged in matters of public health significance concerning the environment.