Greenspace, Air Pollution, Neighborhood Factors, and Preeclampsia in a Population-Based Case-Control Study in California.

Kari A Weber,David K Stevenson,Gary M Shaw,Wei Yang,Amy M Padula,Evan Lyons

doi:10.3390/ijerph18105127

Abstract

To investigate preeclampsia etiologies, we examined relationships between greenspace, air pollution, and neighborhood factors. Data were from hospital records and geocoded residences of 77,406 women in San Joaquin Valley, California from 2000 to 2006. Preeclampsia was divided into mild, severe, or superimposed onto pre-existing hypertension. Greenspace within 100 and 500 m residential buffers was estimated from satellite data using normalized difference vegetation index (NDVI). Air quality data were averaged over pregnancy from daily 24-h averages of nitrogen dioxide, particulate matter <10 µm (PM10) and <2.5 µm (PM2.5), and carbon monoxide. Neighborhood socioeconomic (SES) factors included living below the federal poverty level and median annual income using 2000 US Census data. Odds of preeclampsia were estimated using logistic regression. Effect modification was assessed using Wald tests. More greenspace (500 m) was inversely associated with superimposed preeclampsia (OR = 0.57). High PM2.5 and low SES were associated with mild and severe preeclampsia. We observed differences in associations between greenspace (500 m) and superimposed preeclampsia by neighborhood income and between greenspace (500 m) and severe preeclampsia by PM10, overall and among those living in higher SES neighborhoods. Less greenspace, high particulate matter, and high-poverty/low-income neighborhoods were associated with preeclampsia, and effect modification was observed between these exposures. Further research into exposure combinations and preeclampsia is warranted.

Highlights

Preeclampsia is a hypertensive disorder affecting 3–5% of pregnant women, and it is a major contributor to maternal and neonatal mortality [1,2]
There were few differences observed between women in the highest quartile of greenspace in the 100 or 500 m residential buffers compared to the whole sample, except that women residing in the highest quartiles of greenspace were more likely to live in a low-poverty or high-income census block (Table 2)
particulate matter

Summary

Introduction

Preeclampsia is a hypertensive disorder affecting 3–5% of pregnant women, and it is a major contributor to maternal and neonatal mortality [1,2]. The causes of preeclampsia remain unknown, but the underlying pathology is known to originate in the placenta during the first trimester, possibly from vascular compromise during abnormal placentation [3,4]. Exposure to various environmental factors had been shown to cause oxidative stress, possibly leading to developmental toxicity and affecting placental development [5]. To explore the potential etiologies of preeclampsia, in previous studies, we examined various environmental exposures and their associations with preeclampsia including residential proximity to greenspace [6]. Greenspace, including grass, trees, and other vegetation, has been positively associated with a variety of health outcomes [7,8]. In our study of greenspace, we observed an inverse association between living surrounded

Methods

Results

Discussion

Conclusion