International Journal of Environmental Research and Public Health
Volume 16, Issue 21, 2019

Effects of maternal homelessness, supplemental nutrition programs, and prenatal PM2.5 on birthweight (Article) (Open Access)

Rhee J.* , Patricia Fabian M. , de Cuba S.E. , Coleman S. , Sandel M. , Lane K.J. , Sade M.Y. , Hart J.E. , Schwartz J. , Kloog I. , Laden F. , Levy J.I. , Zanobetti A.
  • a Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States
  • b Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, United States
  • c Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, United States
  • d Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, MA 02118, United States
  • e Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, United States, Department of Pediatrics, Boston Medical Center, Boston, MA 02118, United States
  • f Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, United States
  • g Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States
  • h Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States, Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States
  • i Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States, Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States, Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States
  • j Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
  • k Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States, Department of Medicine, Channing Division of Network Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, United States, Department of Epidemiology, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States
  • l Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, United States
  • m Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, United States

Abstract

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 (PM2.5) 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 PM2.5 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 PM2.5 during the second trimester was marginally associated with reduced birthweight (−8.5 g, 95% CI: −19.3, 2.3) for a 1 µg/m3 increase in PM2.5 . The association of PM2.5 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. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.

Author Keywords

Birthweight Maternal socioeconomic status Maternal homelessness Supplemental nutrition programs PM2.5

Index Keywords

vulnerable population maternal care immigrant nutritional requirement maternal health Massachusetts human controlled study socioeconomic status weight United States social status air pollution female Infant environmental exposure particulate matter concentration (composition) synergistic effect questionnaire electronic health record linear regression analysis seasonal variation Article nutrition major clinical study household income mother human experiment cohort analysis Birth Weight homelessness second trimester pregnancy public health Boston Child
Link
https://www.scopus.com/inward/record.uri?eid=2-s2.0-85074296205&doi=10.3390%2fijerph16214154&partnerID=40&md5=74be59a9e42fb44da95fde10dee0006e
DOI: 10.3390/ijerph16214154
ISSN: 16617827
Original Language: English