本文由小咖机器人翻译整理

期刊来源：N Engl J Med

原文链接：https://doi.org/10.1056/NEJMoa2305681

摘要内容如下：

背景

暴露于家庭空气污染是重症肺炎的危险因素。用液化石油气（LPG）炉灶取代生物质炉灶对婴儿重症肺炎发病率的影响尚不确定。

方法

2018年5月至2021年9月，我们在印度、危地马拉、秘鲁和卢旺达开展了一项随机对照试验，研究对象为年龄在18至34岁之间、妊娠9周至20周以下的孕妇。这些妇女被分配使用无排气口的液化石油气炉灶和燃料（干预组）或继续使用生物质燃料（对照组）。在每个试验组中，我们监测了坚持使用指定炉灶的情况，并测量了妇女及其后代24小时暴露于细可吸入颗粒物（空气动力学直径≤2.5μm[PM2.5]的颗粒）的情况。该试验有四个主要结果；当前报告中提供的数据的主要结果是出生后第一年的严重肺炎，这是通过设施监测或口头尸检确定的。

结果

在3200名接受随机分组的孕妇中，3195名仍符合条件，并生下3061名婴儿（干预组1536名，对照组1525名）。干预措施的高摄取量导致儿童个人PM2.5暴露量减少，干预组暴露量中位数为24.2μg/m3（四分位间距为17.8~36.4），对照组暴露量中位数为66.0μg/m3（四分位间距为35.2~132.0）。在婴儿出生后的第一年内，共确定了175例重症肺炎发作，干预组的发病率为5.67例/100儿童-年（95%可信区间[CI]，4.55-7.07），对照组的发病率为6.06例/100儿童-年（95%可信区间[CI]，4.81-7.62）（发病率比，0.96；98.75%CI为0.64~1.44；P=0.81）。据试验研究人员确定，未报告与干预相关的严重不良事件。

结论

母亲被分配使用液化石油气炉灶和燃料做饭的婴儿与母亲被分配继续使用生物质炉灶做饭的婴儿之间，婴儿重症肺炎的发病率没有显著差异。（由美国国立卫生研究院（NIH）和比尔和梅琳达·盖茨基金会（Bill and Melinda Gates Foundation）资助；Hapin ClinicalTrials.gov，NCT02944682）。

英文原文如下：

Abstracts

BACKGROUND  Exposure to household air pollution is a risk factor for severe pneumonia. The effect of replacing biomass cookstoves with liquefied petroleum gas (LPG) cookstoves on the incidence of severe infant pneumonia is uncertain.

METHODS  We conducted a randomized, controlled trial involving pregnant women 18 to 34 years of age and between 9 to less than 20 weeks' gestation in India, Guatemala, Peru, and Rwanda from May 2018 through September 2021. The women were assigned to cook with unvented LPG stoves and fuel (intervention group) or to continue cooking with biomass fuel (control group). In each trial group, we monitored adherence to the use of the assigned cookstove and measured 24-hour personal exposure to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 μm [PM2.5]) in the women and their offspring. The trial had four primary outcomes; the primary outcome for which data are presented in the current report was severe pneumonia in the first year of life, as identified through facility surveillance or on verbal autopsy.

RESULTS  Among 3200 pregnant women who had undergone randomization, 3195 remained eligible and gave birth to 3061 infants (1536 in the intervention group and 1525 in the control group). High uptake of the intervention led to a reduction in personal exposure to PM2.5 among the children, with a median exposure of 24.2 μg per cubic meter (interquartile range, 17.8 to 36.4) in the intervention group and 66.0 μg per cubic meter (interquartile range, 35.2 to 132.0) in the control group. A total of 175 episodes of severe pneumonia were identified during the first year of life, with an incidence of 5.67 cases per 100 child-years (95% confidence interval [CI], 4.55 to 7.07) in the intervention group and 6.06 cases per 100 child-years (95% CI, 4.81 to 7.62) in the control group (incidence rate ratio, 0.96; 98.75% CI, 0.64 to 1.44; P = 0.81). No severe adverse events were reported to be associated with the intervention, as determined by the trial investigators.

CONCLUSIONS  The incidence of severe pneumonia among infants did not differ significantly between those whose mothers were assigned to cook with LPG stoves and fuel and those whose mothers were assigned to continue cooking with biomass stoves. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).

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