Son Ji-Young, Bell Michelle L
School of Health Policy and Management, College of Health Sciences, Korea University, Seoul 02841, Republic of Korea.
School of the Environment, Yale University, New Haven, CT, USA.
Heliyon. 2024 Jul 19;10(15):e34985. doi: 10.1016/j.heliyon.2024.e34985. eCollection 2024 Aug 15.
Previous studies have linked exposure to concentrated animal feeding operations (CAFOs) with various health outcomes. However, relatively few studies evaluated the impacts of CAFOs on adverse birth outcomes, despite significant public health concerns regarding maternal and child health.
This cross-sectional study investigated the risk of adverse birth outcomes associated with CAFOs exposure and evaluated disparities in exposure to CAFOs and associated health outcomes.
We obtained individual-level birth records from 2003 to 2020 from the Pennsylvania Department of Health. We considered two adverse birth outcomes: (1) preterm birth (PTB); and (2) low birth weight (LBW). Exposure was considered as a binary indicator (presence or absence of CAFO) and as categories based on level of exposure. Logistic regression was applied to estimate the association between CAFOs exposure and adverse birth outcomes. Models were adjusted for infant's sex, maternal demographics (age, race/ethnicity, education), prenatal BMI, prenatal care, smoking status, marital status, plurality, WIC status, and urban/rural indicator. We examined both disparities in exposure and in health response.
Presence of CAFOs was associated with higher risk of PTB, with an increasing trend with higher levels of CAFOs exposure. Compared to the no CAFO exposure group, the odds ratios for PTB were 1.022 (95 % confidence interval 1.003, 1.043), 1.066 (1.034, 1.100), 1.069 (1.042, 1.097) for low, medium, and high CAFOs exposure groups, respectively. Some maternal characteristics were associated with a higher CAFO-related risk of PTB. Similar associations were observed for LBW for some characteristics such as mother's race/ethnicity, education, WIC status, and urbanicity, although some findings were not statistically significant.
Our findings suggest that presence of CAFOs increases risk of preterm birth. Our results indicate that some maternal characteristics may be associated with higher risk of CAFO-related PTB or LBW. This study can inform future research on disparities in CAFO exposure and associated health burden.
以往研究将接触集中式动物饲养场（CAFOs）与多种健康结果联系起来。然而，尽管公众对母婴健康极为关注，但评估CAFOs对不良出生结局影响的研究相对较少。
这项横断面研究调查了与接触CAFOs相关的不良出生结局风险，并评估了接触CAFOs及相关健康结局方面的差异。
我们从宾夕法尼亚州卫生部获取了2003年至2020年的个体层面出生记录。我们考虑了两种不良出生结局：（1）早产（PTB）；以及（2）低出生体重（LBW）。接触被视为一个二元指标（是否存在CAFO）以及基于接触水平的类别。应用逻辑回归来估计接触CAFOs与不良出生结局之间的关联。模型针对婴儿性别、母亲人口统计学特征（年龄、种族/民族、教育程度）、产前体重指数、产前护理、吸烟状况、婚姻状况、多胎情况、妇女、婴儿与儿童营养补充计划（WIC）状况以及城乡指标进行了调整。我们研究了接触方面以及健康反应方面的差异。
存在CAFOs与早产风险较高相关，且随着CAFOs接触水平升高呈上升趋势。与未接触CAFOs组相比，低、中、高CAFOs接触组的早产比值比分别为1.022（95%置信区间1.003, 1.043）、1.066（1.034, 1.100）、1.069（1.042, 1.097）。一些母亲特征与较高的CAFOs相关早产风险有关。对于低出生体重，在母亲的种族/民族、教育程度、WIC状况和城市化程度等一些特征方面也观察到了类似的关联，尽管一些结果在统计学上并不显著。
我们的研究结果表明，存在CAFOs会增加早产风险。我们的结果表明一些母亲特征可能与较高的CAFOs相关早产或低出生体重风险有关。这项研究可为未来关于CAFOs接触差异及相关健康负担的研究提供参考。
