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Study improves understanding of the effects of household air pollution during pregnancy




Study improves understanding of the effects of household air pollution during pregnancy

Violin plots for head circumference (A), abdominal circumference (B), thigh length (C) and estimated fetal weight or birth weight (D) by gestational age category and intervention group. Violin plots are hybrids of box plots and density plots, and are used here to visualize the distribution of fetal growth outcomes. The thick band represents the 50th percentile and the thinner bands represent the 25th and 75th percentiles. Credit: The Lancet Global Health (2024). DOI: 10.1016/S2214-109X(24)00033-0

In a new study, researchers from Oxford’s Nuffield Department of Women’s & Reproductive Health have found that pregnant mothers’ exposure to air pollution from indoor heaters did not affect their babies’ development in any statistically significant way, challenging conventional wisdom about the impact of household chores in casts doubt. air pollution on fetal growth.

The study, published in The Lancet Global Healthwas conducted among 3,200 households in poor environments in Guatemala, India, Rwanda and Peru, and aimed to assess the effects of reducing personal exposure to household air pollution on fetal growth in a randomized controlled trial.

Incomplete combustion of biomass fuels such as wood, crop waste and animal manure, which are used for cooking in 36% of households worldwide, results in household air pollution. Household air pollution is estimated to be responsible for 2.3 million premature deaths and 91.5 million disability-adjusted life years annually. Women, often the main cooks at home, are the hardest hit by exposure to air pollution in households.

To assess the impact of air pollution reduction on fetal growth, half of pregnant women were assigned the use of LPG heaters, which resulted in a significant 66% reduction in particulate matter exposure, while the remaining half continued treatment. using the usual biomass fuels for cooking. Unlike previous studies that relied solely on birth weight, this study used ultrasound to track fetal growth, providing a more nuanced understanding of the impact of air pollution on prenatal development.

However, despite this substantial reduction in exposure, researchers found no clinically meaningful differences in fetal growth between the intervention group and those who continued to use biomass fuels. These results are consistent with previous findings from the same group regarding the impact of air pollution on birth weight.

The lead author, Professor William Checkley of Johns Hopkins University, commented: “While our study underlines the importance of reducing household air pollution, our findings challenge the widely held belief that such pollution significantly affects fetal growth.”

“Our findings suggest that the association between household air pollution and poor fetal growth may be less pronounced than previously thought. Our findings do not support the use of unvented liquefied petroleum gas stoves and fuel delivery interventions as a strategy to reduce poor fetal growth in resources.” -restricted settings.”

Study author Professor Aris Papageorghiou from the University of Oxford added: “In this study we carried out a detailed assessment of fetal growth during pregnancy in 3,200 pregnant women in Peru, Rwanda, Guatemala and India. The intervention was largely successful in reducing air pollution exposures, yet we did not find any benefit in fetal growth trajectories, including estimated fetal weight via birth weight.”

“This suggests that the field requires a reconsideration of intervention strategies that will both reduce household air pollution and improve fetal outcomes, but a strategy based on LPG stove and free fuel is not clear enough.”

The researchers acknowledged the limitations of the study and highlighted the possibility that interventions to reduce household air pollution exposure may need to occur earlier in pregnancy or even before conception. Furthermore, despite the significant reduction in exposure achieved by the intervention group, average prenatal exposure still exceeded recommended air quality guidelines by three times.

More information:
William Checkley et al., Cooking with liquefied petroleum gas or biomass and fetal growth outcomes: a multi-country randomized controlled trial, The Lancet Global Health (2024). DOI: 10.1016/S2214-109X(24)00033-0

Provided by the University of Oxford

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