Effects of Maternal Homelessness, Supplemental Nutrition Programs, and Prenatal PM 2.5 on Birthweight

Jongeun Rhee, M. Patricia Fabian, Stephanie Ettinger de Cuba, Sharon Coleman, Megan Sandel, Kevin James Lane, Maayan Yitshak Sade, Jaime E. Hart, Joel Schwartz, Itai Kloog, Francine Laden, Jonathan I. Levy and Antonella Zanobetti
Additional contact information
Jongeun Rhee: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
M. Patricia Fabian: Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA
Stephanie Ettinger de Cuba: Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, USA
Sharon Coleman: Biostatistics and Epidemiology Data Analytics Center, School of Public Health, Boston University, Boston, MA 02118, USA
Megan Sandel: Department of Pediatrics, School of Medicine, Boston University, Boston, MA 02118, USA
Kevin James Lane: Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA
Maayan Yitshak Sade: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
Jaime E. Hart: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
Joel Schwartz: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
Itai Kloog: Department of Geography and Environmental Development, Ben-Gurion University of the Negev, Beer Sheva, Israel
Francine Laden: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA
Jonathan I. Levy: Department of Environmental Health, School of Public Health, Boston University, Boston, MA 02115, USA
Antonella Zanobetti: Department of Environmental Health, T.H. Chan School of Public Health, Harvard University, Boston, MA 02115, USA

IJERPH, 2019, vol. 16, issue 21, 1-13

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 (PM 2.5 ) 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 PM 2.5 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 PM 2.5 during the second trimester was marginally associated with reduced birthweight (−8.5 g, 95% CI: −19.3, 2.3) for a 1 µg/m 3 increase in PM 2.5 . The association of PM 2.5 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.

Keywords: maternal socioeconomic status; maternal homelessness; supplemental nutrition programs; PM 2.5; birthweight (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

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