Effects of a liquefied petroleum gas stove intervention on gestational blood pressure: intention-to-treat and exposure-response findings from the Household Air Pollution Intervention Network (HAPIN) trial

Details

• Alternative Title:
  Hypertension
• Personal Author:
  Ye, Wenlu ; Steenland, Kyle ; Quinn, Ashlinn ; Liao, Jiawen ; Balakrishnan, Kalpana ; Rosa, Ghislaine ; Ndagijimana, Florien ; de Dieu Ntivuguruzwa, Jean ; Thompson, Lisa M. ; McCracken, John P. ; Díaz-Artiga, Anaité ; Rosenthal, Joshua P. ; Papageorghiou, Aris ; Davila-Roman, Victor G. ; Pillarisetti, Ajay ; Johnson, Michael ; Wang, Jiantong ; Nicolaou, Laura ; Checkley, William ; Peel, Jennifer L. ; Clasen, Thomas F.
• Corporate Authors:
  Household Air Pollution Intervention Network (HAPIN) trial Investigators
• Description:
  Background.
  
  Approximately 3–4 billion people worldwide are exposed to household air pollution (HAP), which has been associated with increased blood pressure (BP) in pregnant women in some studies.
  
  Methods
  
  We recruited 3195 pregnant women in Guatemala, India, Peru, and Rwanda, and randomly assigned them to intervention or control groups. The intervention group received a gas stove and fuel during pregnancy, while the controls continued cooking with solid fuels. We measured BP and personal exposure to PM2.5, black carbon (BC), and carbon monoxide (CO) three times during gestation. We conducted an intention-to-treat (ITT) and exposure-response analysis to determine if HAP exposure was associated with increased gestational BP.
  
  Results
  
  Median 24-hour PM2.5 dropped from 84 μg/m3 to 24 μg/m3 after the intervention; BC and CO decreased similarly. ITT analyses showed an increase in systolic BP (SBP) and diastolic BP (DBP) in both arms during gestation, as expected, but the increase was greater in intervention group for both SBP (0.69 mmHg, 0.03–1.35, p=0.04) and DBP (0.62 mmHg, 0.05–1.19, p=0.03). The exposure-response analyses suggested that higher exposures to HAP were associated with moderately higher SBP and DBP; however, none of these associations reached conventional statistical significance.
  
  Conclusion
  
  In ITT we found higher gestational BP in the intervention group compared to controls, contrary to expected. In exposure-response analyses, we found a slight increase in BP with higher exposure, but it was not statistically significant. Overall, an intervention with gas stoves did not markedly affect gestational BP.
  
  
• Subjects:
  Air Pollution, Indoor Blood Pressure Carbon Monoxide Cooking Female Humans Intention To Treat Analysis Particulate Matter Petroleum Pregnancy
• Keywords:
  Blood Pressure Household Air Pollution Household Energy Intervention Pregnant Women
• Source:
  Hypertension. 79(8):1887-1898
• Pubmed ID:
  35708015
• Pubmed Central ID:
  PMC9278708
• Document Type:
  Journal Article
• Funding:
  T42 OH008429/OH/NIOSH CDC HHSUnited States/ ; UM1 HL134590/HL/NHLBI NIH HHSUnited States/
• Volume:
  79
• Issue:
  8
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha-512:22a32a4a1c6c375a51ea59dad2e9cccc2d7d8625c8582835eb6a0098050a4c4ac703a604369f79c504bd2a7e5cff97e9368f91c9a7c2f7077ed9c7100f1df448
• Download URL:
  https://stacks.cdc.gov/view/cdc/124933/cdc_124933_DS1.pdf
• File Type:
  [PDF - 321.58 KB ]