Combined Prenatal Environmental and Social Exposures and Associations with Weight and Adiposity at Birth in the Denver Healthy Start Birth Cohort

摘要

Background Neighborhood environmental and social exposures are known risk factors for adverse childhood health outcomes, but the effects of combined exposures in these domains are not fully understood, particularly for body mass or adiposity at birth. We assessed single- and multi-domain exposures for participants in the Healthy Start study, a longitudinal cohort of 1410 mother-child pairs in Metropolitan Denver, CO, and tested associations with body measures at birth. Methods Environmental (ENV) exposures including ambient air quality, toxic release data, and built environment characteristics, e.g., impervious surface %; social (SOC) exposures including demographics, population vulnerability, and crime; and combined exposures (CE) averaged over a 5-year period were assessed at census tracts using a weighted index (scaled from 0-100) following CalEnviroScreen 3.0 and assigned using address at enrollment- Offspring body mass, fat mass, and fat mass percent (adiposity) were obtained by air displacement plethysmography within three days of birth. In separate linear regression models we tested associations between body mass or adiposity outcomes with ENV, SOC or CE as the main predictors. Results Exposure and outcome data were available for 993 (74%) participants. Median (range) ENV, SOC and CE values were 65.8 (53.9-82.5), 62.1 (7.3-98.2), and 48.9 (5.5-88.7), respectively. No significant associations were found with adiposity. A 10-point increase in SOC and CE was associated with a 22g (95%CI: 8-35g) and 24g (95%CI: 8-40g) decrease in body mass at birth, respectively. After controlling for maternal and infant covariates, associations for SOC and CE were attenuated and no longer significant at α=0.05. Conclusions Combined exposures during pregnancy may be associated with lower body mass at birth. Future research will explore components of the indices and whether cumulative exposures or exposures during specific gestational periods are associated with offspring mass outcomes.