Maternal and Child Health Journal

, Volume 16, Issue 8, pp 1602–1611

Effectiveness of a Federal Healthy Start Program in Reducing the Impact of Particulate Air Pollutants on Feto-Infant Morbidity Outcomes

Authors

    • Department of Epidemiology and BiostatisticsCollege of Public Health, University of South Florida
  • Euna M. August
    • Department of Community and Family HealthCollege of Public Health, University of South Florida
  • Alfred K. Mbah
    • Department of Epidemiology and BiostatisticsCollege of Public Health, University of South Florida
  • Amina P. Alio
    • Department of Community and Preventive MedicineUniversity of Rochester
  • Raymond de CubaII
    • Department of Epidemiology and BiostatisticsCollege of Public Health, University of South Florida
  • Foday M. Jaward
    • Department of Environmental and Occupational HealthCollege of Public Health, University of South Florida
  • Estrellita Lo Berry
    • REACHUP, Incorporated
Article

DOI: 10.1007/s10995-011-0854-1

Cite this article as:
Salihu, H.M., August, E.M., Mbah, A.K. et al. Matern Child Health J (2012) 16: 1602. doi:10.1007/s10995-011-0854-1

Abstract

We sought to assess (1) the relationship between air particulate pollutants and feto-infant morbidity outcomes and (2) the impact of a Federal Healthy Start program on this relationship. This is a retrospective cohort study using de-identified hospital discharge information linked to vital records, and air pollution data from 2000 through 2007 for the zip codes served by the Central Hillsborough Federal Healthy Start Project in Tampa, Florida. Mathematical modeling was employed to compute minimal Euclidean distances to capture exposure to ambient air particulate matter. The outcomes of interest were low birth weight (LBW), very low birth weight (VLBW), small for gestational age, preterm (PTB), and very preterm birth. We used odds ratios to approximate relative risks. A total of 12,356 live births were analyzed. Overall, women exposed to air particulate pollutants were at elevated risk for LBW (AOR = 1.24; 95% CI = 1.07–1.43), VLBW (AOR = 1.58; 95% CI = 1.09–2.29) and PTB (AOR = 1.18; 95% CI = 1.03–1.34). Analysis by race/ethnicity revealed that the adverse effects of air particulate pollutants were most profound among black infants. Infants of women who received services provided by the Central Hillsborough Federal Healthy Start Project experienced improved feto-infant morbidity outcomes despite exposure to air particulate pollutants. Environmental air pollutants represent important risk factors for adverse birth outcomes, particularly among black women. Multi-level interventional approaches implemented by the Central Hillsborough Federal Healthy Start were found to be associated with reduced likelihood for feto-infant morbidities triggered by exposure to ambient air particulate pollutants.

Keywords

Healthy start Air particulate pollutants Low birth weight Preterm birth Disparity

Copyright information

© Springer Science+Business Media, LLC 2011