Environmental conditions and reproductive health outcomes

Environmental exposures range across multiple domains to affect human health. In an effort to learn how environmental factors combine to contribute to health outcomes we constructed a multiple environmental domain index (MEDI) for use in health research. We used principal components analysis to construct the MEDI with county-level data representing five environmental domains (air, water, land, built and sociodemographic). Using five years of North Carolina birth records data (2000-2005; n=628,010 records), fixed slope, random intercept multilevel logistic and linear models assessed the relationship between the county-level environment (n=100 counties) and preterm and very preterm birth (PTB, VPTB); low and very low birthweight (LBW, VLBW); small for gestational age (SGA); BW percent (%) for gestational age and pregnancy-induced hypertension (PIH). Outcomes were constructed using standard definitions. In models adjusted for maternal age, education, marital status and infant sex, residence in a county with better environmental conditions (4th quartile) compared to the worst conditions (1st quartile) was associated with decreased odds of PTB (odds ratio=0.87; 95% confidence interval (95%CI): 0.79, 0.96). Similar results were found for LBW, SGA and PIH (OR=0.89, 95%CI: 0.82, 0.96; OR=0.90, 95%CI: 0.84, 0.97; OR=0.93, 95%CI: 0.87, 0.98, respectively). Race-stratified results will also be presented. Data representing multiple environmental domains were successfully combined into one index representing overall county level environmental conditions, which was associated with perinatal health outcomes.

Disclaimer: This abstract does not necessarily reflect EPA policy.