(P10-097-24) Effect of a Liquified Petroleum Gas Cookstove and Fuel Intervention on Linear Growth Trajectories Between Birth and 12 Months: Evidence From the Multi-center HAPIN Trial

Objectives: Few intervention studies have examined child linear growth across multiple global regions. We examined the effect of a clean cookstove intervention on linear growth trajectories among infants born to enrolled women and explored factors associated with the trajectories.

Methods: Pregnant women from rural regions of Guatemala, Peru, India, and Rwanda were enrolled in the Household Air Pollution Intervention Network. Women in the intervention group received a liquefied petroleum gas (LPG) cookstove and fuel for eighteen months, while those in the control group continued to use biomass for cooking. Recumbent length was measured at birth and then every three months through twelve months of age. We calculated length-for-age z-score (LAZ) among the 2802 infants who had ≥3 length measurements across the five timepoints and used a multiple group latent class growth analysis to examine if linear growth trajectory classes differed by intervention arm. We also examined linear growth trajectories by child sex within each country site and by timing of intervention delivery within the pooled sample, based on prior evidence of relationships between cleaner cooking interventions and these variables.

Results: We identified three latent classes of linear growth, based on visual inspection of mean LAZ and model fit statistics, that represent higher, medium, and lower LAZ trajectories in the intention-to-treat analysis. The percentages of infants in each latent class were not significantly different between intervention (higher: 12.3% of infants, medium: 27.3%, lower: 10.8%) and control (higher: 10.6%, medium: 27.9%, lower: 12.1%) arms (p=1.000). We observed significant differences in class membership by child sex in the Guatemala site (p < 0.0001), with boys having lower mean LAZ in all trajectory groups and at all timepoints compared to girls. However, there were no significant differences in mean LAZ between infants whose mothers received the intervention later (≥ 18 weeks gestation) compared to infants whose mothers received the intervention < 18 weeks gestation.

Conclusions: An LPG cookstove and fuel intervention during pregnancy and infancy did not significantly impact linear growth trajectories.

Funding Sources: U.S. National Institutes of Health and the Bill & Melinda Gates Foundation