Donee Alexander1, Amanda Northcross2, Nathaniel Wilson3, Anindita Dutta1,4, Rishi Pandya5, Tope Ibigbami6, Damilola Adu6, John Olamijulo6, Oludare Morhason-Bello7, Theodore Karrison8, Oladosu Ojengbede7, Christopher O Olopade1,4. 1. 1 Center for Global Health. 2. 2 Department of Environmental and Occupational Health, Milken Institute School of Public Health, The George Washington University, Washington, District of Columbia. 3. 3 Pritzker School of Medicine. 4. 4 Department of Medicine, and. 5. 5 Bellevue Hospital Center, New York, New York. 6. 6 Healthy Life for All Foundation, Ibadan, Nigeria; and. 7. 7 Department of Obstetrics and Gynecology, University of Ibadan, Ibadan, Nigeria. 8. 8 Department of Public Health Sciences, University of Chicago, Chicago, Illinois.
Abstract
RATIONALE: Hypertension during pregnancy is a leading cause of maternal mortality. Exposure to household air pollution elevates blood pressure (BP). OBJECTIVES: To investigate the ability of a clean cookstove intervention to lower BP during pregnancy. METHODS: We conducted a randomized controlled trial in Nigeria. Pregnant women cooking with kerosene or firewood were randomly assigned to an ethanol arm (n = 162) or a control arm (n = 162). BP measurements were taken during six antenatal visits. In the primary analysis, we compared ethanolusers with control subjects. In subgroup analyses, we compared baseline kerosene users assigned to the intervention with kerosene control subjects and compared baseline firewood users assigned to ethanol with firewood control subjects. MEASUREMENTS AND MAIN RESULTS: The change in diastolic blood pressure (DBP) over time was significantly different between ethanolusers and control subjects (P = 0.040); systolic blood pressure (SBP) did not differ (P = 0.86). In subgroup analyses, there was no significant intervention effect for SBP; a significant difference for DBP (P = 0.031) existed among preintervention kerosene users. At the last visit, mean DBP was 2.8 mm Hg higher in control subjects than in ethanol users (3.6 mm Hg greater in control subjects than in ethanol users among preintervention kerosene users), and 6.4% of control subjects were hypertensive (SBP≥140and/or DBP ≥90 mm Hg) versus 1.9% of ethanol users (P = 0.051). Among preintervention kerosene users, 8.8% of control subjects were hypertensive compared with 1.8% of ethanol users (P = 0.029). CONCLUSIONS: To our knowledge, this is the first cookstove randomized controlled trial examining prenatal BP. Ethanol cookstoves have potential to reduce DBP and hypertension during pregnancy. Accordingly, clean cooking fuels may reduce adverse health impacts associated with household air pollution. Clinical trial registered with www.clinicaltrials.gov (NCT02394574).
RCT Entities:
RATIONALE: Hypertension during pregnancy is a leading cause of maternal mortality. Exposure to household air pollution elevates blood pressure (BP). OBJECTIVES: To investigate the ability of a clean cookstove intervention to lower BP during pregnancy. METHODS: We conducted a randomized controlled trial in Nigeria. Pregnant women cooking with kerosene or firewood were randomly assigned to an ethanol arm (n = 162) or a control arm (n = 162). BP measurements were taken during six antenatal visits. In the primary analysis, we compared ethanol users with control subjects. In subgroup analyses, we compared baseline kerosene users assigned to the intervention with kerosene control subjects and compared baseline firewood users assigned to ethanol with firewood control subjects. MEASUREMENTS AND MAIN RESULTS: The change in diastolic blood pressure (DBP) over time was significantly different between ethanol users and control subjects (P = 0.040); systolic blood pressure (SBP) did not differ (P = 0.86). In subgroup analyses, there was no significant intervention effect for SBP; a significant difference for DBP (P = 0.031) existed among preintervention kerosene users. At the last visit, mean DBP was 2.8 mm Hg higher in control subjects than in ethanol users (3.6 mm Hg greater in control subjects than in ethanol users among preintervention kerosene users), and 6.4% of control subjects were hypertensive (SBP ≥140 and/or DBP ≥90 mm Hg) versus 1.9% of ethanol users (P = 0.051). Among preintervention kerosene users, 8.8% of control subjects were hypertensive compared with 1.8% of ethanol users (P = 0.029). CONCLUSIONS: To our knowledge, this is the first cookstove randomized controlled trial examining prenatal BP. Ethanol cookstoves have potential to reduce DBP and hypertension during pregnancy. Accordingly, clean cooking fuels may reduce adverse health impacts associated with household air pollution. Clinical trial registered with www.clinicaltrials.gov (NCT02394574).
Authors: Anubha Agarwal; Kipruto Kirwa; Melissa N Eliot; Fawaz Alenezi; Diana Menya; Sumeet S Mitter; Eric J Velazquez; Rajesh Vedanthan; Gregory A Wellenius; Gerald S Bloomfield Journal: Am J Respir Crit Care Med Date: 2018-04-01 Impact factor: 21.405
Authors: Kyle Steenland; Ajay Pillarisetti; Miles Kirby; Jennifer Peel; Maggie Clark; Will Checkley; Howard H Chang; Thomas Clasen Journal: Environ Int Date: 2017-11-26 Impact factor: 9.621
Authors: Dean E Schraufnagel; John R Balmes; Clayton T Cowl; Sara De Matteis; Soon-Hee Jung; Kevin Mortimer; Rogelio Perez-Padilla; Mary B Rice; Horacio Riojas-Rodriguez; Akshay Sood; George D Thurston; Teresa To; Anessa Vanker; Donald J Wuebbles Journal: Chest Date: 2018-11-09 Impact factor: 9.410
Authors: Kristen M Fedak; Nicholas Good; Jordyn Dahlke; Arsineh Hecobian; Amy Sullivan; Yong Zhou; Jennifer L Peel; John Volckens Journal: Environ Sci Technol Date: 2018-08-06 Impact factor: 9.028
Authors: Raphael E Arku; Michael Brauer; MyLinh Duong; Li Wei; Bo Hu; Lap Ah Tse; Prem K Mony; P V M Lakshmi; Rajamohanan K Pillai; Viswanathan Mohan; Karen Yeates; Lanthe Kruger; Sumathy Rangarajan; Teo Koon; Salim Yusuf; Perry Hystad Journal: Environ Res Date: 2020-06-27 Impact factor: 6.498
Authors: Matthew Shupler; Perry Hystad; Paul Gustafson; Sumathy Rangarajan; Maha Mushtaha; K G Jayachtria; Prem K Mony; Deepa Mohan; Parthiban Kumar; Pvm Lakshmi; Vivek Sagar; Rajeev Gupta; Indu Mohan; Sanjeev Nair; Ravi Prasad Varma; Wei Li; Bo Hu; Kai You; Tatenda Ncube; Brian Ncube; Jephat Chifamba; Nicola West; Karen Yeates; Romaina Iqbal; Rehman Khawaja; Rita Yusuf; Afreen Khan; Pamela Seron; Fernando Lanas; Patricio Lopez-Jaramillo; Paul A Camacho; Thandi Puoane; Salim Yusuf; Michael Brauer Journal: Environ Res Lett Date: 2019-07-29 Impact factor: 6.793