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A retrospective cohort study of the effect of mobility during pregnancy and traffic exposure on adverse reproductive outcomes in Washington State, 1992-2004
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TitleInfo
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Title
A retrospective cohort study of the effect of mobility during pregnancy and traffic exposure on adverse reproductive outcomes in Washington State, 1992-2004
NonSort
A
Identifier
ETD_1539
Identifier
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http://hdl.rutgers.edu/1782.2/rucore10001600001.ETD.000051175
Language
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eng
Genre
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theses
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(authority = RUETD)
Topic
Public Health
Subject
(ID = SBJ-1);
(authority = ETD-LCSH)
Topic
Air--Pollution--Health aspects
Subject
(ID = SBJ-1);
(authority = ETD-LCSH)
Topic
Air--Pollution--Physiological effect
Subject
(ID = SBJ-1);
(authority = ETD-LCSH)
Topic
Birth weight, Low--Washington (State)
Abstract
Numerous studies have investigated the association between air pollution and adverse reproductive outcomes. Many estimated exposure at the birth residence. Previous research has indicated that up to 32% of mothers change residency during pregnancy. Failure to account for this mobility may result in exposure misclassification.
We assessed the frequency and characteristics of mobile mothers, the association between mobility and term low birth weight (LBW), preterm delivery (PTD) and small for gestational age (SGA) and the effect of a residency change on the association between these outcomes and traffic exposure, a proxy for air pollution. We used routinely collected time-at-current residency data collected on the Washington State birth certificate since 1989 and state-provided traffic counts
We found that a large proportion (32%) of women in Washington State moved during pregnancy and that almost half of these (45%) moved in the third trimester. Compared to non-movers, movers were younger, less educated, unmarried, on Medicaid and unemployed and moved to neighborhoods that were more urbanized, less residentially stable, and had higher percentages of rental and vacant housing units. We found that, multiparous movers, compared to multiparous non-movers, had elevated odds ratios for LBW, PTD and SGA but that primaparous movers, compared to primaparous non-movers, had smaller odds ratios for these outcomes. Finally we found that the birth residences of LBW, PTD and SGA births, compared to residences without these outcomes, and the birth residences of movers, compared to that of non-movers, were located closer to roadways and had higher weighted traffic exposures. We observed higher adjusted odds ratios for our outcomes of interest for movers compared to non-movers for those living within 750 ft. of a roadway compared to living more than 750 ft. from a roadway but higher adjusted odds ratios for non-movers, compared to movers, for the quintiles of weighted traffic exposure for births within 750 ft. of a major roadway.
It is unclear whether the different effects we observed for movers vs. non-movers are due to residual confounding or exposure misclassification. However, our results do suggest that mobility during pregnancy remains a factor to be considered in similar analyses.
We assessed the frequency and characteristics of mobile mothers, the association between mobility and term low birth weight (LBW), preterm delivery (PTD) and small for gestational age (SGA) and the effect of a residency change on the association between these outcomes and traffic exposure, a proxy for air pollution. We used routinely collected time-at-current residency data collected on the Washington State birth certificate since 1989 and state-provided traffic counts
We found that a large proportion (32%) of women in Washington State moved during pregnancy and that almost half of these (45%) moved in the third trimester. Compared to non-movers, movers were younger, less educated, unmarried, on Medicaid and unemployed and moved to neighborhoods that were more urbanized, less residentially stable, and had higher percentages of rental and vacant housing units. We found that, multiparous movers, compared to multiparous non-movers, had elevated odds ratios for LBW, PTD and SGA but that primaparous movers, compared to primaparous non-movers, had smaller odds ratios for these outcomes. Finally we found that the birth residences of LBW, PTD and SGA births, compared to residences without these outcomes, and the birth residences of movers, compared to that of non-movers, were located closer to roadways and had higher weighted traffic exposures. We observed higher adjusted odds ratios for our outcomes of interest for movers compared to non-movers for those living within 750 ft. of a roadway compared to living more than 750 ft. from a roadway but higher adjusted odds ratios for non-movers, compared to movers, for the quintiles of weighted traffic exposure for births within 750 ft. of a major roadway.
It is unclear whether the different effects we observed for movers vs. non-movers are due to residual confounding or exposure misclassification. However, our results do suggest that mobility during pregnancy remains a factor to be considered in similar analyses.
PhysicalDescription
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electronic resource
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vi, 153 p. : ill.
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Note
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Ph.D.
Note
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Includes bibliographical references (p. 115-120)
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by Sylvia R. Brown, MPH
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Brown
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Sylvia R.
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Sylvia R. Brown
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Wartenberg
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Daniel
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chair
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Advisory Committee
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Daniel E Wartenberg
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Marshall
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Elizabeth
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internal member
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Advisory Committee
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Elizabeth Marshall
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Weisel
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Clifford
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Advisory Committee
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Clifford Weisel
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Hoskins
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Richard
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outside member
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Advisory Committee
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Richard E. Hoskins
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Rutgers University
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Graduate School - New Brunswick
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OriginInfo
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2009
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2009-05
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xx
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Rutgers University Electronic Theses and Dissertations
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ETD
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Graduate School - New Brunswick Electronic Theses and Dissertations
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rucore19991600001
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Identifier
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doi:10.7282/T39P31W0
Genre
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ETD doctoral
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The author owns the copyright to this work.
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Open
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Non-exclusive ETD license
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Author Agreement License
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I hereby grant to the Rutgers University Libraries and to my school the non-exclusive right to archive, reproduce and distribute my thesis or dissertation, in whole or in part, and/or my abstract, in whole or in part, in and from an electronic format, subject to the release date subsequently stipulated in this submittal form and approved by my school. I represent and stipulate that the thesis or dissertation and its abstract are my original work, that they do not infringe or violate any rights of others, and that I make these grants as the sole owner of the rights to my thesis or dissertation and its abstract. I represent that I have obtained written permissions, when necessary, from the owner(s) of each third party copyrighted matter to be included in my thesis or dissertation and will supply copies of such upon request by my school. I acknowledge that RU ETD and my school will not distribute my thesis or dissertation or its abstract if, in their reasonable judgment, they believe all such rights have not been secured. I acknowledge that I retain ownership rights to the copyright of my work. I also retain the right to use all or part of this thesis or dissertation in future works, such as articles or books.
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