Neighborhood Deprivation is Associated with Increased Risk of Prenatal Smoke Exposure.
Neighborhood Deprivation is Associated with Increased Risk of Prenatal Smoke Exposure.
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DOI：
10.1007/s11121-022-01355-7
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发表时间：
2022-10
影响因子：
3.5
通讯作者：
Fuemmeler, Bernard F
中科院分区：
文献类型：
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作者：
Wheeler, David C;Boyle, Joseph;Barsell, D Jeremy;Maguire, Rachel L;Dahman, Bassam;Murphy, Susan K;Hoyo, Cathrine;Zhang, Jim;Oliver, Jason A;McClernon, Joseph;Fuemmeler, Bernard F
尽管多年来一直反对这种行为，但在美国，孕妇吸烟仍然是一个持续的公共卫生问题。最近的估计表明，在美国，9.4%的妇女在怀孕前吸烟，7.1%的妇女在怀孕期间吸烟。流行病学研究试图确定怀孕期间吸烟的个人和社区因素，包括教育程度，就业状况，住房条件，贫困和种族人口统计。然而，这些研究中的大多数都依赖于自我报告的吸烟措施，这是受报告偏见。为了更准确和客观地评估母亲在怀孕期间的烟雾暴露，我们使用贝叶斯指数模型来估计北卡罗来纳州达勒姆县街区组的邻里剥夺指数（NDI）及其与可替宁（烟雾暴露的标志物）的相关性（2005-2011年入组的n=887）。结果显示，在调整个体协变量（例如人种/种族和教育）后，NDI和log可替宁之间存在显著正相关（β = 0.20，95%可信区间= [0.11，0.29]）。根据估计的指数权重，NDI中两个最重要的变量是没有高中学历的女性百分比和黑人人口百分比。在个体水平上，与非西班牙裔白人相比，西班牙裔和其他种族/民族与可替宁降低相关。较高的教育水平也与降低可替宁。总之，我们的研究结果提供了更有力的证据，证明教育程度和社区种族组成的社会地理变量是怀孕期间吸烟和二手烟暴露的重要因素，可以用于针对性的干预工作。
Despite years of advisories against the behavior, smoking among pregnant women remains a persistent public health issue in the United States. Recent estimates suggest that 9.4% of women smoke before pregnancy and 7.1% during pregnancy in the United States. Epidemiological research has attempted to pinpoint individual-level and neighborhood-level factors for smoking during pregnancy, including educational attainment, employment status, housing conditions, poverty, and racial demographics. However, most of these studies have relied upon self-reported measures of smoking, which are subject to reporting bias. To more accurately and objectively assess smoke exposure in mothers during pregnancy, we used Bayesian index models to estimate a neighborhood deprivation index (NDI) for block groups in Durham County, North Carolina and its association with cotinine, a marker of smoke exposure, in pregnant mothers (n=887 enrolled 2005–2011). Results showed a significant positive association between NDI and log cotinine (beta = 0.20, 95% credible interval = [0.11, 0.29]) after adjusting for individual covariates (e.g. race/ethnicity and education). The two most important variables in the NDI according to the estimated index weights were percent females without a high school degree and percent Black population. At the individual level, Hispanic and other race/ethnicity were associated with lowered cotinine compared with non-Hispanic Whites. Higher education levels were also associated with lowered cotinine. In summary, our findings provide stronger evidence that the socio-geographic variables of educational attainment and neighborhood racial composition are important factors for smoking and secondhand smoke exposure during pregnancy and can be used to target intervention efforts.
DOI：
10.3390/ijerph15030473
发表时间：
2018-03-08
影响因子：
--
作者：
Grant LP;Gennings C;Wickham EP;Chapman D;Sun S;Wheeler DC
通讯作者：
Wheeler DC