Effects of a Liquefied Petroleum Gas Stove Intervention on Stillbirth, Congenital Anomalies and Neonatal Mortality: A Multi-Country Household Air Pollution Intervention Network Trial

Details

• Personal Author:
  Alarcon LM ; Alkon A ; Balakrishnan K ; Castañaza Gonzalez A ; Chang HH ; Checkley W ; Chiang M ; Clasen TF ; Craik R ; Diaz-Artiga A ; Elon L ; Garg SS ; Harknett K ; Hartinger SM ; Johnson MA ; Kirby MA ; Lovvorn AE ; McCracken JP ; Mukeshimana A ; Naeher LP ; Nicolaou L ; Papageorghiou AT ; Peel JL ; Piedrahita R ; Pillarisetti A ; Rosa G ; Rosenthal J ; Thompson LM ; Toenjes A ; Underhill LJ ; Wang J ; Williams KN ; Ye W ; Younger A
• Corporate Authors:
  Household Air Pollution Intervention Network Investigators
• Description:
  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. [Description provided by NIOSH]
• Subjects:
  Air Pollution, Indoor Occupational Health Pregnancy Safety
• Keywords:
  Author Keywords: Cooking Fuel Birth Outcomes Congenital Anomaly Congenital Effects Cooking Equipment Indoor Air Pollution Liquified Petroleum Gas Low- And Middle-income Countries LPG Neonatal Mortality Prenatal Exposure Stillbirth

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• ISSN:
  0269-7491
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; Colorado ; Georgia ; Maryland ; Massachusetts ; Missouri ; OSHA Region 1 ; OSHA Region 3 ; OSHA Region 4 ; OSHA Region 7 ; OSHA Region 8 ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  345
• NIOSHTIC Number:
  nn:20069296
• Citation:
  Environ Pollut 2024 Mar; 345:123414
• Contact Point Address:
  Ashley Younger, School of Nursing, University of California, 2 Koret Way San Francisco, CA 94143, USA
• Email:
  ashley.younger@wrh.ox.ac.uk
• Federal Fiscal Year:
  2024
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Environmental Pollution
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:c4fd155e70076e3d12b696451f95c35dac707ebb10f3822be890fe6ad16643fb39f65e9b6b9b6c422510934db599a1ad10852c901794ab3529c0c958b4a3fccd
• Download URL:
  https://stacks.cdc.gov/view/cdc/207799/cdc_207799_DS1.pdf
• File Type:
  [PDF - 3.40 MB ]