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Zhu Y, Zhang H, Qi J, Liu Y, Yan Y, Wang T, Zeng P. Evaluating causal influence of maternal educational attainment on offspring birthweight via observational study and Mendelian randomization analyses. SSM Popul Health 2024; 25:101587. [PMID: 38229657 PMCID: PMC10790093 DOI: 10.1016/j.ssmph.2023.101587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 11/25/2023] [Accepted: 12/16/2023] [Indexed: 01/18/2024] Open
Abstract
Background Although extensive discussions on the influence of maternal educational attainment on offspring birthweight, the conclusion remains controversial, and it is challenging to comprehensively assess the causal association between them. Methods To estimate effect of maternal educational attainment on the birthweight of first child, we first conducted an individual-level analysis with UK Biobank participants of white ancestry (n = 208,162). We then implemented Mendelian randomization (MR) methods including inverse variance weighted (IVW) MR and multivariable MR to assess the causal relation between maternal education and maternal-specific birthweight. Finally, using the UK Biobank parent-offspring trio data (n = 618), we performed a polygenic score based MR to simultaneously adjust for confounding effects of fetal-specific birthweight and paternal educational attainment. We also conducted simulations for power evaluation and sensitivity analyses for horizontal pleiotropy of instruments. Results We observed that birthweight of first child was positively influenced by maternal education, with 7 years of maternal education as the reference, adjusted effect = 44.8 (95%CIs 38.0-51.6, P = 6.15 × 10-38), 54.9 (95%CIs 47.6-62.2, P = 4.21 × 10-128), and 89.4 (95%CIs 82.1-96.7, P = 4.28 × 10-34) for 10, 15 and 20 years of maternal educational attainment, respectively. A causal relation between maternal education and offspring birthweight was revealed by IVW MR (estimated effect = 0.074 for one standard deviation increase in maternal education years, 95%CIs 0.054-0.093, P = 2.56 × 10-13) and by complementary MR methods. This connection was not substantially affected by paternal education or horizontal pleiotropy. Further, we found a positive but insignificant causal association (adjusted effect = 24.0, 95%CIs -150.1-198.1, P = 0.787) between maternal education and offspring birthweight after simultaneously controlling for fetal genome and paternal education; this null causality was largely due to limited power of small sample sizes of parent-offspring trios. Conclusion This study offers supportive evidence for a causal association between maternal education and offspring birthweight, highlighting the significance of enhancing maternal education to prevent low birthweight.
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Affiliation(s)
- Yiyang Zhu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Hao Zhang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Jike Qi
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Yuxin Liu
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Yu Yan
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ting Wang
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
| | - Ping Zeng
- Department of Biostatistics, School of Public Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Center for Medical Statistics and Data Analysis, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Human Genetics and Environmental Medicine, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Key Laboratory of Environment and Health, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Xuzhou Engineering Research Innovation Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
- Jiangsu Engineering Research Center of Biological Data Mining and Healthcare Transformation, Xuzhou Medical University, Xuzhou, Jiangsu, 221004, China
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Dunlop AL, Burjak M, Dean LT, Alshawabkeh AN, Avalos LA, Aschner JL, Breton CV, Charifson MA, Cordero J, Dabelea D, D’Sa V, Duarte CS, Elliott AJ, Eick SM, Ferrara A, Fichorova RN, Ganiban JM, Gern JE, Hedderson MM, Herbstman JB, Hipwell AE, Huddleston KC, Karagas M, Karr C, Kerver JM, Koinis-Mitchell D, Lyall K, Madan J, Marsit C, McEvoy CT, Meeker JD, Oken E, O’Shea TM, Padula AM, Sathyanarayana S, Schantz S, Schmidt RJ, Snowden J, Stanford JB, Weiss S, Wright RO, Wright RJ, Zhang X, McGrath M. Association of maternal education, neighborhood deprivation, and racial segregation with gestational age at birth by maternal race/ethnicity and United States Census region in the ECHO cohorts. Front Public Health 2023; 11:1165089. [PMID: 38098826 PMCID: PMC10719953 DOI: 10.3389/fpubh.2023.1165089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/13/2023] [Indexed: 12/17/2023] Open
Abstract
Background In the United States, disparities in gestational age at birth by maternal race, ethnicity, and geography are theorized to be related, in part, to differences in individual- and neighborhood-level socioeconomic status (SES). Yet, few studies have examined their combined effects or whether associations vary by maternal race and ethnicity and United States Census region. Methods We assembled data from 34 cohorts in the Environmental influences on Child Health Outcomes (ECHO) program representing 10,304 participants who delivered a liveborn, singleton infant from 2000 through 2019. We investigated the combined associations of maternal education level, neighborhood deprivation index (NDI), and Index of Concentration at the Extremes for racial residential segregation (ICERace) on gestational weeks at birth using linear regression and on gestational age at birth categories (preterm, early term, post-late term relative to full term) using multinomial logistic regression. Results After adjustment for NDI and ICERace, gestational weeks at birth was significantly lower among those with a high school diploma or less (-0.31 weeks, 95% CI: -0.44, -0.18), and some college (-0.30 weeks, 95% CI: -0.42, -0.18) relative to a master's degree or higher. Those with a high school diploma or less also had an increased odds of preterm (aOR 1.59, 95% CI: 1.20, 2.10) and early term birth (aOR 1.26, 95% CI: 1.05, 1.51). In adjusted models, NDI quartile and ICERace quartile were not associated with gestational weeks at birth. However, higher NDI quartile (most deprived) associated with an increased odds of early term and late term birth, and lower ICERace quartile (least racially privileged) associated with a decreased odds of late or post-term birth. When stratifying by region, gestational weeks at birth was lower among those with a high school education or less and some college only among those living in the Northeast or Midwest. When stratifying by race and ethnicity, gestational weeks at birth was lower among those with a high school education or less only for the non-Hispanic White category. Conclusion In this study, maternal education was consistently associated with shorter duration of pregnancy and increased odds of preterm birth, including in models adjusted for NDI and ICERace.
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Affiliation(s)
- Anne L. Dunlop
- Department of Gynecology and Obstetrics, Emory University School of Medicine, Atlanta, GA, United States
| | - Mohamad Burjak
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Lorraine T. Dean
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Akram N. Alshawabkeh
- Department of Civil and Environmental Engineering, College of Engineering, Northeastern University, Boston, MA, United States
| | - Lyndsay A. Avalos
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Judy L. Aschner
- Albert Einstein College of Medicine, Bronx, NY, United States
- Hackensack Meridian School of Medicine, Nutley, NJ, United States
| | - Carrie V. Breton
- Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Mia A. Charifson
- Division of Epidemiology, New York University Langone Health Grossman School of Medicine, New York, NY, United States
| | - Jose Cordero
- Department of Epidemiology and Biostatistics, University of Georgia College of Public Health, Athens, GA, United States
| | - Dana Dabelea
- Lifecourse Epidemiology of Adiposity and Diabetes Center, University of Colorado Anschutz Medical Campus, Aurora, CO, United States
| | - Viren D’Sa
- Department of Pediatrics, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Cristiane S. Duarte
- Division of Child and Adolescent Psychiatry, Columbia University-New York State Psychiatric Institute, New York, NY, United States
| | - Amy J. Elliott
- Avera Research Institute, Department of Pediatrics, University of South Dakota School of Medicine, Sioux Falls, SD, United States
| | - Stephanie M. Eick
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Assiamira Ferrara
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Raina N. Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, United States
| | - Jody M. Ganiban
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, United States
| | - James E. Gern
- Department of Pediatrics, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, United States
| | - Julie B. Herbstman
- Department of Environmental Health Sciences, Columbia University Mailman School of Public Health, New York, NY, United States
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA, United States
| | - Kathi C. Huddleston
- College of Health and Human Services, George Mason University, Fairfax, VA, United States
| | - Margaret Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Catherine Karr
- Departments of Pediatrics and Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Jean M. Kerver
- Departments of Epidemiology and Biostatistics and Pediatrics and Human Development, College of Human Medicine, Michigan State University, East Lansing, MI, United States
| | - Daphne Koinis-Mitchell
- Department of Pediatrics, Rhode Island Hospital and The Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - Kristen Lyall
- AJ Drexel Autism Institute, Drexel University, Philadelphia, PA, United States
| | - Juliette Madan
- Department of Epidemiology, Pediatrics and Psychiatry, Geisel School of Medicine at Dartmouth, Hanover, NH, United States
| | - Carmen Marsit
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, United States
| | - Cindy T. McEvoy
- Department of Pediatrics, Oregon Health and Science University, Portland, OR, United States
| | - John D. Meeker
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI, United States
| | - Emily Oken
- Division of Chronic Disease Research Across the Lifecourse, Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, United States
| | - T. Michael O’Shea
- Department of Pediatrics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Amy M. Padula
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Sheela Sathyanarayana
- Departments of Pediatrics and Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, United States
| | - Susan Schantz
- Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Rebecca J. Schmidt
- Department of Public Health Sciences, MIND Institute, University of California, Davis, Davis, CA, United States
| | - Jessica Snowden
- Departments of Pediatrics and Biostatistics, University of Arkansas for Medical Sciences, Little Rock, AR, United States
| | - Joseph B. Stanford
- Department of Family and Preventive Medicine, University of Utah School of Medicine, Salt Lake City, UT, United States
| | - Scott Weiss
- Department of Medicine, Harvard School of Medicine, Boston, MA, United States
| | - Robert O. Wright
- Department of Pediatrics, The Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Rosalind J. Wright
- Department of Pediatrics, The Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Xueying Zhang
- Department of Pediatrics, The Kravis Children’s Hospital, Icahn School of Medicine at Mount Sinai, New York, NY, United States
- Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Monica McGrath
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
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Amo-Adjei J, Essuman R, Nurzhynska A, Deliege A, Sharma G, Iddrisu I, Nikoi C. Experiences of parents and stakeholders in caring for, and supporting children with special needs in Ghana. PLoS One 2023; 18:e0281502. [PMID: 36867593 PMCID: PMC9983829 DOI: 10.1371/journal.pone.0281502] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Accepted: 01/24/2023] [Indexed: 03/04/2023] Open
Abstract
We studied the caring, parenting, and support services for children with special needs in Ghana. Many of the study participants reported re-adjusting their lives in virtually every domain-social, economic, and emotional to deal with and manage the new realities. How parents navigate this space varied considerably from setting to setting. Regardless of individual and interpersonal resources, community, institutional, and policy circumstances seemed to exacerbate notions of disability. In many instances, parents had a low depth of suspicion about the precursors to disabling events in their children. Parents are constantly pursuing health care, including a cure for their children with disabilities. Views about "otherness" were noted, and these tended to undermine medical interpretations/explanations of disability generally, which in turn affected formal education and health-seeking for children. Institutional arrangements exist to encourage parents to invest in their children regardless of their perceived abilities. However, these do not seem to be sufficient, particularly for health and formal education. Programming and policy implications are highlighted.
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Affiliation(s)
- Joshua Amo-Adjei
- Faculty of Social Sciences, Department of Population and Health, University of Cape Coast, Cape Coast, Ghana
- * E-mail:
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Liu Y, Jin C, Ni LF, Zheng T, Liu XC, Wang SS, Huang HJ, Jin MM, Cheng BW, Yan HT, Yang XJ. Educational attainment and offspring birth weight: A bidirectional Mendelian randomization study. Front Genet 2022; 13:922382. [PMID: 36437958 PMCID: PMC9682907 DOI: 10.3389/fgene.2022.922382] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/19/2022] [Indexed: 09/03/2023] Open
Abstract
Background: The association between educational attainment (EA) and offspring birth weight (BW) has been reported by several traditional epidemiological studies. However, evidence for this association tends to be mixed and confounded. This study aimed to investigate the causal association between EA of parents and offspring BW. Methods: Here, we carried out a two-sample bidirectional Mendelian randomization (MR) analysis to examine the causal association between EA of males (n = 131,695) and females (n = 162,028) and offspring BW using genetic instruments. Summary statistics of EA associated single nucleotide polymorphisms (SNPs) were extracted from a GWAS incorporating 293,723 individuals of European descent performed by the Social Science Genetic Association Consortium (SSGAC), and the effects of these SNPs on offspring BW were estimated using a GWAS meta-analysis of 86,577 participants of European descent from 25 studies. Univariable MR analyses were conducted using the inverse-variance weighted (IVW) method and four other methods. Further sensitivity analyses were carried out to test the viability of the results. Multivariable MR was used to examine the confounders between the exposure and outcome. Results: The result shows evidence that the offspring BW is positively causally affected by female EA. Each one standard deviation (SD) increase in female EA was associated with 0.24 SD higher of offspring BW (95% confidence interval [CI], 0.10 to 0.37, p < 0.001 for the IVW method). Similarly, change in offspring BW was 0.21 SD (95% CI: 0.07 to 0.34, p = 2.82 × 10-3) per one SD higher in male EA. No causal effect of BW on EA was found by any of the five methods. The causal association between female EA and offspring BW maintained after adjusting for alcoholic drinks per week and BMI. The effect of male EA on offspring BW was attenuated when we adjusted for BMI and alcoholic drinks per week using multivariable MR analysis. Conclusion: Our study indicated that female EA is positively causally associated with offspring BW. The association between male EA and offspring BW may be confounded by alcoholic drinks per week and BMI.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | - Xin-Jun Yang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Wenzhou Medical University, Wenzhou, China
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Bai X, Zhou Z, Su M, Li Y, Yang L, Liu K, Yang H, Zhu H, Chen S, Pan H. Predictive models for small-for-gestational-age births in women exposed to pesticides before pregnancy based on multiple machine learning algorithms. Front Public Health 2022; 10:940182. [PMID: 36003638 PMCID: PMC9394741 DOI: 10.3389/fpubh.2022.940182] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2022] [Accepted: 07/19/2022] [Indexed: 11/25/2022] Open
Abstract
Background The association between prenatal pesticide exposures and a higher incidence of small-for-gestational-age (SGA) births has been reported. No prediction model has been developed for SGA neonates in pregnant women exposed to pesticides prior to pregnancy. Methods A retrospective cohort study was conducted using information from the National Free Preconception Health Examination Project between 2010 and 2012. A development set (n = 606) and a validation set (n = 151) of the dataset were split at random. Traditional logistic regression (LR) method and six machine learning classifiers were used to develop prediction models for SGA neonates. The Shapley Additive Explanation (SHAP) model was applied to determine the most influential variables that contributed to the outcome of the prediction. Results 757 neonates in total were analyzed. SGA occurred in 12.9% (n = 98) of cases overall. With an area under the receiver-operating-characteristic curve (AUC) of 0.855 [95% confidence interval (CI): 0.752–0.959], the model based on category boosting (CatBoost) algorithm obtained the best performance in the validation set. With the exception of the LR model (AUC: 0.691, 95% CI: 0.554–0.828), all models had good AUCs. Using recursive feature elimination (RFE) approach to perform the feature selection, we included 15 variables in the final model based on CatBoost classifier, achieving the AUC of 0.811 (95% CI: 0.675–0.947). Conclusions Machine learning algorithms can develop satisfactory tools for SGA prediction in mothers exposed to pesticides prior to pregnancy, which might become a tool to predict SGA neonates in the high-risk population.
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Affiliation(s)
- Xi Bai
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Zhibo Zhou
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | | | - Yansheng Li
- DHC Mediway Technology Co., Ltd, Beijing, China
| | | | - Kejia Liu
- DHC Mediway Technology Co., Ltd, Beijing, China
| | - Hongbo Yang
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Huijuan Zhu
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
| | - Shi Chen
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- *Correspondence: Hui Pan
| | - Hui Pan
- Key Laboratory of Endocrinology of National Health Commission, Department of Endocrinology, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Science and Peking Union Medical College, Beijing, China
- Shi Chen
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Payne-Sturges DC, Puett R, Cory-Slechta DA. Both parents matter: a national-scale analysis of parental race/ethnicity, disparities in prenatal PM 2.5 exposures and related impacts on birth outcomes. Environ Health 2022; 21:47. [PMID: 35513869 PMCID: PMC9074320 DOI: 10.1186/s12940-022-00856-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Accepted: 04/12/2022] [Indexed: 05/05/2023]
Abstract
BACKGROUND Most U.S. studies that report racial/ethnic disparities in increased risk of low birth weight associated with air pollution exposures have been conducted in California or northeastern states and/or urban areas, limiting generalizability of study results. Few of these studies have examined maternal racial/ethnic groups other than Non-Hispanic Black, non-Hispanic White and Hispanic, nor have they included paternal race. We aimed to examine the independent effects of PM2.5 on birth weight among a nationally representative sample of U.S. singleton infants and how both maternal and paternal race/ethnicity modify relationships between prenatal PM2.5 exposures and birth outcomes. METHODS We used data from the Early Childhood Longitudinal Study, Birth Cohort (ECLS-B), a longitudinal nationally representative cohort of 10,700 U.S. children born in 2001, which we linked to U.S.EPA's Community Multi-scale Air Quality (CMAQ)-derived predicted daily PM2.5 concentrations at the centroid of each Census Bureau Zip Code Tabulation Area (ZCTA) for maternal residences. We examined relationships between term birthweight (TBW), term low birthweight rate (TLBW) and gestational PM2.5 pollutant using multivariate regression models. Effect modification of air pollution exposures on birth outcomes by maternal and paternal race was evaluated using stratified models. All analyses were conducted with sample weights to provide national-scale estimates. RESULTS The majority of mothers were White (61%). Fourteen percent of mothers identified as Black, 21% as Hispanic, 3% Asian American and Pacific Islander (AAPI) and 1% American Indian and Alaskan Native (AIAN). Fathers were also racially/ethnically diverse with 55% identified as White Non-Hispanic, 10% as Black Non-Hispanic, 19% as Hispanic, 3% as AAPI and 1% as AIAN. Results from the chi-square and ANOVA tests of significance for racial/ethnic differences indicate disparities in prenatal exposures and birth outcomes by both maternal and paternal race/ethnicity. Prenatal PM2.5 was associated with reduced birthweights during second and third trimester and over the entire gestational period in adjusted regression models, although results did not reach statistical significance. In models stratified by maternal race and paternal race, one unit increase in PM2.5 was statistically significantly associated with lower birthweights among AAPI mothers, -5.6 g (95% CI:-10.3, -1.0 g) and AAPI fathers, -7.6 g (95% CI: -13.1, -2.1 g) during 3rd trimester and among births where father's race was not reported, -14.2 g (95% CI: -24.0, -4.4 g). CONCLUSIONS These data suggest that paternal characteristics should be used, in addition to maternal characteristics, to describe the risks of adverse birth outcomes. Additionally, our study suggests that serious consideration should be given to investigating environmental and social mechanisms, such as air pollution exposures, as potential contributors to disparities in birth outcomes among AAPI populations.
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Affiliation(s)
- Devon C Payne-Sturges
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA.
| | - Robin Puett
- School of Public Health, Maryland Institute for Applied Environmental Health, University of Maryland, 255 Valley Drive, College Park, MD, 20742, USA
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Development and Evaluation of a Machine Learning Prediction Model for Small-for-Gestational-Age Births in Women Exposed to Radiation before Pregnancy. J Pers Med 2022; 12:jpm12040550. [PMID: 35455666 PMCID: PMC9031835 DOI: 10.3390/jpm12040550] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 03/15/2022] [Accepted: 03/16/2022] [Indexed: 12/22/2022] Open
Abstract
Exposure to radiation has been associated with increased risk of delivering small-for-gestational-age (SGA) newborns. There are no tools to predict SGA newborns in pregnant women exposed to radiation before pregnancy. Here, we aimed to develop an array of machine learning (ML) models to predict SGA newborns in women exposed to radiation before pregnancy. Patients’ data was obtained from the National Free Preconception Health Examination Project from 2010 to 2012. The data were randomly divided into a training dataset (n = 364) and a testing dataset (n = 91). Eight various ML models were compared for solving the binary classification of SGA prediction, followed by a post hoc explainability based on the SHAP model to identify and interpret the most important features that contribute to the prediction outcome. A total of 455 newborns were included, with the occurrence of 60 SGA births (13.2%). Overall, the model obtained by extreme gradient boosting (XGBoost) achieved the highest area under the receiver-operating-characteristic curve (AUC) in the testing set (0.844, 95% confidence interval (CI): 0.713–0.974). All models showed satisfied AUCs, except for the logistic regression model (AUC: 0.561, 95% CI: 0.355–0.768). After feature selection by recursive feature elimination (RFE), 15 features were included in the final prediction model using the XGBoost algorithm, with an AUC of 0.821 (95% CI: 0.650–0.993). ML algorithms can generate robust models to predict SGA newborns in pregnant women exposed to radiation before pregnancy, which may thus be used as a prediction tool for SGA newborns in high-risk pregnant women.
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Swaminathan A, Lahaie Luna M, Rennicks White R, Smith G, Rodger M, Wen SW, Walker M, Corsi DJ. The influence of maternal and paternal education on birth outcomes: an analysis of the Ottawa and Kingston (OaK) birth cohort. J Matern Fetal Neonatal Med 2022; 35:9631-9638. [PMID: 35287537 DOI: 10.1080/14767058.2022.2049751] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND Education is considered one of the most robust determinants of health. However, it is unclear whether maternal education and paternal education have differential impacts on perinatal health outcomes. We assess maternal and paternal education differences and their association with adverse birth outcomes in a large birth cohort from Ontario, Canada. METHODS The OaK Birth Cohort recruited patients from Ontario, Canada, between October 2002 and April 2009. We recruited mothers were recruited between 12 and 20 weeks' gestation and collected both mother and infant data. The final sample size of the cohort was 8,085 participants. We use logistic regression to model the probability of preterm birth (less than 34 and 37 weeks' gestation), small-for-gestational-age (SGA), or stillbirth as a function of maternal and paternal educational attainment. We adjust for household-level income, maternal and paternal race and ethnicity, and compare the strength of the association between maternal and paternal education on outcomes using Wald tests. RESULTS 7,928 mother-father-offspring triads were available for the current analysis. 75% of mothers and fathers had college or university level education, and 8.7% of mothers experienced preterm delivery. Compared to mothers with college or university education, mothers with a high school education had an odds ratio of 1.37 (95% CI: 1.01-1.87) for SGA. Paternal education was not associated with infant outcomes. Comparing the odds ratios for maternal education and paternal education showed a stronger association than paternal education at the high school level for SGA birth (difference in odds ratio: 1.95, 95% CI: 1.13-3.36, p = .016) among women at least 25 years old. CONCLUSION Maternal education was associated with SGA, and this effect was more robust than paternal education, but both associations were weaker than previously reported.
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Affiliation(s)
| | | | | | - Graeme Smith
- Department of Obstetrics and Gynecology, Queen's Perinatal Research Unit, Kingston General Hospital, Queens University, Kingston, ON, Canada
| | - Marc Rodger
- Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Shi Wu Wen
- OMNI Research Group, Ottawa Hospital Research Institute, and School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada
| | - Mark Walker
- OMNI Research Group, Ottawa Hospital Research Institute, and Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON, Canada
| | - Daniel J Corsi
- OMNI Research Group, Ottawa Hospital Research Institute, School of Epidemiology and Public Health, University of Ottawa, Ottawa, ON, Canada.,CHEO Research Institute, Ottawa, ON, Canada
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9
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Hispanic Ethnicity, Nativity and the Risk of Stillbirth. J Immigr Minor Health 2022; 24:1379-1386. [PMID: 35044554 DOI: 10.1007/s10903-022-01332-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
The objective of this study was to examine stillbirth risk by nativity and Hispanic ethnicity. We analyzed births and fetal deaths among women of Hispanic origin within gestational ages of 20-42 weeks from the 2014-2019 Birth and Fetal Death. Foreign-born Hispanic mothers were 8% less likely (HR 0.92, 95% CI 0.90-0.95) to experience stillbirth than their counterparts. Stratified by ethnicity, foreign-born Mexican and Central/South American women had a lower risk of stillbirth (HR 0.85, 95% CI 0.81-0.88 and HR 0.68, 95% CI 0.63-0.75, respectively) while foreign-born Puerto Rican women were more likely to experience stillbirth (HR 1.37, 95% CI 1.24-1.51) than their native-born counterparts. While overall foreign-born Hispanic mothers were less likely to experience stillbirth than native-born Hispanic mothers, this differed depending on ethnicity. Counseling regarding risk of stillbirth among Hispanic women should take into consideration nativity and country of origin as influential factors.
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10
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Behlim T, Basso O, Bushnik T, Kramer MS, Kaufman JS, Yang S. Differences in birthweight by maternal and paternal nativity status in Canada. Paediatr Perinat Epidemiol 2022; 36:113-122. [PMID: 34811763 DOI: 10.1111/ppe.12817] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 08/25/2021] [Accepted: 08/27/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Parental nativity, as well as duration of residence of foreign-born parents in the host country, has been shown to be associated with size at birth. However, most studies have focused on maternal nativity status only and have not accounted for important characteristics of both parents. OBJECTIVE To explore whether maternal and paternal nativity and length of residence (LOR) are independently associated with birthweight for gestational age in a representative sample of infants in Canada. METHODS We compared mean differences in sex- and gestational age-standardised birthweight z-score by nativity status of both parents in a nationally representative sample of 130,532 singleton infants born between May 2004 and May 2006 to mothers residing in Canada. We categorised parental nativity status into four groups (both parents Canada-born, mother only foreign-born, father only foreign-born and both parents foreign-born) and parents' LOR into three (both ≤10 years, only one parent ≤10 years and both >10 years). We estimated mean differences in birthweight z-score and their 95% confidence intervals in linear regression models adjusted for parity, parents' ages, education, ethnicity and marital status of the mother. RESULTS Compared with babies of Canada-born couples, those of two foreign-born parents had on average smaller birthweight z-score, -0.23 (95% CI -0.28, -0.25). However, after adjustment, the mean difference in z-score was -0.02 (95% CI -0.05, 0.00). Infants born to parents who had both resided in Canada for ≤10 years had a unadjusted mean difference in z-score of -0.27 (95% CI -0.29, -0.26), compared infants whose parents were both Canada-born, but the difference became negligible (-0.02, 95% CI -0.04, 0.01) after adjustment. CONCLUSION The birthweight differences by parental nativity or length of residence observed in our study population could be attributed to differences in the distribution of other parental characteristics that affect birthweight.
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Affiliation(s)
- Tarannum Behlim
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Olga Basso
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Obstetrics and Gynecology, Faculty of Medicine, Montreal, QC, Canada
| | | | - Michael S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada.,Department of Paediatrics, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montreal, QC, Canada
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11
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Shapiro GD, Sheppard AJ, Mashford-Pringle A, Bushnik T, Kramer MS, Kaufman JS, Yang S. Housing conditions and adverse birth outcomes among Indigenous people in Canada. Canadian Journal of Public Health 2021; 112:903-911. [PMID: 34037966 PMCID: PMC8152187 DOI: 10.17269/s41997-021-00527-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 04/06/2021] [Indexed: 11/17/2022]
Abstract
Objectives Poor housing conditions and household crowding have been identified as important health concerns for Indigenous populations in many countries but have not been explored in relation to adverse birth outcomes in these populations. We investigated housing conditions and adverse birth outcomes in a nationally representative sample of Indigenous people in Canada. Methods Data were from a cohort of births between May 2004 and May 2006 created by linking birth and infant death registration data with the 2006 Canadian census. Log-binomial regression was used to examine associations between housing variables (persons per room and needed household repairs) and three adverse birth outcomes: preterm birth (PTB), small-for-gestational-age (SGA) birth, and infant mortality. Separate regression models were run for First Nations, Métis and Inuit mothers, with adjustment for parity and parental socio-economic variables. Results Need for major household repairs was associated with a slightly increased risk of PTB among First Nations and Métis mothers (adjusted RRs 1.12 and 1.13, respectively; 95% CI 0.94–1.34 and 0.89–1.44, respectively) and a moderately increased risk of infant death in all three groups (aRR = 1.69, 95% CI 1.00–2.85). Household crowding was also associated with a slightly elevated risk of PTB in all three groups (aRR = 1.10, 95% CI 0.95–1.29) and with an increased risk of infant mortality among First Nations (aRR = 1.57, 95% CI 0.97–2.53). Conclusion This study highlights the need to improve understanding of links between housing conditions and perinatal health outcomes in Indigenous populations, including examining cause-specific infant mortality in relation to housing characteristics. Supplementary Information The online version contains supplementary material available at 10.17269/s41997-021-00527-2.
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Affiliation(s)
- Gabriel D Shapiro
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, Quebec, H3A 1A2, Canada.
| | - Amanda J Sheppard
- Indigenous Cancer Control Unit, Cancer Care Ontario, 505 University Avenue, Toronto, Ontario, M5G 2L7, Canada.,Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada
| | - Angela Mashford-Pringle
- Dalla Lana School of Public Health, University of Toronto, Health Sciences Building, 155 College Street, 6th Floor, Toronto, Ontario, M5T 3M7, Canada
| | - Tracey Bushnik
- Health Analysis Division, Statistics Canada, 150 Tunney's Pasture Driveway, Ottawa, Ontario, K1A 0T6, Canada
| | - Michael S Kramer
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, Quebec, H3A 1A2, Canada.,Department of Pediatrics, McGill University, 1001 Décarie Boulevard, Montreal, Quebec, H4A 3J1, Canada
| | - Jay S Kaufman
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, Quebec, H3A 1A2, Canada
| | - Seungmi Yang
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Purvis Hall, 1020 Pine Ave West, Montreal, Quebec, H3A 1A2, Canada
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12
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Dunlop AL, Essalmi AG, Alvalos L, Breton C, Camargo CA, Cowell WJ, Dabelea D, Dager SR, Duarte C, Elliott A, Fichorova R, Gern J, Hedderson MM, Thepaksorn EH, Huddleston K, Karagas MR, Kleinman K, Leve L, Li X, Li Y, Litonjua A, Ludena-Rodriguez Y, Madan JC, Nino JM, McEvoy C, O’Connor TG, Padula AM, Paneth N, Perera F, Sathyanarayana S, Schmidt RJ, Schultz RT, Snowden J, Stanford JB, Trasande L, Volk HE, Wheaton W, Wright RJ, McGrath M. Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts. PLoS One 2021; 16:e0245064. [PMID: 33418560 PMCID: PMC7794036 DOI: 10.1371/journal.pone.0245064] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Accepted: 12/21/2020] [Indexed: 12/20/2022] Open
Abstract
Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate's degree, vocational or technical training [reference category]; bachelor's degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor's degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61-0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00-1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor's degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography.
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Affiliation(s)
- Anne L. Dunlop
- Woodruff Health Sciences Center, School of Medicine and Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, United States of America
| | - Alicynne Glazier Essalmi
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Lyndsay Alvalos
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Carrie Breton
- Department of Preventive Medicine, University of Southern California, Los Angeles, California, United States of America
| | - Carlos A. Camargo
- Department of Epidemiology Harvard University, Cambridge, Massachusetts, United States of America
| | - Whitney J. Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Dana Dabelea
- Department of Epidemiology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America
| | - Stephen R. Dager
- Department of Radiology and Bioengineering, University of Washington, Seattle, Washington, United States of America
| | - Cristiane Duarte
- Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Amy Elliott
- Avera Research Institute Center for Pediatric & Community Research, Sioux Falls, South Dakota, United States of America
| | - Raina Fichorova
- Department of Obstetrics, Gynecology and Reproductive Biology, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts, United States of America
| | - James Gern
- Department of Medicine, University of Wisconsin, Madison, Wisconsin, United States of America
| | - Monique M. Hedderson
- Division of Research, Kaiser Permanente Northern California, Oakland, California, United States of America
| | - Elizabeth Hom Thepaksorn
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Kathi Huddleston
- College of Health and Human Services, George Mason University, Fairfax, Virginia, United States of America
| | - Margaret R. Karagas
- Department of Epidemiology, Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire, United States of America
| | - Ken Kleinman
- Department of Biostatistics and Epidemiology, University of Massachusetts Amherst, Amherst, Massachusetts, United States of America
| | - Leslie Leve
- Prevention Science Institute, University of Oregon, Eugene, Oregon, United States of America
| | - Ximin Li
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America
| | - Yijun Li
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America
| | - Augusto Litonjua
- Division of Pediatric Pulmonary Medicine, Golisano Children’s Hospital at Strong, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Yunin Ludena-Rodriguez
- Division of Environmental and Occupational Health, Public Health Sciences, School of Medicine, University of California, Davis, California, United States of America
| | - Juliette C. Madan
- Department of Epidemiology Geisel School of Medicine at Dartmouth Hitchcock Medical Center, Hanover, New Hampshire, United States of America
| | - Julio Mateus Nino
- Obstetrics and Gynecology, Maternal and Fetal Medicine, Atrium Health, Charlotte, North Carolina, United States of America
| | - Cynthia McEvoy
- Division of Neonatal, Department of Pediatrics, Oregon Health & Science University, Portland, Oregon, United States of America
| | - Thomas G. O’Connor
- Department of Psychiatry, School of Medicine and Dentistry, University of Rochester Medical Center, Rochester, New York, United States of America
| | - Amy M. Padula
- Program on Reproductive Health and the Environment, Department of Obstetrics, Gynecology and Reproductive Sciences, University of California San Francisco, San Francisco, California, United States of America
| | - Nigel Paneth
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, United States of America
| | - Frederica Perera
- Department of Psychiatry, Columbia University, New York, New York, United States of America
| | - Sheela Sathyanarayana
- Department of Pediatrics, University of Washington & Seattle Children’s Research Institute, Seattle, Washington, United States of America
| | - Rebecca J. Schmidt
- Division of Environmental and Occupational Health, Public Health Sciences, School of Medicine, University of California, Davis, California, United States of America
| | - Robert T. Schultz
- Department of Pediatrics, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, United States of America
| | - Jessica Snowden
- Department of Pediatrics, University of Arkansas Medical Sciences, Little Rock, Arkansas, United States of America
| | - Joseph B. Stanford
- Department of Family Preventative Medicine, University of Utah School of Medicine, Salt Lake City, Utah, United States of America
| | - Leonardo Trasande
- Department of Pediatrics, New York University Grossman School of Medicine, New York, New York, United States of America
| | - Heather E. Volk
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America
| | - William Wheaton
- Science and Technology Program, RTI International, Research Triangle Park, North Carolina, United States of America
| | - Rosalind J. Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, New York, United States of America
| | - Monica McGrath
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland United States of America
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13
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Li J, Qiu J, Lv L, Mao B, Huang L, Yang T, Wang C, Liu Q. Paternal factors and adverse birth outcomes in Lanzhou, China. BMC Pregnancy Childbirth 2021; 21:19. [PMID: 33407234 PMCID: PMC7789361 DOI: 10.1186/s12884-020-03492-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 12/11/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Many maternal factors are known to be associated with adverse birth outcomes, but studies about paternal factors yielded inconsistent conclusions. The study was to assess whether paternal factors are associated with low birth weight (LBW), preterm birth (PTB), and small for gestational age (SGA). METHODS A birth cohort study was conducted in 2010-2012 at the Gansu Provincial Maternity and Child Care Hospital, the largest maternity and childcare hospital in Lanzhou, China. Paternal age, ethnicity, educational level, height, weight, smoking, and drinking were collected. Birth outcomes and pregnancy complications were extracted from the medical records. RESULTS During the study period, 10,121 participants were included; the overall prevalence of LBW, PTB, and SGA was 7.2, 9.9, and 7.8%, respectively. Paternal higher height (OR = 0.64 95%CI: 0.49, 0.83), higher weight (P for trend < 0.001), and higher BMI (P for trend < 0.001) could decrease the rate of LBW. Paternal higher education (OR = 0.55, 95%CI: 0.43, 0.71) and higher weight (P for trend < 0.001,) were associated with lower rate of PTB. Fathers who smoked more than 6 pack-years were associated with PTB (OR = 1.31, 95%CI: 1.07, 1.61). Paternal BMI > 23.9 kg/m2 (P for trend < 0.001,) and paternal education which above college (OR = 0.61, 95%CI: 0.50, 0.82) were associated with a lower rate of SGA. CONCLUSION Paternal low education is independently associated with PTB and SGA. Paternal heavy smoking is associated with PTB. Low paternal weight/BMI is independently associated with LBW, PTB, and SGA.
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Affiliation(s)
- Jing Li
- Research center, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Jie Qiu
- Obstetrical department, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Ling Lv
- Obstetrical department, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Baohong Mao
- Research center, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Lei Huang
- Pediatrics department, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Tao Yang
- Galactophore department, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Cheng Wang
- Research center, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China
| | - Qing Liu
- Gynaecology department, Gansu Provincial Maternity and Child Care Hospital, Lanzhou, Gansu, China.
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14
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Vik ES, Aasheim V, Nilsen RM, Small R, Moster D, Schytt E. Paternal country of origin and adverse neonatal outcomes in births to foreign-born women in Norway: A population-based cohort study. PLoS Med 2020; 17:e1003395. [PMID: 33147226 PMCID: PMC7641355 DOI: 10.1371/journal.pmed.1003395] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 09/18/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Migration is a risk factor for adverse neonatal outcomes. The various impacts of maternal origin have been reported previously. The aim of this study was to investigate associations between paternal origin and adverse neonatal outcomes in births to migrant and Norwegian-born women in Norway. METHODS AND FINDINGS This nationwide population-based study included births to migrant (n = 240,759, mean age 29.6 years [±5.3 SD]) and Norwegian-born women (n = 1,232,327, mean age 29.0 years [±5.1 SD]) giving birth in Norway in 1990-2016. The main exposure was paternal origin (Norwegian-born, foreign-born, or unregistered). Neonatal outcomes were very preterm birth (22+0-31+6 gestational weeks), moderately preterm birth (32+0-36+6 gestational weeks), small for gestational age (SGA), low Apgar score (<7 at 5 minutes), and stillbirth. Associations were investigated in migrant and Norwegian-born women separately using multiple logistic regression and reported as adjusted odds ratios (aORs) with 95% confidence intervals (CIs), adjusted for year of birth, parity, maternal and paternal age, marital status, maternal education, and mother's gross income. In births to migrant women, a foreign-born father was associated with increased odds of very preterm birth (1.1% versus 0.9%, aOR 1.20; CI 1.08-1.33, p = 0.001), SGA (13.4% versus 9.5%, aOR 1.48; CI 1.43-1.53, p < 0.001), low Apgar score (1.7% versus 1.5%, aOR 1.14; CI 1.05-1.23, p = 0.001), and stillbirth (0.5% versus 0.3%, aOR 1.26; CI 1.08-1.48, p = 0.004) compared with a Norwegian-born father. In Norwegian-born women, a foreign-born father was associated with increased odds of SGA (9.3% versus 8.1%, aOR 1.13; CI 1.09-1.16, p < 0.001) and decreased odds of moderately preterm birth (4.3% versus 4.4%, aOR 0.95; CI 0.91-0.99, p = 0.015) when compared with a Norwegian-born father. In migrant women, unregistered paternal origin was associated with increased odds of very preterm birth (2.2% versus 0.9%, aOR 2.29; CI 1.97-2.66, p < 0.001), moderately preterm birth (5.6% versus 4.7%, aOR 1.15; CI 1.06-1.25, p = 0.001), SGA (13.0% versus 9.5%, aOR 1.50; CI 1.42-1.58, p < 0.001), low Apgar score (3.4% versus 1.5%, aOR 2.23; CI 1.99-2.50, p < 0.001), and stillbirth (1.5% versus 0.3%, aOR 4.87; CI 3.98-5.96, p < 0.001) compared with a Norwegian-born father. In Norwegian-born women, unregistered paternal origin was associated with increased odds of very preterm birth (4.6% versus 1.0%, aOR 4.39; CI 4.05-4.76, p < 0.001), moderately preterm birth (7.8% versus 4.4%, aOR 1.62; CI 1.53-1.71, p < 0.001), SGA (11.4% versus 8.1%, aOR 1.30; CI 1.24-1.36, p < 0.001), low Apgar score (4.6% versus 1.3%, aOR 3.51; CI 3.26-3.78, p < 0.001), and stillbirth (3.2% versus 0.4%, aOR 9.00; CI 8.15-9.93, p < 0.001) compared with births with a Norwegian-born father. The main limitations of this study were the restricted access to paternal demographics and inability to account for all lifestyle factors. CONCLUSION We found that a foreign-born father was associated with adverse neonatal outcomes among births to migrant women, but to a lesser degree among births to nonmigrant women, when compared with a Norwegian-born father. Unregistered paternal origin was associated with higher odds of adverse neonatal outcomes in births to both migrant and nonmigrant women when compared with Norwegian-born fathers. Increased attention to paternal origin may help identify women in maternity care at risk for adverse neonatal outcomes.
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Affiliation(s)
- Eline S. Vik
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- * E-mail:
| | - Vigdis Aasheim
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Roy M. Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
| | - Rhonda Small
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Judith Lumley Centre, La Trobe University, Melbourne, Australia
| | - Dag Moster
- Department of Global Public Health and Primary Care, University of Bergen, Norway
- Department of Pediatrics, Haukeland University Hospital, Norway
| | - Erica Schytt
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Norway
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Clinical Research Dalarna, Uppsala University, Sweden
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15
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Paternal Education and Infant Health: Variation by Race/Ethnicity. J Racial Ethn Health Disparities 2020; 8:1406-1414. [PMID: 33098039 DOI: 10.1007/s40615-020-00902-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/12/2020] [Accepted: 10/14/2020] [Indexed: 10/23/2022]
Abstract
In the USA, efforts to improve unequal infant health outcomes require knowledge about how the relationship between education and infant health varies by parental gender and race/ethnicity. Drawing from a pooled random sample of over 1 million live births from the 2011 to 2017 National Vital Statistics System data, we examine the relationship between maternal and paternal education and infant health and assess how it varies by maternal racial and ethnic background. The model fit statistics suggest that the relationship between paternal education and infant health is about equal to maternal education and infant health. However, we find a weaker relationship overall between parental education and infant health among Asian and Hispanic fathers than Whites, American Indian, and Black fathers. Black fathers' education is more strongly associated with infant health than that of Black mothers. At some levels, paternal education is also more strongly related to health among Hispanic infants. The results suggest a greater focus on fathers' contributions to infant health is warranted, and programs or policies that focus on fathers could help address racial and ethnic infant health disparities.
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16
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Lamichhane DK, Lee SY, Ahn K, Kim KW, Shin YH, Suh DI, Hong SJ, Kim HC. Quantile regression analysis of the socioeconomic inequalities in air pollution and birth weight. ENVIRONMENT INTERNATIONAL 2020; 142:105875. [PMID: 32590283 DOI: 10.1016/j.envint.2020.105875] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Revised: 04/02/2020] [Accepted: 05/16/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND An association between maternal exposure to air pollution and the birth weight distribution has been reported, but the extent to which this relationship varies according to socioeconomic status (SES) is unknown. This study examined the relationship using the data from a Korean birth cohort. METHODS Data for singleton births in Seoul from 2007 to 2017 (n = 1739) were analyzed. Maternal exposures to particulate matter with an aerodynamic diameter <10 µm (PM10) and <2.5 µm (PM2.5), as well as to nitrogen dioxide (NO2) and ozone (O3) for each trimester and the entire pregnancy were estimated using residential address, gestational age, and the birth date. The associations between the interquartile range (IQR) increases in pollutant concentrations and the changes in birth weight were examined using linear regression and quantile regression models. The socioeconomic disparities in the associations were investigated using a derived SES variable based on the composite of parental education and occupation. This SES variable was then interacted with the air pollutant. RESULTS In the gestational age-adjusted models, particulate air pollutants (PM10 and PM2.5) and O3 were associated with birth weight decreases for the lower birth weight percentiles. For example, the decrease in mean birthweight per IQR increase in PM2.5 during second trimester was -21.1 g (95% confidence interval (CI) = -41.8, -0.4), whereas the quantile-specific associations were: 10th percentile -27.0 g (95% CI = -46.6, -7.3); 50th percentile -22.2 g (95% CI = -39.6, -4.8); and 90th percentile -22.9 g (95% CI = -45.5, -0.2). Particulate air pollutants and O3 showed a pattern of socioeconomic inequalities; the reduced birth weight was of greater magnitude for children from a low SES group. CONCLUSIONS Negative associations between particulate air pollutants and O3 and birth weight were consistently greater at the lower quantiles of the birth weight distribution, especially in lower SES group.
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Affiliation(s)
- Dirga Kumar Lamichhane
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea
| | - So-Yeon Lee
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Kangmo Ahn
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Environmental Health Center for Atopic Diseases, Samsung Medical Center, Seoul, Republic of Korea
| | - Kyung Won Kim
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Youn Ho Shin
- Department of Pediatrics, CHA Gangnam Medical Center, CHA University School of Medicine, Seoul, Republic of Korea
| | - Dong In Suh
- Department of Pediatrics, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Soo-Jong Hong
- Department of Pediatrics, Childhood Asthma Atopy Center, Humidifier Disinfectant Health Center, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.
| | - Hwan-Cheol Kim
- Department of Occupational and Environmental Medicine, Inha University School of Medicine, Incheon, Republic of Korea.
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17
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Arneja J, Hung RJ, Seeto RA, Knight JA, Hewko SL, Bocking A, Lye SJ, Brooks JD. Association between maternal acetaminophen use and adverse birth outcomes in a pregnancy and birth cohort. Pediatr Res 2020; 87:1263-1269. [PMID: 31852009 DOI: 10.1038/s41390-019-0726-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Revised: 11/11/2019] [Accepted: 11/22/2019] [Indexed: 01/10/2023]
Abstract
INTRODUCTION Acetaminophen is the only analgesic recommended for use during pregnancy. This use has recently been linked to childhood developmental disorders, a finding that requires further investigation. Adverse birth outcomes-preterm birth, low birthweight, and small for gestational age-are associated with increased risk of developmental disorders and can serve as intermediate outcomes when examining the impact of maternal acetaminophen use. METHODS Clinical and lifestyle-factor data were gathered from 1200 women within the Ontario Birth Study who delivered between January 2013 and June 2017. Poisson regression with robust error variance was used to estimate the relationship between acetaminophen use before and during pregnancy and low birthweight, preterm birth, and small for gestational age. RESULTS Offspring of mothers who used acetaminophen before pregnancy had a higher risk of low birthweight and small for gestational age. Acetaminophen use <once/week was associated with small for gestational age, adjusted relative risk (aRR) = 1.46 (95% CI 1.02, 2.11). Acetaminophen use ≥once/week was associated with both small for gestational age, RR = 1.82 (95% CI 1.12, 2.94), and low birthweight, aRR = 2.16 (95% CI 1.02, 4.54). Acetaminophen use during pregnancy was not associated with the examined outcomes. CONCLUSIONS Prepregnancy acetaminophen use may be associated with higher risk of adverse birth outcomes.
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Affiliation(s)
- Jasleen Arneja
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Rayjean J Hung
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Ryan A Seeto
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Julia A Knight
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Sheryl L Hewko
- Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada
| | - Alan Bocking
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
| | - Stephen J Lye
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, Sinai Health System, Toronto, ON, Canada.,Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON, Canada
| | - Jennifer D Brooks
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
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18
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Sierra-Rodríguez VL, Cardona-Arango D, Arroyave I. Ethnicity and Low Birth Weight: Inequalities Between Ethnic Minorities and the Predominant Mestizo Population, Colombia, 2008-2014. J Immigr Minor Health 2020; 23:62-70. [PMID: 32445162 DOI: 10.1007/s10903-020-01031-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Low birth weight (LBW) is a global problem that annually affects nearly 20 million children, 96% of these in developing countries. According to the WHO, the poorest and the ethnic minorities are the groups most affected by this indicator. A cross-sectional study of the database of all newborns officially registered in Colombia in 2008-2014 was done. While dichotomizing the mestizo population and ethnic minorities (Afro-descendants, indigenous, ROM), normal and low birth weight was used as the dependent variable and ethnicity as the explanatory variable. Other variables of the parents and the newborns were used as covariates. To assess associations, bivariate and multivariate logistic regression analyses were performed. The incidence of LBW among newborns registered in Colombia fluctuated at around 9%. Among the ethnic minorities, the probability of LBW, adjusted for other variables, was significantly higher (OR 1.07, 95% CI 1.05-1.08) than among mestizos. A significantly higher risk of LBW to newborns in the ethnic minorities' group, and those with unfavorable socioeconomic conditions, was found.
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Affiliation(s)
| | | | - Ivan Arroyave
- National School of Public Health, University of Antioquia, Medellin, Colombia.
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19
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Jha SC, Xia K, Ahn M, Girault JB, Li G, Wang L, Shen D, Zou F, Zhu H, Styner M, Gilmore JH, Knickmeyer RC. Environmental Influences on Infant Cortical Thickness and Surface Area. Cereb Cortex 2020; 29:1139-1149. [PMID: 29420697 DOI: 10.1093/cercor/bhy020] [Citation(s) in RCA: 50] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Indexed: 01/07/2023] Open
Abstract
Cortical thickness (CT) and surface area (SA) vary widely between individuals and are associated with intellectual ability and risk for various psychiatric and neurodevelopmental conditions. Factors influencing this variability remain poorly understood, but the radial unit hypothesis, as well as the more recent supragranular cortex expansion hypothesis, suggests that prenatal and perinatal influences may be particularly important. In this report, we examine the impact of 17 major demographic and obstetric history variables on interindividual variation in CT and SA in a unique sample of 805 neonates who received MRI scans of the brain around 2 weeks of age. Birth weight, postnatal age at MRI, gestational age at birth, and sex emerged as important predictors of SA. Postnatal age at MRI, paternal education, and maternal ethnicity emerged as important predictors of CT. These findings suggest that individual variation in infant CT and SA is explained by different sets of environmental factors with neonatal SA more strongly influenced by sex and obstetric history and CT more strongly influenced by socioeconomic and ethnic disparities. Findings raise the possibility that interventions aimed at reducing disparities and improving obstetric outcomes may alter prenatal/perinatal cortical development.
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Affiliation(s)
- Shaili C Jha
- Curriculum in Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Kai Xia
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Mihye Ahn
- Department of Mathematics and Statistics, University of Nevada, Reno, NV, USA
| | - Jessica B Girault
- Curriculum in Neuroscience, University of North Carolina, Chapel Hill, NC, USA
| | - Gang Li
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Li Wang
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Dinggang Shen
- Biomedical Research Imaging Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.,Department of Brain and Cognitive Engineering, Korea University, Seoul, Republic of Korea
| | - Fei Zou
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA
| | - Hongtu Zhu
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC, USA.,Department of Biostatistics, University of Texas, MD Andersen Cancer Center, Houston, TX, USA
| | - Martin Styner
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - John H Gilmore
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
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20
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Chen YH, Li L, Chen W, Liu ZB, Ma L, Gao XX, He JL, Wang H, Zhao M, Yang YY, Xu DX. Pre-pregnancy underweight and obesity are positively associated with small-for-gestational-age infants in a Chinese population. Sci Rep 2019; 9:15544. [PMID: 31664141 PMCID: PMC6820714 DOI: 10.1038/s41598-019-52018-7] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Accepted: 10/10/2019] [Indexed: 01/12/2023] Open
Abstract
The association between suboptimal pre-pregnancy body mass index (BMI) and small-for-gestational-age (SGA) infants is not well defined. We investigated the association between pre-pregnancy BMI and the risk of SGA infants in a Chinese population. We performed a cohort study among 12029 mothers with a pregnancy. This cohort consisted of pregnant women that were: normal-weight (62.02%), underweight (17.09%), overweight (17.77%) and obese (3.12%). Birth sizes were reduced in the underweight and obese groups compared with the normal-weight group. Linear regression analysis indicated that birth size was positively associated with BMI in both the underweight and normal-weight groups. Further analysis showed that 12.74% of neonates were SGA infants in the underweight group, higher than 7.43% of neonates reported in the normal-weight group (adjusted RR = 1.92; 95% CI: 1.61, 2.30). Unexpectedly, 17.60% of neonates were SGA infants in the obese group, much higher than the normal-weight group (adjusted RR = 2.17; 95% CI: 1.57, 3.00). Additionally, 18.40% of neonates were large-for-gestational-age (LGA) infants in the obese group, higher than 7.26% of neonates reported in the normal-weight group (adjusted RR = 3.00; 95% CI: 2.21, 4.06). These results suggest that pre-pregnancy underweight increases the risk of SGA infants, whereas obesity increases the risks of not only LGA infants, but also SGA infants.
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Affiliation(s)
- Yuan Hua Chen
- School of Basic Medical Sciences, Anhui Medical University, Hefei, 230032, China. .,School of Public Health, Anhui Medical University, Hefei, 230032, China. .,Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, VIC, Australia.
| | - Li Li
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - Wei Chen
- School of Basic Medical Sciences, Anhui Medical University, Hefei, 230032, China
| | - Zhi Bing Liu
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Li Ma
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Xing Xing Gao
- School of Basic Medical Sciences, Anhui Medical University, Hefei, 230032, China
| | - Jia Liu He
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Hua Wang
- School of Public Health, Anhui Medical University, Hefei, 230032, China
| | - Mei Zhao
- School of Nursing, Anhui Medical University, Hefei, 230032, China
| | - Yuan Yuan Yang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Anhui Medical University, Hefei, 230022, China
| | - De Xiang Xu
- School of Public Health, Anhui Medical University, Hefei, 230032, China.
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21
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Enders C, Pearson D, Harley K, Ebisu K. Exposure to coarse particulate matter during gestation and term low birthweight in California: Variation in exposure and risk across region and socioeconomic subgroup. THE SCIENCE OF THE TOTAL ENVIRONMENT 2019; 653:1435-1444. [PMID: 30759582 DOI: 10.1016/j.scitotenv.2018.10.323] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Revised: 08/24/2018] [Accepted: 10/24/2018] [Indexed: 05/12/2023]
Abstract
Despite evidence that particulate matter with an aerodynamic diameter ≤10 μm (PM10) or ≤2.5 μm (PM2.5) are associated with several adverse birth outcomes, research on the association between coarse particulate matter (PM10-2.5) and birth outcomes is scarce, and results have been inconsistent. Furthermore, the literature is unclear whether associations between PM10 and adverse birth outcomes were driven by PM2.5 alone or also by PM10-2.5 exposure. Research on the variation in exposure to and risk from PM10-2.5 across populations is also needed to identify potentially vulnerable subgroups. We used birth certificate and ambient air monitoring data in California from 2002 to 2013 to develop a retrospective cohort study of pregnant women and their infants. Averaged gestational and trimester-specific exposures of PM10-2.5 and PM2.5 were calculated for mothers whose residential zip code tabulation areas were within a 20 km radius of monitors. We assessed the relationship between prenatal exposure to PM10-2.5 and term low birthweight (TLBW) using logistic and linear regression, adjusting for maternal and paternal demographic, environmental, temporal, and health-related covariates. We also conducted analyses stratified by socioeconomic characteristics and regions. We found a relationship between PM10-2.5 exposure during pregnancy and TLBW after controlling for PM2.5 exposure: odds ratio for second quartile of exposure: 1.00 (95% confidence interval: 0.98, 1.03), third quartile: 1.03 (1.00, 1.06), fourth quartile: 1.04 (1.01, 1.07), compared to the first quartile. Associations were strong among Non-Hispanic Black mothers, mothers living in the Central Valley, and fathers without a college degree. Exposure to and risk from PM10-2.5 were heterogeneous across California indicating environmental justice implications. We also found that paternal characteristics were associated with the risk of TLBW even after controlling for maternal characteristics. In addition to PM10-2.5 total mass, further research is needed on the components of PM10-2.5 which may be driving these associations.
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Affiliation(s)
- Catherine Enders
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA 94612, USA; School of Public Health, University of California, Berkeley, 50 University Hall, #7360, Berkeley, CA 94720, USA
| | - Dharshani Pearson
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA 94612, USA
| | - Kim Harley
- School of Public Health, University of California, Berkeley, 50 University Hall, #7360, Berkeley, CA 94720, USA
| | - Keita Ebisu
- Office of Environmental Health Hazard Assessment, California Environmental Protection Agency, 1515 Clay Street, 16th floor, Oakland, CA 94612, USA.
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22
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The Effect of Prenatal Stress, Proxied by Marital and Paternity Status, on the Risk of Preterm Birth. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16020273. [PMID: 30669349 PMCID: PMC6352213 DOI: 10.3390/ijerph16020273] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 01/09/2023]
Abstract
Uncertainty and insecurity in the relationship between the mother and father of a child are responsible for heightened maternal stress, which can lead to preterm birth (PTB). Different intensities of prenatal stress (proxied by four levels of marital status linked with the presence or absence of paternal data on birth records) were defined as the Marital-Father Data index. We assessed the impact of those varying intensities of prenatal stress on PTB with respect to parity among a group of Polish mothers residing in Krakow (N = 87,916). We found a pattern across the adjusted risk ratios (RR) of preterm birth that ordered these estimates in an increasing trend towards higher risk, beginning with the group of married mothers with father data present (baseline), through the groups of legitimizing marriages—married after conception with father data present (RR = 1.1; 95% Confidence Intervals (CI) 1.0–1.2) and unmarried mothers with father data present (RR = 1.3; 95% CI 1.2–1.5) to the group of unmarried mothers with father data absent (RR = 1.9; 95% CI 1.7–2.2). The adjusted p for the linear trend between Marital-Father Data index and PTB was less than 0.001. The adjusted effect of perceived prenatal stress differed with respect to parity (confirmed by statistically significant interactions between Marital-Father Data index levels and parity), with a higher magnitude of this effect noted among multiparous versus primiparous women. Low paternal involvement and support during pregnancy may negatively affect PTB risk and this effect may differ in relation to parity status. More attention should be paid to maternal pregnancy stress, especially of multiparous mothers, to decrease the risk of unfavorable birth outcomes.
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23
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Abstract
Objective To determine the contribution of paternal factors to the risk of adverse birth outcomes. Methods This is a retrospective cross-sectional analysis using birth certificate data from 2004 to 2015 retrieved from the Finger Lakes Regional Perinatal Data System. Primiparous women with singleton pregnancies were analyzed in the study. Two multivariate logistic regression models were conducted to assess potential paternal risk factors including age, race/ethnicity, and education on four birth outcomes, including preterm birth (PTB), low birthweight (LBW), high birthweight (HBW), and small for gestational age (SGA). Results A total of 36,731 singleton births were included in the analysis. Less paternal education was significantly related to an elevated risk of PTB, LBW, and SGA, even after adjustment for maternal demographic, medical, and lifestyle factors (P < 0.05). Paternal race/ethnicity was also significantly associated with all four birth outcomes (P < 0.05) while controlling for maternal factors. Older paternal age was associated with increased odds (OR 1.012, 95% CI 1.003-1.022) of LBW. Maternal race/ethnicity partially mediated the association of paternal race/ethnicity with HBW and SGA. Maternal education partially mediated the relationship between paternal education and SGA. Conclusion Paternal factors were important predictors of adverse birth outcomes. Our results support the inclusion of fathers in future studies and clinical programs aimed at reducing adverse birth outcomes.
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Affiliation(s)
- Ying Meng
- Clinical and Translational Science Institute, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA.
| | - Susan W Groth
- School of Nursing, University of Rochester, 601 Elmwood Avenue, Rochester, NY, 14642, USA
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