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孕期和婴儿期提供液化石油气炉灶及燃料与出生至12个月期间的线性生长轨迹:来自多中心家庭空气污染干预网络(HAPIN)试验的证据

Provision of a liquefied petroleum gas cookstove and fuel during pregnancy and infancy and linear growth trajectories between birth and 12 months: evidence from the multi-center Household Air Pollution Intervention Network (HAPIN) trial.

作者信息

Sivalogan Kasthuri, Stein Aryeh D, Thompson Lisa M, Wang Jiantong, Diaz-Artiga Anaite, Aravindalochanan Vigneswari, Jabbarzadeh Shirin, Nicolaou Laura, Williams Kendra N, Balakrishnan Kalpana, Peel Jennifer L, Checkley William, Clasen Thomas, Sinharoy Sheela S

机构信息

Emory University School of Public Health.

Emory University Rollins School of Public Health.

出版信息

medRxiv. 2025 Jun 6:2025.06.05.25329099. doi: 10.1101/2025.06.05.25329099.

Abstract

OBJECTIVE

Exposure to particulate pollution from cooking with solid biomass fuels is associated with impaired child linear growth. We examined the effect of a liquefied petroleum gas (LPG) cookstove randomized control trial during pregnancy and infancy on linear growth trajectories among infants born to women enrolled during pregnancy.

METHODS

The Household Air Pollution Intervention Network (HAPIN) randomized control trial enrolled 3195 pregnant women (9 to <20 weeks gestation) from rural areas in Guatemala, Peru, India, and Rwanda that relied primarily on biomass fuels for cooking. Women in the intervention group received an LPG cookstove and fuel for approximately eighteen months, while those in the control group continued to use biomass for cooking. We measured the children's recumbent length at birth and 3, 6, 9 and 12 months of age and calculated length-for-age z-score (LAZ). We conducted a multiple group latent class growth analysis among the 2802 infants who finished the study and had ≥3 length measurements across the five timepoints to examine if latent classes differed by intervention arm.

RESULTS

We identified three latent classes of linear growth, based on visual inspection of mean LAZ and model fit statistics, that represent higher, medium, and lower LAZ trajectories. Approximately 13.2% of infants belong to the high LAZ trajectory, 53.8% of infants belong to the medium LAZ trajectory and 33.0% belong to the low LAZ trajectory. The distribution of infants in each latent class did not differ by intervention assignment.

CONCLUSIONS

Provision of an LPG cookstove and fuel during pregnancy and infancy did not alter linear growth trajectories among the offspring.

CLINICAL TRIALS REGISTRATION NUMBER

NCT02944682.

FUNDING SOURCE

U.S. National Institutes of Health and the Bill & Melinda Gates Foundation.

摘要

目的

接触使用固体生物质燃料烹饪产生的颗粒物污染与儿童线性生长受损有关。我们研究了孕期和婴儿期使用液化石油气(LPG)炉灶的随机对照试验对孕期入组妇女所生婴儿线性生长轨迹的影响。

方法

家庭空气污染干预网络(HAPIN)随机对照试验招募了3195名来自危地马拉、秘鲁、印度和卢旺达农村地区的孕妇(妊娠9至<20周),她们主要依靠生物质燃料做饭。干预组的妇女获得了一个LPG炉灶和大约18个月的燃料,而对照组的妇女继续使用生物质燃料做饭。我们测量了儿童出生时、3、6、9和12个月大时的卧位身长,并计算了年龄别身长Z评分(LAZ)。我们对2802名完成研究且在五个时间点有≥3次身长测量的婴儿进行了多组潜在类别生长分析,以检查潜在类别是否因干预组不同而有所差异。

结果

根据对平均LAZ的直观检查和模型拟合统计数据,我们确定了三种线性生长的潜在类别,分别代表较高、中等和较低的LAZ轨迹。约13.2%的婴儿属于高LAZ轨迹,53.8%的婴儿属于中等LAZ轨迹,33.0%的婴儿属于低LAZ轨迹。每个潜在类别中婴儿的分布在干预分配上没有差异。

结论

孕期和婴儿期提供LPG炉灶和燃料并未改变后代的线性生长轨迹。

临床试验注册号

NCT02944682。

资金来源

美国国立卫生研究院和比尔及梅琳达·盖茨基金会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/de06/12155024/dcde679e916f/nihpp-2025.06.05.25329099v1-f0001.jpg

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