학술논문
Is gastroschisis associated with county-level socio-environmental quality during pregnancy?
Document Type
Academic Journal
Author
Krajewski AK; United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, North Carolina, USA.; Patel A; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Gray CL; Duke Global Health Institute, Durham, North Carolina, USA.; Messer LC; OHSU-PSU School of Public Health, Portland, Oregon, USA.; Keeler CY; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.; Langlois PH; Department of Epidemiology, Human Genetics, and Environmental Sciences, University of Texas School of Public Health-Austin Regional Campus, Austin, Texas, USA.; Reefhuis J; Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Infant Disorders, Atlanta, Georgia, USA.; Gilboa SM; Centers for Disease Control and Prevention, National Center on Birth Defects and Developmental Disabilities, Division of Birth Defects and Infant Disorders, Atlanta, Georgia, USA.; Werler MM; Department of Epidemiology, Boston University, School of Public Health, Boston, Massachusetts, USA.; Shaw GM; Stanford University, School of Medicine, Stanford, California, USA.; Carmichael SL; Stanford University, School of Medicine, Stanford, California, USA.; Nembhard WN; Department of Epidemiology, University of Arkansas for Medical Sciences, Fay W. Boozman College of Public Health, Little Rock, Arkansas, USA.; Insaf TZ; New York State Department of Health, Center for Environmental Health, Bureau of Environmental and Occupational Epidemiology, Albany, New York, USA.; Department of Epidemiology and Biostatistics, University at Albany, Albany, New York, USA.; Feldkamp ML; Department of Pediatrics, Division of Medical Genetics, University of Utah, Salt Lake City, Utah, USA.; Conway KM; Department of Epidemiology, The University of Iowa, College of Public Health, Iowa City, Iowa, USA.; Lobdell DT; United States Environmental Protection Agency (U.S. EPA), Office of Research and Development, Center for Public Health & Environmental Assessment, Research Triangle Park, North Carolina, USA.; Desrosiers TA; Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.
Source
Publisher: John Wiley & Sons, Inc Country of Publication: United States NLM ID: 101701004 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2472-1727 (Electronic) NLM ISO Abbreviation: Birth Defects Res Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Gastroschisis prevalence more than doubled between 1995 and 2012. While there are individual-level risk factors (e.g., young maternal age, low body mass index), the impact of environmental exposures is not well understood.
Methods: We used the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) as a county-level estimate of cumulative environmental exposures for five domains (air, water, land, sociodemographic, and built) and overall from 2006 to 2010. Adjusted odds ratios (aOR) and 95% confidence interval (CI) were estimated from logistic regression models between EQI tertiles (better environmental quality (reference); mid; poorer) and gastroschisis in the National Birth Defects Prevention Study from births delivered between 2006 and 2011. Our analysis included 594 cases with gastroschisis and 4105 infants without a birth defect (controls).
Results: Overall EQI was modestly associated with gastroschisis (aOR [95% CI]: 1.29 [0.98, 1.71]) for maternal residence in counties with poorer environmental quality, compared to the reference (better environmental quality). Within domain-specific indices, only the sociodemographic domain (aOR: 1.51 [0.99, 2.29]) was modestly associated with gastroschisis, when comparing poorer to better environmental quality.
Conclusions: Future work could elucidate pathway(s) by which components of the sociodemographic domain or possibly related psychosocial factors like chronic stress potentially contribute to risk of gastroschisis.
(© 2023 Wiley Periodicals LLC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)
Methods: We used the U.S. Environmental Protection Agency's Environmental Quality Index (EQI) as a county-level estimate of cumulative environmental exposures for five domains (air, water, land, sociodemographic, and built) and overall from 2006 to 2010. Adjusted odds ratios (aOR) and 95% confidence interval (CI) were estimated from logistic regression models between EQI tertiles (better environmental quality (reference); mid; poorer) and gastroschisis in the National Birth Defects Prevention Study from births delivered between 2006 and 2011. Our analysis included 594 cases with gastroschisis and 4105 infants without a birth defect (controls).
Results: Overall EQI was modestly associated with gastroschisis (aOR [95% CI]: 1.29 [0.98, 1.71]) for maternal residence in counties with poorer environmental quality, compared to the reference (better environmental quality). Within domain-specific indices, only the sociodemographic domain (aOR: 1.51 [0.99, 2.29]) was modestly associated with gastroschisis, when comparing poorer to better environmental quality.
Conclusions: Future work could elucidate pathway(s) by which components of the sociodemographic domain or possibly related psychosocial factors like chronic stress potentially contribute to risk of gastroschisis.
(© 2023 Wiley Periodicals LLC. This article has been contributed to by U.S. Government employees and their work is in the public domain in the USA.)