Environmental pollution and social factors as contributors to preterm birth in Fresno County - PubMed (original) (raw)

Environmental pollution and social factors as contributors to preterm birth in Fresno County

Amy M Padula et al. Environ Health. 2018.

Abstract

Background: Environmental pollution exposure during pregnancy has been identified as a risk factor for preterm birth. Most studies have evaluated exposures individually and in limited study populations.

Methods: We examined the associations between several environmental exposures, both individually and cumulatively, and risk of preterm birth in Fresno County, California. We also evaluated early (< 34 weeks) and spontaneous preterm birth. We used the Communities Environmental Health Screening Tool and linked hospital discharge records by census tract from 2009 to 2012. The environmental factors included air pollution, drinking water contaminants, pesticides, hazardous waste, traffic exposure and others. Social factors, including area-level socioeconomic status (SES) and race/ethnicity were also evaluated as potential modifiers of the relationship between pollution and preterm birth.

Results: In our study of 53,843 births, risk of preterm birth was associated with higher exposure to cumulative pollution scores and drinking water contaminants. Risk of preterm birth was twice as likely for those exposed to high versus low levels of pollution. An exposure-response relationship was observed across the quintiles of the pollution burden score. The associations were stronger among early preterm births in areas of low SES.

Conclusions: In Fresno County, we found multiple pollution exposures associated with increased risk for preterm birth, with higher associations among the most disadvantaged. This supports other evidence finding environmental exposures are important risk factors for preterm birth, and furthermore the burden is higher in areas of low SES. This data supports efforts to reduce the environmental burden on pregnant women.

Keywords: Environmental exposure; Pollution; Prematurity; Preterm birth; Social factors.

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Conflict of interest statement

Methods and protocols for the study were approved by the Committee for the Protection of Human Subjects within the Health and Human Services Agency of the State of California.

Not applicable

Competing interests

The authors declare that they have no competing interests.

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Figures

Fig. 1

Fig. 1

Components of the CalEnviroScreen 2.0

Fig. 2

Fig. 2

Flow Chart of Our Study Population of Births in Fresno County, California

References

    1. McCormick MC, Litt JS, Smith VC, Zupancic JA. Prematurity: an overview and public health implications. Annu Rev Public Health. 2011;32:367–379. doi: 10.1146/annurev-publhealth-090810-182459. -DOI -PubMed
    1. Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med. 2005;352(1):9–19. doi: 10.1056/NEJMoa041367. -DOI -PubMed
    1. Anderson P, Doyle LW, Group VICS Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289(24):3264–3272. doi: 10.1001/jama.289.24.3264. -DOI -PubMed
    1. Hamilton B, Martin J, Osterman M, et al. Births: final data for 2014. National vital statistics reports. Hyattsville: National Center for Health Statistics; 2015. -PubMed
    1. Behrman R, Butler A. Institute of Medicine (US). Committee on understanding premature birth and assuring healthy outcomes. Preterm birth: causes, consequences, and prevention. Washington, DC: National Academies Press; 2007. -PubMed

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