• A cluster randomized controlled trial was conducted over 15 months in rural Bangladesh, involving 1267 pregnant women.

• 639 participants were randomized into the control group and continued using traditional cookstoves, whereas 628 participants were allotted to the intervention group and were provided with a low-cost kitchen with improved cookstoves.

• The study aimed to assess the impact of a low-smoke environment during pregnancy on birth outcomes.

• The low-cost model kitchen featured the following to reduce biomass fuel exposure during pregnancy:

1. A concrete pillar

2. A cement concrete floor

3. A single door with three windows

4. A wooden roof frame with ample ventilation

• This intervention was initiated during the first trimester, and the follow-up was until 42 days postpartum.

• The results furnished are:

1. The prevalence of LBW among neonates and maternal blood carbon monoxide saturation (SpCO) were assessed.

2. The risk of LBW was reduced by 37% (adjusted risk ratio:0.63) in the group with a better cooking environment as compared to the group with traditional cookstoves.

3. The maternal SPCO levels were significantly reduced between the second and third trimesters in the intervention group.

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