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/NEJMoa2302687

摘要内容如下：

背景

家庭空气污染与婴儿发育迟缓有关。用液化石油气（LPG）代替生物质燃料（如木材、粪便或农作物废料）用于烹饪是否可以降低发育不良的风险尚不清楚。

方法

我们进行了一项随机试验，涉及四个中低收入国家的3200名18至34岁的孕妇。妊娠9周至20周以下的妇女被随机分为两组，一组使用免费的液化石油气炉灶，并连续18个月提供免费燃料（干预组），另一组继续使用生物质炉灶（对照组）。在12个月大时测量每个婴儿的身长，并从怀孕开始监测个人暴露于细小可吸入颗粒物（空气动力学直径≤2.5μm的颗粒）的情况，一直持续到婴儿1岁。当前报告中提供数据的主要结果-发育迟缓（定义为12个月大时的身高Z评分比生长标准的中位数低两个标准差以上）-是该试验的四个主要结果之一。进行意向性治疗分析以评估发育迟缓的相对风险。

结果

对干预措施的依从性很高，干预措施导致产前和产后24小时个人暴露于精细可吸入颗粒物的程度低于对照组（平均产前暴露量，35.0μg/m3对103.3μg/m3；出生后平均暴露量为37.9微克/立方米，出生后平均暴露量为109.2微克/立方米）。在3061名活产婴儿中，干预组妇女所生的1536名婴儿中有1171名（76.2%）和对照组妇女所生的1525名婴儿中有1186名（77.8%）在12个月大时进行了有效长度测量。干预组妇女所生的1171名婴儿中有321名（27.4%）发生发育迟缓，对照组妇女所生的1186名婴儿中有299名（25.2%）发生发育迟缓（相对风险为1.10；98.75%置信区间，0.94至1.29；P=0.12）。

结论

从怀孕开始、旨在通过用液化石油气替代生物质燃料做饭来减少家庭空气污染的干预战略并没有降低婴儿发育迟缓的风险。（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  Household air pollution is associated with stunted growth in infants. Whether the replacement of biomass fuel (e.g., wood, dung, or agricultural crop waste) with liquefied petroleum gas (LPG) for cooking can reduce the risk of stunting is unknown.

METHODS  We conducted a randomized trial involving 3200 pregnant women 18 to 34 years of age in four low- and middle-income countries. Women at 9 to less than 20 weeks' gestation were randomly assigned to use a free LPG cookstove with continuous free fuel delivery for 18 months (intervention group) or to continue using a biomass cookstove (control group). The length of each infant was measured at 12 months of age, and personal exposures to fine particulate matter (particles with an aerodynamic diameter of ≤2.5 μm) were monitored starting at pregnancy and continuing until the infants were 1 year of age. The primary outcome for which data are presented in the current report - stunting (defined as a length-for-age z score that was more than two standard deviations below the median of a growth standard) at 12 months of age - was one of four primary outcomes of the trial. Intention-to-treat analyses were performed to estimate the relative risk of stunting.

RESULTS  Adherence to the intervention was high, and the intervention resulted in lower prenatal and postnatal 24-hour personal exposures to fine particulate matter than the control (mean prenatal exposure, 35.0 μg per cubic meter vs. 103.3 μg per cubic meter; mean postnatal exposure, 37.9 μg per cubic meter vs. 109.2 μg per cubic meter). Among 3061 live births, 1171 (76.2%) of the 1536 infants born to women in the intervention group and 1186 (77.8%) of the 1525 infants born to women in the control group had a valid length measurement at 12 months of age. Stunting occurred in 321 of the 1171 infants included in the analysis (27.4%) of the infants born to women in the intervention group and in 299 of the 1186 infants included in the analysis (25.2%) of those born to women in the control group (relative risk, 1.10; 98.75% confidence interval, 0.94 to 1.29; P = 0.12).

CONCLUSIONS  An intervention strategy starting in pregnancy and aimed at mitigating household air pollution by replacing biomass fuel with LPG for cooking did not reduce the risk of stunting in infants. (Funded by the National Institutes of Health and the Bill and Melinda Gates Foundation; HAPIN ClinicalTrials.gov number, NCT02944682.).

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