Effects of cooking with liquefied petroleum gas versus biomass on hemoglobin concentrations in pregnant women: a pre-specified exploratory analysis of the HAPIN trial
Abstract
Abstract Evidence linking household air pollution exposure and blood hemoglobin concentration is lacking. We examine the effect of a liquefied petroleum gas cookstove and fuel intervention on hemoglobin concentration, along with associations between household air pollution exposures and hemoglobin concentration, among pregnant women. We enroll 800 pregnant women each in Guatemala, Peru, India, and Rwanda in an open-label randomized controlled trial (NCT02944682). In 3178 women (intervention=1585; control=1593), we measure hemoglobin concentration and 24-hour personal exposure to particulate matter with an aerodynamic diameter ≤2.5μm (PM 2.5 ), black carbon (BC), and carbon monoxide (CO) at three timepoints (9-20, 24-28, and 32-36 weeks gestation). We evaluate the effects of the intervention on hemoglobin concentration and conduct exposure-response analyses to examine associations between 24-hour personal exposure to measured pollutants and hemoglobin concentration. We identify a significant increase in hemoglobin in the intervention group (0.074 g/dL, 95% CI: 0.002, 0.145) compared to the control group. In exposure-response analyses, each 1ppm increase in CO exposure is associated with a 0.015 g/dL (95% CI: 0.008, 0.023) increase in hemoglobin. In our analyses, neither PM 2.5 nor BC are associated with hemoglobin concentration. Further research may be needed to examine the biological mechanisms underlying our findings.
Article Details
Authors (104)
Sheela S. Sinharoy
Wenlu Ye
Ajay Pillarisetti
Sant-Rayn Pasricha
Lisa M. Thompson
Anaite Diaz-Artiga
Usha Ramakrishnan
Ghislaine Rosa
Maggie L. Clark
Vigneswari Aravindalochanan
Kyle Steenland
Shirin Jabbarzadeh
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta
Lindsay J. Underhill
Miles A. Kirby
Amy E. Lovvorn
William Checkley
Jennifer L. Peel
Thomas F. Clasen
Kirk R. Smith
Eduardo Canuz
Adly Castañaza
Carmen Lucia Contreras
Oscar De León
Irma Sayury Pineda Fuentes
Mayari Hengstermann
John P. McCracken
Erick Mollinedo
Libny Monroy
Alexander Ramirez
Elisa Puzzolo
Sarah Rajkumar
Bonnie N. Young
Dana Boyd Barr
Priya D’Souza
Savannah Gupton
Ian Hennessee
Grace Lee
Jiawen Liao
Julia N. McPeek
Parinya Panuwet
P. Barry Ryan
Kalpana Balakrishnan
Sarada Satyamoorthy Garg
Krishnendu Mukhopadhyay
Durairaj Natesan
Naveen Puttaswamy
Karthikeyan Dharmapuri Rajamani
Rengaraj Ramasami
Sudhakar Saidam
Sankar Sambandam
Saritha Sendhil
Gurusamy Thangavel
Howard H. Chang
Yunyun Chen
Lisa Elon
Marjorie Howard
Azhar Nizam
Amit Verma
Lance A. Waller
Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta
Jiantong Wang
Megan Warnock
Victor G. Dávila-Román
Lisa de las Fuentes
Washington University in St. Louis, St. Louis, MO, USA.
Patricia M. Lenzen
Rachel Meyers
Ashley K. Toenjes
Dina Goodman-Palmer
Phabiola M. Herrera
Shakir Hossen
Laura Nicolaou
Kendra N. Williams
Gloriose Bankundiye
Ephrem Dusabimana
Jane Mbabazi
Alexie Mukeshimana
Moses Mutabazi
Bernard Mutariyani
Florien Ndagijimana
Adolphe Ndikubwimana
Jean de Dieu Ntivuguruzwa
Vanessa Burrowes
Steven A. Harvey
Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Wauwatosa
Eric D. McCollum
Lawrence H. Moulton
Alejandra Bussalleu
Marilú Chiang
Juan Gabriel Espinoza
Stella M. Hartinger
J. Jaime Miranda
Devan Campbell
Katherine Kearns
Jacob Kremer
Luke P. Naeher
Damien Swearing
Rachel Craik
Aris T. Papageorghiou
Ashley Younger
Ahana Ghosh
Michael A. Johnson
Ricardo Piedrahita
Sarah Hamid
Joshua Rosenthal
Suzanne Simkovich
Viviane Valdes