Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA.
Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA.
Int J Environ Res Public Health. 2019 Oct 28;16(21):4154. doi: 10.3390/ijerph16214154.
Few studies examined the impact of maternal socioeconomic status and of its combined effects with environmental exposures on birthweight. Our goal was to examine the impact of maternal homelessness (mothers ever homeless or who lived in shelters during pregnancy) and participation in the Special Supplemental Nutrition Program for Women, Infants and Children (WIC) during pregnancy in conjunction with air pollution exposure on birthweight in the Boston-based Children's HealthWatch cohort from 2007 through 2015 (n = 3366). Birthweight was obtained from electronic health records. Information on maternal homelessness and WIC participation during pregnancy were provided via a questionnaire. Prenatal fine particulate matter (PM) exposures, estimated at the subject's residential address, were calculated for each trimester. We fit linear regression models adjusting for maternal and child characteristics, seasonality, and block-group-level median household income and examined the interactions between PM and each covariate. Prenatal maternal homelessness was associated with reduced birthweight (-55.7 g, 95% CI: -97.8 g, -13.7 g), while participating in WIC was marginally associated with increased birthweight (36.1 g, 95% CI: -7.3 g, 79.4 g). Only average PM during the second trimester was marginally associated with reduced birthweight (-8.5 g, 95% CI: -19.3, 2.3) for a 1 µg/m increase in PM. The association of PM during the second trimester with reduced birthweight was stronger among non-Hispanic Black mothers and trended toward significance among immigrants and single mothers. Our study emphasizes the independent and synergistic effects of social and environmental stressors on birthweight, particularly the potentially protective effect of participating in WIC for vulnerable populations.
很少有研究探讨产妇社会经济地位及其与环境暴露的综合影响对出生体重的影响。我们的目标是检验母体无家可归（曾无家可归或在怀孕期间居住在收容所的母亲）和在怀孕期间参加妇女、婴儿和儿童特别补充营养计划（WIC）与空气污染暴露相结合对 2007 年至 2015 年期间在波士顿儿童健康观察队列中出生体重的影响（n = 3366）。出生体重从电子健康记录中获得。怀孕期间母体无家可归和 WIC 参与情况的信息通过问卷提供。每个季度都在研究对象的居住地址计算产前细颗粒物（PM）暴露量。我们拟合了线性回归模型，调整了母婴特征、季节性以及街区组级中位数家庭收入，并检查了 PM 与每个协变量之间的相互作用。产前母体无家可归与出生体重降低有关（-55.7g，95%CI：-97.8g，-13.7g），而参加 WIC 则与出生体重略有增加有关（36.1g，95%CI：-7.3g，79.4g）。仅在第二个三个月期间的平均 PM 与出生体重略有降低有关（-8.5g，95%CI：-19.3，2.3），PM 增加 1μg/m。在第二个三个月期间，PM 与出生体重降低之间的关联在非西班牙裔黑人母亲中更强，在移民和单身母亲中也呈趋势。我们的研究强调了社会和环境压力源对出生体重的独立和协同影响，特别是对于弱势群体参与 WIC 的潜在保护作用。
