You are here:
Five domains of environmental quality and birth outcomes
Citation:
Rapazzo, K., L. C. Messer, J. S. JAGAI, AND D. T. LOBDELL. Five domains of environmental quality and birth outcomes. Presented at Society for Prenatal/Perinatal Epidemiology Research (SPER) Annual Meeting, Minneapolis, MN, June 25 - 27, 2012.
Impact/Purpose:
we constructed a county-level Environmental Quality Index (EQI) with data representing five environmental domains (air, water, land, built and sociodemographic) for health research.
Description:
Human health is affected by simultaneous exposure to stressors and amenities, but research employs single exposure models. To address this, we constructed a county-level Environmental Quality Index (EQI) with data representing five environmental domains (air, water, land, built and sociodemographic) for health research. We report on associations between domain-specific and overall indices and singleton births to primiparous mothers in the United States using data from the National Center for Health Statistics (2002; n=1,551,244). We performed racecombined and -stratified fixed slope, random intercept multilevel logistic models, adjusted for maternal age, education, marital status, and infant sex, to assess relationships between countylevel environmental quality and domain-specific indices with birth outcomes, including preterm birth (PTB; less than 37 weeks gestation) and low birth weight (LBW; birth weight below 2500 grams). We calculated odds ratios (OR) and 95%) confidence intervals (95%CI) comparing residence in a county with poor environmental quality (4th quartile) to the best quality (1st quartile). The air and built environment domains were positively associated with both PTB (OR(95°.loCI) air: 1.002(0.950, 1.057); built: 1.037(0.994, 1.081» and LBW. While the overall EQI and other domains were inversely associated (e.q., PTB: EQI 0.931(0.890, 0.969); sociodemographic 0.892(0.858,0.927». We combined data for multiple environmental domains to construct one index representing overall county-level environmental conditions; the EQI quantifies the environmental burden counties face and domain specific indices provide policy makers and planners with information regarding primary stressors in the area. Domain-specific models showed mixed associations with birth outcomes.