Raheel Hina, Sinharoy Sheela, Diaz-Artiga Anaité, Garg Sarada S, Pillarisetti Ajay, Balakrishnan Kalpana, Chiang Marilu, Lovvorn Amy, Kirby Miles, Ramakrishnan Usha, Jabbarzadeh Shirin, Mukeshimana Alexie, Johnson Michael, McCracken John P, Naeher Luke P, Rosa Ghislaine, Wang Jiantong, Rosenthal Joshua, Checkley William, Clasen Thomas F, Peel Jennifer L, Thompson Lisa M
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA.
Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, USA.
Environ Int. 2025 Jan;195:109211. doi: 10.1016/j.envint.2024.109211. Epub 2024 Dec 24.
Air pollution may impair child growth and cognitive development, with potential markers including birth length and head circumference.
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.
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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.
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.
The study has been registered with ClinicalTrials.gov (Identifier NCT02944682).
空气污染可能会损害儿童生长和认知发育，潜在指标包括出生时身长和头围。
家庭空气污染干预网络（HAPIN）试验是一项开放标签的多国随机对照试验，将3200名年龄在18 - 34岁（妊娠9 - 19周）的孕妇按1:1比例随机分组，一组接受液化石油气（LPG）炉灶干预，另一组妇女继续使用固体燃料烹饪18个月。在孕期对细颗粒物≤2.5微米（PM2.5）、黑碳（BC）和一氧化碳（CO）的24小时个人暴露情况进行了三次测量。在出生后<24小时测量头围和身长。我们进行了意向性分析和暴露 - 反应分析，以确定干预效果以及孕期家庭空气污染（HAP）暴露与出生时头围、头围相对于胎龄的Z评分、身长以及身长相对于胎龄的Z评分之间的关联。
gov。
在2018年5月至2020年2月期间，3200名孕妇被随机分配至干预组（n = 1593）和对照组（n = 1607），分析纳入了3060例出生病例。干预组的PM2.5降低了71.9%，BC和CO也有类似程度的降低。意向性分析表明，干预对出生时头围（β = -0.01厘米，95%CI -0.11，0.09）、头围相对于胎龄的Z评分（β = -0.01，95%CI -0.08，0.07）或身长（β = 0.14厘米，95%CI -0.01，0.29）没有影响，但确实增加了身长相对于胎龄的Z评分（β = 0.09，95%CI 0.01，0.16）。在进行协变量调整后，暴露 - 反应分析显示，BC每增加一个对数单位，与身长相对于胎龄的Z评分降低相关（β = -0.07，95%CI -0.13，-0.005）。没有证据表明与PM2.5或CO存在假设的关联。
LPG干预降低了孕期的HAP暴露，但对身长相对于胎龄的Z评分影响较小。身长相对于胎龄仅与BC相关。
该研究已在ClinicalTrials.gov注册（标识符NCT02944682）。
