Introduction
premature deaths, death
HYPERTENSIVE DISORDER, SPONTANEOUS ABORTION
Approximately 2.3 million premature deaths and 91.5 million disability-adjusted life years (DALYs) were attributed to household air pollution globally annually (Several studies have linked household air pollution exposure with adverse birth outcomes like low birth weight, stillbirth, and neonatal death, though evidence on maternal health outcomes has been mixed (The Household Air Pollution Intervention Network (HAPIN) Trial was a randomized controlled trial (RCT) of a LPG stove intervention with continuous, free fuel distribution and behavioral reinforcement to encourage LPG use in intervention homes across four countries: Guatemala, India, Peru and Rwanda. The overall objective of the HAPIN trial was to investigate the effect of a randomized LPG stove and fuel intervention on health outcomes in four diverse LMIC populations, determine the exposure–response relationships and measure targeted and exploratory biomarkers of exposure on health effects (The objective of this study is to investigate whether adverse maternal outcomes (spontaneous abortion, hypertensive disorders of pregnancy, postpartum hemorrhage and maternal mortality) differ based on study arm across four country sites within the HAPIN trial. Given that the LPG intervention reduced personal exposures to household air pollution during pregnancy on average, we hypothesize that it would also reduce the incidence of adverse maternal outcomes compared to women in the control arm who continued to cook with solid fuels during pregnancy.