Increased Stillbirth Rates and Exposure to Environmental Risk Factors for Stillbirth in Counties with Higher Social Vulnerability: United States, 2015-2018.

Autor: Moore J; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, US. vin2@cdc.gov.; Division of Infectious Disease Readiness and Innovation, National Center on Emerging and Zoonotic Infectious Diseases, US Centers for Disease Control and Prevention, 1600 Clifton Rd, Mail Stop: H24-3, Atlanta, GA, 30329, US. vin2@cdc.gov., Evans S; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, US., Rose CE; National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, US., Shin M; Division of Environmental Health Science and Practice, National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, US., Carroll Y; Division of Environmental Health Science and Practice, National Center for Environmental Health, US Centers for Disease Control and Prevention, Atlanta, US., Duke CW; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, US., Cohen CR; Department of Obstetrics, Gynecology & Reproductive Sciences, Bixby Center for Global Reproductive Health, University of California San Francisco, San Francisco, US., Broussard CS; Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, US Centers for Disease Control and Prevention, Atlanta, Georgia, US.
Jazyk: angličtina
Zdroj: Maternal and child health journal [Matern Child Health J] 2024 Dec; Vol. 28 (12), pp. 2026-2036. Date of Electronic Publication: 2024 Oct 08.
DOI: 10.1007/s10995-024-04003-4
Abstrakt: Introduction: Exposure to unfavorable environmental conditions during pregnancy, such as extreme heat and air pollution, has been linked to increased risk of stillbirth, defined as fetal mortality at or after 20 weeks' gestation, however no studies have examined its association with social vulnerability. We examined associations between county-level stillbirth rates, environmental risk factors for stillbirth, and social vulnerability in the United States.
Methods: This ecologic study linked county-level data from three nationwide datasets on stillbirths (National Vital Statistics System), environmental conditions (North American Land Data Assimilation System and Environmental Protection Agency), and social vulnerability (Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index). Poisson and negative binomial models were fit to the variables and produced rate ratios to estimate associations among stillbirth rates, environmental risk factors, and social vulnerability.
Results: Social vulnerability was positively associated withn stillbirth rates, annual average number of extreme heat days, and ambient concentration of particulate matter ≤ 2.5 μm in diameter (PM2.5). The average number of days that ozone and PM2.5 each exceeded regulatory standards were not associated with stillbirth rates or social vulnerability. A positive association between average annual PM2.5 concentration and stillbirth rates was detected; no other significant associations between environmental risk factors and stillbirth rates were observed.
Discussion: We found evidence of associations between social vulnerability and stillbirth rates, and between social vulnerability and environmental risk factors for stillbirth at the county level. Further research could inform understanding of how social vulnerability impacts the relationship between environmental exposures and stillbirth risk.
Competing Interests: Declarations Ethical Approval This project received CDC ethical approval and was determined to be Not Research - Public Health Surveillance under 45 CFR 46.102(l)(2). Consent to Participate Not applicable. Consent for Publication Not applicable. Disclaimer The findings and conclusions in this report are those of the authors and do not necessarily represent the official position of the Centers for Disease Control and Prevention. Conflict of Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(© 2024. This is a U.S. Government work and not under copyright protection in the US; foreign copyright protection may apply.)
Databáze: MEDLINE
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