Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)

Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Per...

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Main Authors: Younger, A, Alkon, A, Harknett, K, Kirby, MA, Elon, L, Lovvorn, AE, Wang, J, Ye, W, Diaz-Artiga, A, McCracken, JP, Castañaza Gonzalez, A, Monroy Alarcon, L, Mukeshimana, A, Rosa, G, Chiang, M, Balakrishnan, K, Garg, SS, Pillarisetti, A, Piedrahita, R, Johnson, M, Craik, R, Papageorghiou, AT, Toenjes, A, Quinn, A, Williams, KN, Underhill, L, Chang, HH, Naeher, LP, Rosenthal, J, Checkley, W, Peel, JL, Clasen, TF, Thompson, LM
Other Authors: HAPIN investigators
Format: Journal article
Language:English
Published: Elsevier 2023
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author Younger, A
Alkon, A
Harknett, K
Kirby, MA
Elon, L
Lovvorn, AE
Wang, J
Ye, W
Diaz-Artiga, A
McCracken, JP
Castañaza Gonzalez, A
Monroy Alarcon, L
Mukeshimana, A
Rosa, G
Chiang, M
Balakrishnan, K
Garg, SS
Pillarisetti, A
Piedrahita, R
Johnson, M
Craik, R
Papageorghiou, AT
Toenjes, A
Quinn, A
Williams, KN
Underhill, L
Chang, HH
Naeher, LP
Rosenthal, J
Checkley, W
Peel, JL
Clasen, TF
Thompson, LM
author2 HAPIN investigators
author_facet HAPIN investigators
Younger, A
Alkon, A
Harknett, K
Kirby, MA
Elon, L
Lovvorn, AE
Wang, J
Ye, W
Diaz-Artiga, A
McCracken, JP
Castañaza Gonzalez, A
Monroy Alarcon, L
Mukeshimana, A
Rosa, G
Chiang, M
Balakrishnan, K
Garg, SS
Pillarisetti, A
Piedrahita, R
Johnson, M
Craik, R
Papageorghiou, AT
Toenjes, A
Quinn, A
Williams, KN
Underhill, L
Chang, HH
Naeher, LP
Rosenthal, J
Checkley, W
Peel, JL
Clasen, TF
Thompson, LM
author_sort Younger, A
collection OXFORD
description Household air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid cooking fuels. Pregnant women (18-34 years of age; gestation confirmed by ultrasound at 9-19 weeks) were randomly assigned to an intervention (n = 1593) or control (n = 1607) arm. Intention-to-treat analyses compared outcomes between the two arms using log-binomial models. Among the 3195 pregnant women in the study, there were 10 spontaneous abortions (7 intervention, 3 control), 93 hypertensive disorders of pregnancy (47 intervention, 46 control), 11 post postpartum hemorrhage (5 intervention, 6 control) and 4 maternal deaths (3 intervention, 1 control). Compared to the control arm, the relative risk of spontaneous abortion among women randomized to the intervention was 2.32 (95% confidence interval (CI): 0.60, 8.96), hypertensive disorders of pregnancy 1.02 (95% CI: 0.68, 1.52), postpartum hemorrhage 0.83 (95% CI: 0.25, 2.71) and 2.98 (95% CI: 0.31, 28.66) for maternal mortality. In this study, we found that adverse maternal outcomes did not differ based on randomized stove type across four country research sites.
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spelling oxford-uuid:1e1e193d-8eef-4759-84ec-1aeb65211e362023-10-05T16:57:25ZEffects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)Journal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:1e1e193d-8eef-4759-84ec-1aeb65211e36EnglishSymplectic ElementsElsevier2023Younger, AAlkon, AHarknett, KKirby, MAElon, LLovvorn, AEWang, JYe, WDiaz-Artiga, AMcCracken, JPCastañaza Gonzalez, AMonroy Alarcon, LMukeshimana, ARosa, GChiang, MBalakrishnan, KGarg, SSPillarisetti, APiedrahita, RJohnson, MCraik, RPapageorghiou, ATToenjes, AQuinn, AWilliams, KNUnderhill, LChang, HHNaeher, LPRosenthal, JCheckley, WPeel, JLClasen, TFThompson, LMHAPIN investigatorsHousehold air pollution from solid cooking fuel use during gestation has been associated with adverse pregnancy and birth outcomes. The Household Air Pollution Intervention Network (HAPIN) trial was a randomized controlled trial of free liquefied petroleum gas (LPG) stoves and fuel in Guatemala, Peru, India, and Rwanda. A primary outcome of the main trial was to report the effects of the intervention on infant birth weight. Here we evaluate the effects of a LPG stove and fuel intervention during pregnancy on spontaneous abortion, postpartum hemorrhage, hypertensive disorders of pregnancy, and maternal mortality compared to women who continued to use solid cooking fuels. Pregnant women (18-34 years of age; gestation confirmed by ultrasound at 9-19 weeks) were randomly assigned to an intervention (n = 1593) or control (n = 1607) arm. Intention-to-treat analyses compared outcomes between the two arms using log-binomial models. Among the 3195 pregnant women in the study, there were 10 spontaneous abortions (7 intervention, 3 control), 93 hypertensive disorders of pregnancy (47 intervention, 46 control), 11 post postpartum hemorrhage (5 intervention, 6 control) and 4 maternal deaths (3 intervention, 1 control). Compared to the control arm, the relative risk of spontaneous abortion among women randomized to the intervention was 2.32 (95% confidence interval (CI): 0.60, 8.96), hypertensive disorders of pregnancy 1.02 (95% CI: 0.68, 1.52), postpartum hemorrhage 0.83 (95% CI: 0.25, 2.71) and 2.98 (95% CI: 0.31, 28.66) for maternal mortality. In this study, we found that adverse maternal outcomes did not differ based on randomized stove type across four country research sites.
spellingShingle Younger, A
Alkon, A
Harknett, K
Kirby, MA
Elon, L
Lovvorn, AE
Wang, J
Ye, W
Diaz-Artiga, A
McCracken, JP
Castañaza Gonzalez, A
Monroy Alarcon, L
Mukeshimana, A
Rosa, G
Chiang, M
Balakrishnan, K
Garg, SS
Pillarisetti, A
Piedrahita, R
Johnson, M
Craik, R
Papageorghiou, AT
Toenjes, A
Quinn, A
Williams, KN
Underhill, L
Chang, HH
Naeher, LP
Rosenthal, J
Checkley, W
Peel, JL
Clasen, TF
Thompson, LM
Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title_full Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title_fullStr Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title_full_unstemmed Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title_short Effects of a LPG stove and fuel intervention on adverse maternal outcomes: a multi-country randomized controlled trial conducted by the Household Air Pollution Intervention Network (HAPIN)
title_sort effects of a lpg stove and fuel intervention on adverse maternal outcomes a multi country randomized controlled trial conducted by the household air pollution intervention network hapin
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