Background

Household air pollution (HAP) exposure has been linked to adverse pregnancy outcomes.

Objectives

A randomized controlled trial was undertaken in Ibadan, Nigeria to determine the impact of cooking with ethanol on pregnancy outcomes.

Methods

Three-hundred-twenty-four pregnant women were randomized to either the control (continued cooking using kerosene/firewood stove, n = 162) or intervention group (received ethanol stove, n = 162). Primary outcome variables were birthweight, preterm delivery, intrauterine growth restriction (IUGR), and occurrence of miscarriage/stillbirth.

Results

Mean birthweights for ethanol and controls were 3076 and 2988 g, respectively; the difference, 88 g, (95% confidence interval: − 18 g to 194 g), was not statistically significant (p = 0.10). After adjusting for covariates, the difference reached significance (p = 0.020). Rates of preterm delivery were 6.7% (ethanol) and 11.0% (control), (p = 0.22). Number of miscarriages was 1(ethanol) vs. 4 (control) and stillbirths was 3 (ethanol) vs. 7 (control) (both non-significant). Average gestational age at delivery was significantly (p = 0.015) higher in ethanol-users (39.2 weeks) compared to controls (38.2 weeks). Perinatal mortality (stillbirths and neonatal deaths) was twice as high in controls compared to ethanol-users (7.9% vs. 3.9%; p = 0.045, after adjustment for covariates). We did not detect significant differences in exposure levels between the two treatment arms, perhaps due to large seasonal effects and high ambient air pollution levels.

Conclusions

Transition from traditional biomass/kerosene fuel to ethanol reduced adverse pregnancy outcomes. However, the difference in birthweight was statistically significant only after covariate adjustment and the other significant differences were in tertiary endpoints. Our results are suggestive of a beneficial effect of ethanol use. Larger trials are required to validate these findings.

中文翻译：

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妊娠结局和乙醇炉灶干预：尼日利亚伊巴丹的一项随机对照试验^☆

背景

家庭空气污染（HAP）暴露已与不良妊娠结局联系在一起。

目标

在尼日利亚伊巴丹进行了一项随机对照试验，以确定用乙醇做饭对妊娠结局的影响。

方法

344名孕妇被随机分为对照组（使用煤油/柴火炉连续烹饪，n = 162）或干预组（接受乙醇炉，n = 162）。主要结局变量为出生体重，早产，宫内生长受限（IUGR）和流产/死胎的发生。

结果

乙醇和对照组的平均出生体重分别为3076和2988 g；差异88 g（95％置信区间：− 18 g至194 g）在统计学上不显着（p = 0.10）。调整协变量后，差异达到显着性（p = 0.020）。早产率分别为6.7％（乙醇）和11.0％（对照）（p = 0.22）。流产数为1（乙醇）对4（对照），死胎为3（乙醇）对7（对照）（均无统计学意义）。与对照组（38.2周）相比，乙醇使用者（39.2周）分娩时的平均胎龄显着高（p = 0.015）。与乙醇使用者相比，对照组的围产期死亡率（死产和新生儿死亡）是乙醇使用者的两倍（校正协变量后，分别为7.9％和3.9％； p = 0.045）。

结论

从传统的生物质/煤油燃料过渡到乙醇可减少不良妊娠结局。然而，仅在协变量调整后，出生体重的差异才具有统计学意义，而其他显着差异则在三级终点上。我们的结果表明乙醇的有益作用。需要更大的试验来验证这些发现。