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首页> 外文期刊>International Journal of Environmental Research and Public Health >Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research
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Using an External Exposome Framework to Examine Pregnancy-Related Morbidities and Mortalities: Implications for Health Disparities Research

机译：使用外部暴露框架检查与妊娠相关的发病率和死亡率：对健康差异研究的启示

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Objective: We have conducted a study to assess the role of environment on the burden of maternal morbidities and mortalities among women using an external exposome approach for the purpose of developing targeted public health interventions to decrease disparities. Methods: We identified counties in the 48 contiguous USA where observed low birthweight (LBW) rates were higher than expected during a five-year study period. The identification was conducted using a retrospective space-time analysis scan for statistically significant clusters with high or low rates by a Discrete Poisson Model. Results: We observed statistically significant associations of LBW rate with a set of predictive variables. However, in one of the two spatiotemporal models we discovered LBW to be associated with five predictive variables (teen birth rate, adult obesity, uninsured adults, physically unhealthy days, and percent of adults who smoke) in two counties situated in Alabama after adjusting for location changes. Counties with higher than expected LBW rates were similarly associated with two environmental variables (ozone and fine particulate matter). Conclusions: The county-level predictive measures of LBW offer new insights into spatiotemporal patterns relative to key contributory factors. An external framework provides a promising place-based approach for identifying “hotspots” with implications for designing targeted interventions and control measures to reduce and eliminate health disparities.
机译：目的：我们进行了一项研究，使用外部暴露方法评估环境对妇女孕产妇死亡和死亡负担的作用，目的是开发有针对性的公共卫生干预措施以减少差异。方法：我们确定了美国48个连续县，在五年研究期内观察到的低出生体重（LBW）率高于预期。使用回顾性时空分析扫描，通过离散泊松模型对具有高或低比率的具有统计意义的聚类进行了鉴定。结果：我们观察到LBW率与一组预测变量之间具有统计学意义的关联。但是，在两个时空模型之一中，我们在对LBW进行了校正后，发现了LBW与阿拉巴马州两个县的五个预测变量（出生率，成年肥胖，未保险的成年人，身体不健康的日子以及吸烟的成年人百分比）相关。位置改变。 LBW高于预期的县与两个环境变量（臭氧和细颗粒物）相似。结论：LBW的县级预测措施提供了与主要贡献因素相关的时空模式的新见解。外部框架为确定“热点”提供了一种有前途的基于地点的方法，对设计针对性的干预措施和控制措施以减少和消除健康差异具有影响。

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