The associations between environmental quality and preterm birth in the United States, 2000-2005: a cross-sectional analysis.

Published

Journal Article

Many environmental factors have been independently associated with preterm birth (PTB). However, exposure is not isolated to a single environmental factor, but rather to many positive and negative factors that co-occur. The environmental quality index (EQI), a measure of cumulative environmental exposure across all US counties from 2000-2005, was used to investigate associations between ambient environment and PTB.With 2000-2005 birth data from the National Center for Health Statistics for the United States (n = 24,483,348), we estimated the association between increasing quintiles of the EQI and county-level and individual-level PTB; we also considered environmental domain-specific (air, water, land, sociodemographic and built environment) and urban-rural stratifications.Effect estimates for the relationship between environmental quality and PTB varied by domain and by urban-rural strata but were consistent across county- and individual-level analyses. The county-level prevalence difference (PD (95% confidence interval) for the non-stratified EQI comparing the highest quintile (poorest environmental quality) to the lowest quintile (best environmental quality) was -0.0166 (-0.0198, -0.0134). The air and sociodemographic domains had the strongest associations with PTB; PDs were 0.0196 (0.0162, 0.0229) and -0.0262 (-0.0300, -0.0224) for the air and sociodemographic domain indices, respectively. Within the most urban strata, the PD for the sociodemographic domain index was 0.0256 (0.0205, 0.0307). Odds ratios (OR) for the individual-level analysis were congruent with PDs.We observed both strong positive and negative associations between measures of broad environmental quality and preterm birth. Associations differed by rural-urban stratum and by the five environmental domains. Our study demonstrates the use of a large scale composite environment exposure metric with preterm birth, an important indicator of population health and shows potential for future research.

Full Text

Duke Authors

Cited Authors

  • Rappazzo, KM; Messer, LC; Jagai, JS; Gray, CL; Grabich, SC; Lobdell, DT

Published Date

  • January 2015

Published In

Volume / Issue

  • 14 /

Start / End Page

  • 50 -

PubMed ID

  • 26051702

Pubmed Central ID

  • 26051702

Electronic International Standard Serial Number (EISSN)

  • 1476-069X

International Standard Serial Number (ISSN)

  • 1476-069X

Digital Object Identifier (DOI)

  • 10.1186/s12940-015-0038-3

Language

  • eng