Unconventional Natural Gas Development and Birth Outcomes in Pennsylvania, USA.
Unconventional Natural Gas Development and Birth Outcomes in Pennsylvania, USA.
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DOI：
10.1097/ede.0000000000000387
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发表时间：
2016-03
期刊：
影响因子：
--
通讯作者：
Schwartz BS
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文献类型：
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作者：
Casey JA;Savitz DA;Rasmussen SG;Ogburn EL;Pollak J;Mercer DG;Schwartz BS
非常规天然气开发规模迅速扩大。在宾夕法尼亚州，生产井的数量从2005年的零增加到2013年的3689口。据我们所知，之前没有出版物关注非常规天然气的开发和生育结果。我们对2009年1月至2013年1月Geisinger卫生系统中与10946名新生儿相关的9384名母亲的电子健康记录数据进行了回顾性队列研究。我们使用了一个包含到母亲家的距离的反距离平方模型来估计非常规天然气开发活动的累积暴露量；井台开发、钻井和水力压裂的日期和持续时间；以及怀孕期间的产量比。我们使用多水平线性和逻辑回归模型来检验活动指数四分位数与足月出生体重、早产、低5分钟Apgar评分和胎龄小之间的关系，同时控制潜在的混杂变量。在调整后的模型中，非常规天然气开发活动与早产之间的关联在四分位数中有所增加，第四个四分位数的优势比为1.4 （95% CI: 1.0-1.9）。活动量与Apgar评分无关联，与胎龄或足月出生体重（经年际调整后）关系较小。在事后分析中，从问题列表中确定的医生记录的高危妊娠与此相关（第四对第一四分位数，1.3 [95% CI: 1.1-1.7]）。产前居住暴露于非常规天然气开发活动与两种妊娠结局有关，这进一步证明非常规天然气开发可能影响健康。
Unconventional natural gas development has expanded rapidly. In Pennsylvania the number of producing wells increased from zero in 2005 to 3689 in 2013. To our knowledge, no prior publications have focused on unconventional natural gas development and birth outcomes. We performed a retrospective cohort study using electronic health record data on 9384 mothers linked to 10946 neonates in the Geisinger Health System from January 2009-January 2013. We estimated cumulative exposure to unconventional natural gas development activity with an inverse-distance squared model that incorporated distance to the mother’s home; dates and durations of well pad development, drilling, and hydraulic fracturing; and production volume during the pregnancy. We used multilevel linear and logistic regression models to examine associations between activity index quartile and term birth weight, preterm birth, low 5 minute Apgar score and small size for gestational age, while controlling for potential confounding variables. In adjusted models, there was an association between unconventional natural gas development activity and preterm birth that increased across quartiles, with a fourth quartile odds ratio of 1.4 (95% CI: 1.0-1.9). There were no associations of activity with Apgar score, small for gestational age, or term birth weight (after adjustment for year). In a post-hoc analysis, there was an association with physician-recorded high-risk pregnancy identified from the problem list (fourth vs. first quartile, 1.3 [95% CI: 1.1-1.7]). Prenatal residential exposure to unconventional natural gas development activity was associated with two pregnancy outcomes, adding to evidence that unconventional natural gas development may impact health.