University of Kentucky, College of Public Health, Lexington, Department of Epidemiology, Lexington, KY 40504-3381, USA.
Public Health Rep. 2012 Jan-Feb;127(1):72-80. doi: 10.1177/003335491212700108.
Approximately 13% of all births occur prior to 37 weeks gestation in the U.S. Some established risk factors exist for preterm birth, but the etiology remains largely unknown. Recent studies have suggested an association with environmental exposures. We examined the relationship between preterm birth and exposure to a commonly used herbicide, atrazine, in drinking water.
We reviewed Kentucky birth certificate data for 2004-2006 to collect duration of pregnancy and other individual-level covariates. We assessed existing data sources for atrazine levels in public drinking water for the years 2000-2008, classifying maternal county of residence into three atrazine exposure groups. We used logistic regression to analyze the relationship between atrazine exposure and preterm birth, controlling for maternal age, race/ethnicity, education, smoking, and prenatal care.
An increase in the odds of preterm birth was found for women residing in the counties included in the highest atrazine exposure group compared with women residing in counties in the lowest exposure group, while controlling for covariates. Analyses using the three exposure assessment approaches produced odds ratios ranging from 1.20 (95% confidence interval [CI] 1.14, 1.27) to 1.26 (95% CI 1.19, 1.32), for the highest compared with the lowest exposure group.
Suboptimal characterization of environmental exposure and variables of interest limited the analytical options of this study. Still, our findings suggest a positive association between atrazine and preterm birth, and illustrate the need for an improved assessment of environmental exposures to accurately address this important public health issue.
在美国,约有 13%的婴儿在 37 周妊娠前出生。一些已确立的早产风险因素存在,但病因仍很大程度上未知。最近的研究表明与环境暴露有关。我们研究了早产与饮用水中常用除草剂莠去津暴露之间的关系。
我们查阅了 2004 年至 2006 年肯塔基州的出生证明数据,以收集妊娠持续时间和其他个体水平的协变量。我们评估了现有的公共饮用水中莠去津水平的现有数据源,将产妇县居住情况分为三个莠去津暴露组。我们使用逻辑回归分析莠去津暴露与早产之间的关系,同时控制母亲的年龄、种族/族裔、教育、吸烟和产前护理。
与居住在暴露程度最低的县的妇女相比,居住在暴露程度最高的县的妇女早产的几率增加,同时控制了协变量。使用三种暴露评估方法进行的分析产生的比值比范围为 1.20(95%置信区间[CI]1.14,1.27)至 1.26(95%CI1.19,1.32),最高与最低暴露组相比。
环境暴露和感兴趣变量的描述不足限制了本研究的分析选择。尽管如此,我们的研究结果表明莠去津与早产之间存在正相关关系,并说明了需要改进环境暴露评估,以准确解决这一重要的公共卫生问题。