College of Health Sciences, Department of Public Health, Debre Tabor University, Debre Tabor, Ethiopia.
Institution of Health, Department of Environmental Health Science and Technology, Jimma University, Jimma, Ethiopia.
BMC Pregnancy Childbirth. 2024 Mar 12;24(1):192. doi: 10.1186/s12884-024-06363-9.
Exposure to household air pollution during pregnancy has been linked to adverse pregnancy outcomes. Improved stove was implemented in Ethiopia to reduce this exposure and related health problems. However, the effects of improved stove interventions on pregnancy outcomes remains uncertain.
Individually randomized stove replacement trial was conducted among 422 households in six low-income rural kebeles of Northwestern Ethiopia. Pregnant women without known health conditions were recruited at ≤ 24 weeks gestation and randomized to an intervention or control group with a 1:1 ratio. A baseline survey was collected and a balance test was done. Two-sided independent samples t-test for continuous outcomes and chi-square for categorical variables were used to compare the effect of the intervention between the groups. Mean differences with 95% CIs were calculated and a p-value of < 0.05 was considered statistically significant.
In this study, the mean birth weight was 3065 g (SD = 453) among the intervention group and not statistically different from 2995 g (SD = 541) of control group. After adjusting for covariates, infants born from intervention group weighed 55 g more [95% CI: - 43 to 170) than infants born from the control group, but the difference was not statistically significant (P = 0.274). The respective percentages for low birth weight were 8% and 10.3% for intervention and control groups respectively (P = 0.346). However, the average gestational age at delivery was higher among improved stove users (38 weeks (SD = 8.2) compared to control groups 36.5 weeks (SD = 9.6) with statistically significant difference at 0.91 weeks (95% CI: 0.52 to 1.30 weeks, p < 0.001). The corresponding difference in risk ratio for preterm birth is 0.94 (95% CI:0.92 to 0.97; p < 0.001). The percentages for maternal complications, stillbirth, and miscarriage in the intervention group were not statistically different from the control group.
While the increase in average birth weight among babies born to mothers using improved stoves was not statistically significant, babies had a longer gestational age on average, offering valuable health benefits. However, the study didn't find a significant impact on other pregnancy outcomes like stillbirth, miscarriage, or maternal complications.
The study was registered at the Pan African Clinical Trial Registry website under the code PACTR202111534227089, ( https://pactr.samrc.ac.za/ (Identifier). The first trial registration date was (11/11/2021).
孕期暴露于家庭空气污染与不良妊娠结局有关。在埃塞俄比亚，改良炉灶的推广应用旨在减少这种暴露及其相关的健康问题。然而，改良炉灶干预对妊娠结局的影响仍不确定。
在埃塞俄比亚西北部 6 个低收入农村基贝拉，对 422 户家庭进行了个体随机化炉灶更换试验。在妊娠 24 周前无已知健康状况的孕妇被招募，并按照 1:1 的比例随机分配到干预组或对照组。收集基线调查并进行平衡测试。使用双侧独立样本 t 检验比较连续结果，使用卡方检验比较分类变量，以比较两组干预的效果。计算均值差异和 95%置信区间，并认为 p 值<0.05 具有统计学意义。
在这项研究中，干预组婴儿的平均出生体重为 3065 克（SD=453），与对照组的 2995 克（SD=541）无统计学差异。在调整了协变量后，干预组出生的婴儿比对照组出生的婴儿重 55 克[95%CI：-43 至 170），但差异无统计学意义（P=0.274）。干预组和对照组的低出生体重百分比分别为 8%和 10.3%（P=0.346）。然而，改良炉灶使用者的平均分娩孕周较高（38 周（SD=8.2）），而对照组为 36.5 周（SD=9.6），差异具有统计学意义（0.91 周（95%CI：0.52 至 1.30 周，p<0.001）。早产风险比的相应差异为 0.94（95%CI：0.92 至 0.97；p<0.001）。干预组产妇并发症、死胎和流产的百分比与对照组无统计学差异。
虽然使用改良炉灶的母亲所生婴儿的平均出生体重增加没有统计学意义，但婴儿的平均胎龄更长，带来了有价值的健康益处。然而，研究并未发现对其他妊娠结局（如死胎、流产或产妇并发症）有显著影响。
该研究在泛非临床试验注册中心网站上注册，代码为 PACTR202111534227089，（https://pactr.samrc.ac.za/（标识符）。首次试验注册日期为（2021 年 11 月 11 日）。
