A Randomized Air Filter Intervention Study of Air Pollution and Fetal Growth in a Highly Polluted Community

Conditions

Fetal Growth Restriction

Keywords

Air pollution, Particulate matter, Mongolia, Pregnancy, Intrauterine growth restriction (IUGR), Fetal growth, Birth weight, Gestational age, Obesity, IQ, Autism, Wheeze

Brief summary

The purpose of this study is to use an air filter intervention to evaluate the relationship between particulate matter air pollution exposure during pregnancy and fetal growth. We hypothesize that: 1) portable high efficiency air (HEPA) filters will produce major reductions in home indoor concentrations of particulate matter and 2) pregnant women whose exposures to particulate matter are reduced by this intervention will give birth to children with greater mean body weight for gestational age. In an extended follow-up of this cohort, we aim to evaluate the relationship between use of portable air purifiers during pregnancy and the growth and development of children from birth to age four years. In particular, the follow-up study will focus on children's physical growth, respiratory symptoms, and behavioral, social and neurocognitive development.

Enkhbat U, Gombojav E, Banzrai C, Batsukh S, Boldbaatar B, Enkhtuya E, Bellinger DC, Lanphear BP, McCandless LC, Allen RW.

2022-07-257 citations

10.1016/j.envint.2022.107432

Portable HEPA filter air cleaner use during pregnancy and children's behavior problem scores: a secondary analysis of the UGAAR randomized controlled trial.

Enkhbat U, Gombojav E, Banzrai C, Batsukh S, Boldbaatar B, Enkhtuya E, Ochir C, Bellinger DC, Lanphear BP, McCandless LC, Allen RW.

2021-07-057 citations

10.1186/s12940-021-00763-6

The effect of portable HEPA filter air cleaner use during pregnancy on fetal growth: The UGAAR randomized controlled trial.

Barn P, Gombojav E, Ochir C, Boldbaatar B, Beejin B, Naidan G, Galsuren J, Legtseg B, Byambaa T, Hutcheon JA, Janes C, Janssen PA, Lanphear BP, McCandless LC, Takaro TK, Venners SA, Webster GM, Allen RW.

2018-09-1032 citations

10.1016/j.envint.2018.08.036

Interventions

DEVICEHEPA Filter

Study design

Allocation

RANDOMIZED

Intervention model

PARALLEL

Primary purpose

PREVENTION

Masking

SINGLE (Outcomes Assessor)

Eligibility

Sex/Gender

FEMALE

Age

18 Years to No maximum

Healthy volunteers

Yes

Inclusion criteria

* Adult (\>18 years) * Pregnant woman in first trimester (\<14 weeks) * Single gestation pregnancy * Non-smoker

Exclusion criteria

* Multiple-gestation pregnancy * Current smoker * Currently operating an air filter in the home * Currently living in a ger (traditional Mongolian felt-lined yurt) * Plan to give birth outside of a hospital or clinic in Ulaanbaatar

Design outcomes

Primary

Measure	Time frame	Description
Child social development	Age 4 years	Social Responsiveness Scale, Second Edition (SRS-2) scores
Child wheeze	Annually from birth to age 4 years	Parent-reported wheeze (ever/never and phenotypes)
Child behavioural development	Age 2 years	Sub-scales and composite scores from the Behavior Assessment System for Children, Third Edition (BASC-3)
Child neurocognitive development	Age 4 years	Sub-scales and index scores from the Wechsler Preschool and Primary Scale of Intelligence, Fourth Edition (WPPSI-IV)
Gestational-age adjusted birthweight	At birth	—
Birthweight	At birth	—
Gestational age	At birth	—
Head circumference	At birth	—
Small for gestational age	At birth	\<10%ile of birth weight for gestational age
Birth length	At birth	Birth length
Child body mass index	Age 2 years	BMI = weight(kg)/height(m)\^2

Secondary

Measure	Time frame	Description
C-reactive protein	At approximately 10 and 30 weeks gestation	—
Stratified Analyses	Various	For all variables, we will explore effect modification by maternal exposure to environmental tobacco smoke, fraction of time spent at home, sex of the baby, season of birth, gestational age at birth, and the fraction of time that the HEPA filter(s) were used.
Blood pressure	At approximately 10, 11, 30 and 31 weeks gestation	—

Countries

Mongolia

Outcome results

None listed