Dataset Information

Green spaces and pregnancy outcomes in Southern California.

ABSTRACT: Little is known about the impacts of green spaces on pregnancy outcomes. The relationship between green space exposure and preeclampsia has never been studied. We used a hospital-based perinatal database including more than 80,000 births to study the relationships between greenness exposure and three pregnancy outcomes: birth weight in term born infants, preterm deliveries and preeclampsia. Greenness was characterized using the normalized difference vegetation index (NDVI) within circular buffers surrounding maternal homes. Analyses were conducted using generalized estimating equations, adjusted for potential confounders. We observed an increase in birth weight in term born infants and a reduced risk of preterm births associated with an increase in NDVI. No significant association was observed between greenness and preeclampsia. This study provides modest support for beneficial effects of greenness exposure on pregnancy outcomes and calls for confirmation in other study settings.

SUBMITTER: Laurent O

PROVIDER: S-EPMC10916679 | biostudies-literature | 2013 Nov

REPOSITORIES: biostudies-literature

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Green spaces and pregnancy outcomes in Southern California.

Laurent Olivier O Wu Jun J Li Lianfa L Milesi Cristina C

Health & place 20131009

Little is known about the impacts of green spaces on pregnancy outcomes. The relationship between green space exposure and preeclampsia has never been studied. We used a hospital-based perinatal database including more than 80,000 births to study the relationships between greenness exposure and three pregnancy outcomes: birth weight in term born infants, preterm deliveries and preeclampsia. Greenness was characterized using the normalized difference vegetation index (NDVI) within circular buffer ...[more]

PMID: 24140704

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Project description:BackgroundFindings from national surveys suggest that everyone in the United States is exposed to perchlorate. At high doses, perchlorate, thiocyanate, and nitrate inhibit iodide uptake into the thyroid and decrease thyroid hormone production. Small changes in thyroid hormones during pregnancy, including changes within normal reference ranges, have been linked to cognitive function declines in the offspring.ObjectivesWe evaluated the potential effects of low environmental exposures to perchlorate on thyroid function.MethodsSerum thyroid hormones and anti-thyroid antibodies and urinary perchlorate, thiocyanate, nitrate, and iodide concentrations were measured in 1,880 pregnant women from San Diego County, California, during 2000-2003, a period when much of the area's water supply was contaminated from an industrial plant with perchlorate at levels near the 2007 California regulatory standard of 6 μg/L. Linear regression was used to evaluate associations between urinary perchlorate and serum thyroid hormone concentrations in models adjusted for urinary creatinine and thiocyanate, maternal age and education, ethnicity, and gestational age at serum collection.ResultsThe median urinary perchlorate concentration was 6.5 μg/L, about two times higher than in the general U.S.PopulationAdjusted associations were identified between increasing log10 perchlorate and decreasing total thyroxine (T4) [regression coefficient (β) = -0.70; 95% CI: -1.06, -0.34], decreasing free thyroxine (fT4) (β = -0.053; 95% CI: -0.092, -0.013), and increasing log10 thyroid-stimulating hormone (β = 0.071; 95% CI: 0.008, 0.133).ConclusionsThese results suggest that environmental perchlorate exposures may affect thyroid hormone production during pregnancy. This could have implications for public health given widespread perchlorate exposure and the importance of thyroid hormone in fetal neurodevelopment.CitationSteinmaus C, Pearl M, Kharrazi M, Blount BC, Miller MD, Pearce EN, Valentin-Blasini L, DeLorenze G, Hoofnagle AN, Liaw J. 2016. Thyroid hormones and moderate exposure to perchlorate during pregnancy in women in Southern California. Environ Health Perspect 124:861-867; http://dx.doi.org/10.1289/ehp.1409614.

Project description:Colorectal cancer (CRC) screening can reduce cancer deaths. However, screening and abnormal test follow-up rates are low among underserved populations. The screening rates of 19-58%, and rates of colonoscopy completion after abnormal stool tests of 18-57% in community health centers (CHC) systems are low. This highlights an opportunity to improve early detection and decrease burden of CRC in our region. Mailed outreach and navigation programs have been shown to increase colonoscopy completion rate. The next step is to understand how to best implement these programs in the community on a larger scale. To achieve this goal, the investigators propose a Hub-and-Spoke intervention combining centralized strategies to maximize CRC screening, follow-up, and referral-to-care. The investigators hypothesize that this intervention will be superior to usual care for increasing CRC screening, abnormal test follow-up, and referral-to-care. The investigators will conduct a randomized trial to determine effectiveness in: 1) improvement in proportion of individuals up-to-date with screening 3 years post implementation; 2) proportion with abnormal FIT who complete diagnostic colonoscopy within 6 months; and 3) proportion with CRC completing first treatment evaluation. The investigators will also evaluate the implementation, scalability, and sustainability of the multi-level implementation strategy. The intervention consists of: Mailed FIT and Reminders. Eligible individuals will receive an introductory letter describing the importance of CRC screening and noting that follow-up mail will include a FIT Kit. It will also be offered to patients who completed prior mailed FIT with normal test results. All materials will be in English and Spanish. Two weeks later, participants will receive a packet via mail containing the FIT kit, a one-page invitation inviting FIT completion and FIT instructions, a postage-paid envelope for return to the patient’s CHC, and COVID-19 message. For non-compliant individuals not returning the kit, a reminder phone call and text message will be delivered 2 weeks later. The investigators will track returned letters, individuals who are later found to be up-to date with screening, and those who decline screening. The CHC will provide care coordination for patients with an abnormal FIT result.

Dataset Information

Green spaces and pregnancy outcomes in Southern California.

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Green spaces and pregnancy outcomes in Southern California.

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