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Associations between Cumulative Environmental Quality and Oral Cleft Birth Defects
Citation:
Krajewski, A., K. Rappazzo, P. Langlois, L. Messer, AND D. Lobdell. Associations between Cumulative Environmental Quality and Oral Cleft Birth Defects. SPER/SER, Minneapolis, Minnesota, June 17 - 21, 2019.
Impact/Purpose:
This study utilizes the EPA created Environmental Quality Index to assess the impact of poor overall environmental quality on oral cleft birth defects in the state of Texas.
Description:
The etiology of most birth defects are unknown. While genetics, maternal factors (age, smoking) and environmental exposures have all been linked to birth defects such as oral cleft (OC), cleft palate (CP), and cleft lip with and without cleft palate (CL ± CP), cumulative environmental quality (EQ) may also contribute to these associations. The Environmental Quality Index (EQI), a county-level measure of cumulative environmental exposure from 2000-2005, was used to explore potential associations with Texas Birth Defects Registry and birth records for OC, CP, and CL ± CP births between 2000 through 2006 among Texas counties. Poisson regression models estimated the prevalence ratio (PR) and 95% CI for associations between increasing percentile (%) categories (75%) of overall and domain-specific EQI (air, water, land, sociodemographic (SD), built) and OC, CP, and CL ± CP defects, adjusted for potential confounders. Comparing highest % category (worst EQ) to lowest % category (better EQ) for overall EQI, the PRs were 1.01 (95% CI: 0.93,1.10) for OC, 1.04 (0.96,1.14) for CP, and 0.99 (0.91,1.08) for CL ± CP. In domain specific analyses, the strongest associations for all three defects were seen with the SD domain. The PRs for OC were 1.74 (1.32, 2.26) and 1.35 (1.22,1.50) for mid EQ and better EQ compared to the worst EQ. The PRs for CP were 1.45 (1.08,1.90) and 1.18 (1.05,1.32) for mid EQ and better EQ compared to the worst EQ. The PRs for CL ± CP were 1.87 (1.43, 2.41) and 1.42 (1.28,1.57) for mid EQ and better EQ compared to the worst EQ. The results suggest that SD factors may contribute to the associations between OC, CP, and CL ± CP birth defects, as observed in the SD domain. This abstract does not reflect EPA policy.