Korfmacher Katrina Smith, Suter Barbara J, Cai Xueya, Brownson Susan A, Dozier Ann M
Department of Environmental Medicine, Environmental Health Sciences Center, University of Rochester, 601 Elmwood Avenue, Box EHSC, Rochester, NY, 14642, USA,
Matern Child Health J. 2014 Jul;18(5):1155-68. doi: 10.1007/s10995-013-1345-3.
Environmental exposures during pregnancy have a lasting impact on children's health. We combined environmental and maternal risk factor survey data to inform efforts to protect children's health. We made recommendations for future use of such data. A modified version of the Pregnancy Risk Assessment Monitoring System (PRAMS) mail survey was conducted based on weighted sampling design with low-income and non-low income women in Monroe County, NY (1,022 respondents). A series of environmental questions were included in the questionnaire. Data were analyzed using Chi square tests and Poisson loglinear regression model to identify patterns in environmental health risk and sociodemographic characteristics. We identified women who rented their homes, had lower incomes, and lived in inner city zip codes as "high environmental health risk" (HEHR). HEHR respondents were more likely to report that a health care provider talked with them about lead and on average reported more behaviors to protect their children from lead poisoning. Combining environmental and perinatal risk factor data could yield important recommendations for medical practice, health education, and policy development. However, at present PRAMS gathers only limited and inconsistent environmental data. We found that existing PRAMS environmental questions are insufficient. Further work is needed to develop updated and more comprehensive environmental health survey questions and implement them consistently across the country.
孕期的环境暴露会对儿童健康产生持久影响。我们整合了环境和孕产妇风险因素调查数据，以为保护儿童健康的工作提供信息。我们对这类数据的未来使用提出了建议。基于加权抽样设计，对纽约州门罗县的低收入和非低收入女性开展了一份经过修改的妊娠风险评估监测系统（PRAMS）邮件调查（1022名受访者）。问卷中包含了一系列环境问题。使用卡方检验和泊松对数线性回归模型对数据进行分析，以确定环境健康风险和社会人口学特征方面的模式。我们将租房、收入较低且居住在市中心邮政编码区域的女性确定为“高环境健康风险”（HEHR）人群。HEHR受访者更有可能报告称有医疗保健人员与她们谈论过铅的问题，并且平均而言，她们报告的保护孩子免受铅中毒的行为更多。整合环境和围产期风险因素数据可为医疗实践、健康教育和政策制定提供重要建议。然而，目前PRAMS仅收集有限且不一致的环境数据。我们发现现有的PRAMS环境问题并不充分。需要进一步开展工作，以开发更新且更全面的环境健康调查问题，并在全国范围内持续实施这些问题。
