Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Cases | Controls b | |||
---|---|---|---|---|
Mild | Severe | Superimposed | ||
n = 983 | n = 1043 | n = 256 | n = 75,124 | |
Age (years) | ||||
<20 | 18.3 | 17.1 | 3.5 | 13.6 |
20–24 | 27.4 | 27.0 | 16.0 | 29.7 |
25–29 | 21.8 | 23.6 | 24.6 | 27.7 |
30–34 | 17.9 | 17.2 | 27.0 | 19.1 |
≥35 | 14.6 | 15.2 | 28.9 | 10.0 |
Missing | 0.1 | -- | -- | -- |
Race/ethnicity | ||||
White, non-Hispanic | 29.4 | 26.1 | 29.3 | 30.7 |
US-born Hispanic | 31.7 | 30.9 | 25.8 | 25.4 |
Foreign-born Hispanic | 22.6 | 25.8 | 20.7 | 28.7 |
Black, non-Hispanic | 7.9 | 6.9 | 14.8 | 5.2 |
Other | 7.9 | 9.7 | 8.6 | 9.7 |
Missing | 0.4 | 0.7 | 0.8 | 0.4 |
Education | ||||
Less than high school | 28.0 | 27.6 | 25.0 | 31.2 |
High school | 35.6 | 34.5 | 36.7 | 32.5 |
More than high school | 34.5 | 35.3 | 36.3 | 34.6 |
Missing | 1.9 | 2.6 | 2.0 | 1.7 |
Parity | ||||
1 | 53.1 | 57.2 | 34.4 | 35.1 |
≥2 | 46.9 | 42.6 | 65.6 | 64.8 |
Missing | -- | 0.2 | -- | <0.1 |
Payer type for delivery | ||||
Medi-Cal | 56.1 | 52.0 | 44.9 | 52.8 |
Private | 41.8 | 44.4 | 51.2 | 44.7 |
Other | 1.8 | 3.6 | 3.5 | 2.4 |
Missing | 0.3 | 0.1 | 0.4 | 0.1 |
Season of conception | ||||
Winter (Dec–Feb) | 26.1 | 24.5 | 23.1 | 26.2 |
Spring (March–May) | 25.9 | 23.7 | 23.8 | 24.9 |
Summer (June–Aug) | 23.7 | 27.0 | 23.1 | 23.6 |
Fall (Sep–Nov) | 24.2 | 24.8 | 30.1 | 25.4 |
Income below the federal poverty level (proportion greater than 20%) c | ||||
No | 55.5 | 54.0 | 59.0 | 57.9 |
Yes | 44.5 | 46.0 | 41.0 | 42.1 |
Median household annual income (less than $30,000) c | ||||
No | 57.4 | 56.5 | 60.6 | 60.2 |
Yes | 42.6 | 43.5 | 39.5 | 39.8 |
100 m Buffer (75th %) | 500 m Buffer (75th %) | All Subjects | |
---|---|---|---|
n = 19,320 | n = 19,279 | n = 77,406 | |
Maternal age (years) | |||
<20 | 13.6 | 12.2 | 13.7 |
20–24 | 28.6 | 27.1 | 29.6 |
25–29 | 26.9 | 27.8 | 27.5 |
30–34 | 19.6 | 21.2 | 19.1 |
≥35 | 11.4 | 11.7 | 10.2 |
Maternal race/ethnicity | |||
White, non-Hispanic | 34.3 | 35.6 | 30.6 |
US-born Hispanic | 24.2 | 22.6 | 25.5 |
Foreign-born Hispanic | 28.6 | 28.2 | 28.6 |
Black, non-Hispanic | 4.3 | 4.1 | 5.3 |
Other | 8.1 | 9.0 | 9.7 |
Missing | 0.5 | 0.5 | 0.4 |
Maternal education | |||
Less than high school | 31.0 | 28.7 | 31.1 |
High school | 31.9 | 31.4 | 32.6 |
More than high school | 36.0 | 38.6 | 34.6 |
Missing | 1.0 | 1.3 | 1.7 |
Parity | |||
1 | 36.3 | 35.7 | 35.7 |
≥2 | 63.7 | 64.3 | 64.3 |
Missing | <0.1 | <0.1 | <0.1 |
Payer type for delivery | |||
Medi-Cal | 50.3 | 46.6 | 52.8 |
Private | 47.0 | 50.9 | 44.7 |
Other | 2.6 | 2.4 | 2.4 |
Missing | <0.1 | 0.1 | 0.1 |
Season of conception | |||
Winter (Dec–Feb) | 26.3 | 25.8 | 26.1 |
Spring (March–May) | 24.4 | 24.7 | 24.8 |
Summer (June–Aug) | 23.9 | 24.0 | 23.7 |
Fall (Sep–Nov) | 25.4 | 25.5 | 25.4 |
Income below the federal poverty level (proportion greater than 20%) b | |||
No | 64.3 | 70.8 | 57.9 |
Yes | 35.7 | 29.2 | 42.2 |
Median household annual income (less than $30,000) b | |||
No | 65.9 | 73.3 | 60.1 |
Yes | 34.1 | 26.7 | 39.9 |
Mild Preeclampsia | Severe Preeclampsia | Superimposed Preeclampsia | |
---|---|---|---|
aOR (95% CI) | |||
100 m Buffer (>75% vs. ≤25%) | 0.83 (0.69,1.00) | 1.04 (0.87,1.24) | 0.86 (0.60,1.22) |
500 m Buffer (>75% vs. ≤25%) | 0.82 (0.69,0.99) | 0.98 (0.82,1.17) | 0.56 (0.40,0.80) |
CO (>75% vs. ≤75%) | 1.06 (0.89,1.25) | 1.10 (0.94,1.30) | 0.93 (0.67,1.30) |
NO2 (>75% vs. ≤75%) | 1.13 (0.97,1.31) | 1.11 (0.96,1.29) | 0.99 (0.74,1.34) |
PM10 (>75% vs. ≤75%) | 1.20 (1.04,1.39) | 0.99 (0.86,1.15) | 1.07 (0.80,1.44) |
PM2.5 (>75% vs. ≤75%) | 1.28 (1.10,1.49) | 1.38 (1.19,1.59) | 1.23 (0.92,1.65) |
Neighborhood Poverty >20% (Yes vs. No) | 1.24 (1.08,1.42) | 1.31 (1.15,1.50) | 1.29 (0.99,1.69) |
Median Income <30 K (Yes vs. No) | 1.25 (1.09,1.43) | 1.29 (1.13,1.47) | 1.32 (1.01,1.73) |
Preeclampsia Phenotype | Adjusted a Odds Ratio (95% Confidence Intervals) | p-Value Interaction | |
---|---|---|---|
High Poverty | Low Poverty | ||
Mild | 0.79 (0.59,1.05) | 0.93 (0.73,1.20) | 0.44 |
Severe | 1.17 (0.91,1.52) | 0.97 (0.75,1.25) | 0.27 |
Superimposed | 0.80 (0.45,1.44) | 0.46 (0.30,0.71) | 0.13 |
Low Income | High Income | ||
Mild | 0.83 (0.62,1.11) | 0.91 (0.71,1.16) | 0.66 |
Severe | 1.07 (0.82,1.40) | 1.06 (0.82,1.36) | 0.89 |
Superimposed | 1.01 (0.57,1.81) | 0.42 (0.27,0.65) | 0.01 |
Neighborhood SES | Preeclampsia Phenotype | Adjusted a Odds Ratio (95% Confidence Intervals) | p-Value Interaction | |
---|---|---|---|---|
PM10 High Exposure | PM10 Low Exposure | |||
Overall | Mild | 1.00 (0.69,1.45) | 0.81 (0.64,1.01) | 0.18 |
Severe | 1.41 (0.98,2.03) | 0.87 (0.71,1.08) | 0.01 | |
Superimposed | 0.51 (0.21,1.23) | 0.59 (0.39,0.89) | 1.00 | |
High Poverty | Mild | 0.87 (0.51,1.49) | 0.76 (0.52,1.09) | 0.52 |
Severe | 1.45 (0.90,2.35) | 1.07 (0.78,1.48) | 0.21 | |
Superimposed | 0.54 (0.16,1.84) | 1.09 (0.51,2.35) | 0.40 | |
Low Poverty | Mild | 1.30 (0.75,2.24) | 0.90 (0.66,1.22) | 0.15 |
Severe | 1.56 (0.87,2.78) | 0.83 (0.62,1.11) | 0.02 | |
Superimposed | 0.56 (0.15,2.05) | 0.41 (0.25,0.67) | 0.54 | |
Low Income | Mild | 0.86 (0.49,1.51) | 0.84 (0.58,1.21) | 0.77 |
Severe | 1.35 (0.82,2.24) | 0.96 (0.69,1.34) | 0.19 | |
Superimposed | 0.47 (0.11,2.06) | 1.32 (0.65,2.68) | 0.27 | |
High Income | Mild | 1.28 (0.76,2.17) | 0.85 (0.63,1.16) | 0.10 |
Severe | 1.75 (1.00,3.06) | 0.90 (0.67,1.21) | 0.01 | |
Superimposed | 0.58 (0.19,1.80) | 0.40 (0.24,0.66) | 0.42 | |
PM2.5 High Exposure | PM2.5 Low Exposure | |||
Overall | Mild | 0.93 (0.65,1.32) | 0.84 (0.67,1.05) | 0.58 |
Severe | 1.17 (0.84,1.64) | 1.01 (0.81,1.25) | 0.28 | |
Superimposed | 0.61 (0.30,1.23) | 0.58 (0.38,0.88) | 0.69 | |
High Poverty | Mild | 1.05 (0.63,1.76) | 0.73 (0.51,1.05) | 0.21 |
Severe | 1.41 (0.90,2.21) | 1.24 (0.89,1.71) | 0.53 | |
Superimposed | 0.86 (0.28,2.63) | 0.87 (0.43,1.78) | 0.89 | |
Low Poverty | Mild | 0.95 (0.57,1.58) | 0.97 (0.72,1.31) | 0.94 |
Severe | 1.30 (0.77,2.18) | 0.92 (0.69,1.24) | 0.17 | |
Superimposed | 0.51 (0.20,1.28) | 0.45 (0.27,0.75) | 0.65 | |
Low Income | Mild | 1.08 (0.64,1.82) | 0.77 (0.53,1.12) | 0.26 |
Severe | 0.97 (0.58,1.62) | 1.23 (0.88,1.71) | 0.62 | |
Superimposed | 0.78 (0.22,2.76) | 1.08 (0.55,2.12) | 0.76 | |
High Income | Mild | 0.96 (0.58,1.58) | 0.94 (0.70,1.27) | 0.98 |
Severe | 1.69 (1.03,2.75) | 0.96 (0.72,1.29) | 0.04 | |
Superimposed | 0.51 (0.22,1.21) | 0.43 (0.26,0.72) | 0.56 |
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Weber, K.A.; Yang, W.; Lyons, E.; Stevenson, D.K.; Padula, A.M.; Shaw, G.M. Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California. Int. J. Environ. Res. Public Health 2021, 18, 5127. https://doi.org/10.3390/ijerph18105127
Weber KA, Yang W, Lyons E, Stevenson DK, Padula AM, Shaw GM. Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California. International Journal of Environmental Research and Public Health. 2021; 18(10):5127. https://doi.org/10.3390/ijerph18105127
Chicago/Turabian StyleWeber, Kari A., Wei Yang, Evan Lyons, David K. Stevenson, Amy M. Padula, and Gary M. Shaw. 2021. "Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California" International Journal of Environmental Research and Public Health 18, no. 10: 5127. https://doi.org/10.3390/ijerph18105127