Liquefied Petroleum Gas or Biomass for Cooking and Effects on Birth Weight.
Liquefied Petroleum Gas or Biomass for Cooking and Effects on Birth Weight.
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DOI：
10.1056/nejmoa2206734
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发表时间：
2022-11-10
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怀孕期间暴露于燃烧固体生物质燃料造成的家庭空气污染与不利的健康后果有关，包括低出生体重。目前尚不清楚用液化石油气(LPG)炉子取代生物质炉子是否会导致新生儿体重增加。我们在危地马拉、印度、秘鲁和卢旺达进行了一项随机对照试验，研究对象为怀孕9周至20周的18岁至35岁的孕妇。这些妇女按1：1的比例被分配使用免费的液化石油气炉子和燃料(干预组)或继续使用生物质炉子(对照组)。出生体重是四个预先指定的主要结果之一，是本报告的主要结果；其他三个结果的数据尚未获得。出生后24小时内测量出生体重。此外，在基线和怀孕期间两次测量了24小时个人接触细颗粒物(直径为PM2.5μm[PM2.5])、黑碳和一氧化碳的情况。共有3200名女性接受了随机分组；1593名女性被分配到干预组，1607名女性被分配到对照组。干预措施的使用已接近完成，传统生物质炉灶的使用率中位数为每月不到1天。随机分组后，干预组24小时个人暴露于细颗粒物的中位数为23.9μg/立方米，对照组为70.7μg/立方米。在3061例活产儿中，干预组94.9%的产妇所生婴儿达到有效出生体重，对照组92.7%的新生儿达到有效出生体重。干预组和对照组的平均出生体重(±SD)分别为2921±474.3 g和2898±467.9 g，调整后的平均体重相差19.6g(95%可信区间，−10.1~49.2)。使用液化石油气炉灶的妇女所生婴儿的出生体重与使用生物质炉灶的妇女所生婴儿的出生体重没有显著差异。(由国家卫生研究院和比尔和梅林达·盖茨基金会资助；HAPIN ClinicalTrials.gov编号，NCT02944682。)
Exposure during pregnancy to household air pollution caused by the burning of solid biomass fuel is associated with adverse health outcomes, including low birth weight. Whether the replacement of a biomass cookstove with a liquefied petroleum gas (LPG) cookstove would result in an increase in birth weight is unclear. We performed a randomized, controlled trial involving pregnant women (18 to <35 years of age and at 9 to <20 weeks’ gestation as confirmed on ultrasonography) in Guatemala, India, Peru, and Rwanda. The women were assigned in a 1:1 ratio to use a free LPG cookstove and fuel (intervention group) or to continue using a biomass cookstove (control group). Birth weight, one of four prespecified primary outcomes, was the primary outcome for this report; data for the other three outcomes are not yet available. Birth weight was measured within 24 hours after birth. In addition, 24-hour personal exposures to fine particulate matter (particles with a diameter of ≤2.5 μm [PM2.5]), black carbon, and carbon monoxide were measured at baseline and twice during pregnancy. A total of 3200 women underwent randomization; 1593 were assigned to the intervention group, and 1607 to the control group. Uptake of the intervention was nearly complete, with traditional biomass cookstoves being used at a median rate of less than 1 day per month. After randomization, the median 24-hour personal exposure to fine particulate matter was 23.9 μg per cubic meter in the intervention group and 70.7 μg per cubic meter in the control group. Among 3061 live births, a valid birth weight was available for 94.9% of the infants born to women in the intervention group and for 92.7% of infants born to those in the control group. The mean (±SD) birth weight was 2921±474.3 g in the intervention group and 2898±467.9 g in the control group, for an adjusted mean difference of 19.6 g (95% confidence interval, −10.1 to 49.2). The birth weight of infants did not differ significantly between those born to women who used LPG cookstoves and those born to women who used biomass cookstoves. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.)