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The Use of Environmental Justice Screening Tool and Self-Reported Data to Inform Pregnancy and Birth Outcomes in a Population of Central Ohio Deliveries

Bollinger, Claire Eastment
http://orcid.org/0000-0002-7059-708X
http://rave.ohiolink.edu/etdc/view?acc_num=osu150325024608655

Abstract Details

2017, Doctor of Philosophy, Ohio State University, Public Health.
This dissertation examines the role of traffic-related air pollutants (TRAP) on the incidence of adverse maternal and birth outcomes in a population of Central Ohio women, and leverages electronic health records (EHR) and personal health records (PHR) as recruitment tools. Gestational diabetes mellitus (GDM), early births, and small births all represent public health concerns due to the direct morbidity of the conditions and the increased risk of morbidities later in life, especially obesity-related comorbidities. In addition to examination of the association between TRAP and these adverse conditions, this dissertation explores physical activity in pregnancy and the role of the built environment in its promotion. Aim one of this dissertation was to determine if publicly available and self-reported data on proxies of exposure to TRAP are significant predictors of GDM risk in a population of women with no history of diabetes. Overall, there were no significant associations found between proxy measures of exposure and GDM. Similarly, no significant associations were found between many of the traditional risk factors for GDM, such as high pre-pregnancy BMI, advanced maternal age, or parity. Conception during cold months of the year (November – April) was associated with 3.54 times the odds of GDM compared to conception during warmer months (May – October). The second aim of this dissertation focused on births occurring “too soon” and babies born “too small.” Contrary to the associations observed by others, this analysis found that higher area levels of some TRAP were inversely associated with births occurring “too soon”. No statistically significant associations were found between proxies of TRAP levels and odds of infants born “too small.” In the third aim, this dissertation examines which, if any, aspects of the built environment are supportive of physical activity before and during pregnancy, along with predictors that women do not decrease their physical activity along the course of pregnancy. Municipal supports and neighborhood cultural factors were significant predictors that women either maintained or increased their physical activity. Physical proximity to outdoor supports, namely multi-use bike paths and parks, were not associated with physical activity behaviors at any point, and high degrees of concordance between perception of access and proximity suggest this lack of association is not due to lack of knowledge. Overall, this dissertation contributes to the current body of knowledge regarding exposure to TRAP and odds of adverse health outcomes by examining the associations in a population of women in Central Ohio, a region not extensively studied, but one greatly affected by GDM, small births, and early deliveries, along with alarming infant mortality rates. Physical activity behaviors can reduce risks of these conditions and this work examining how the built environment can be supportive provides valuable information for physicians, public health professionals, and policy makers who work toward ensuring healthier pregnancies and healthier populations.
Darryl Hood, PhD (Advisor)
Julie Bower, PhD (Advisor)
Michael Bisesi, PhD (Committee Member)
Michael Pennell, PhD (Committee Member)
230 p.
Environmental Health; Epidemiology; Public Health
maternal health, birth outcomes, EHR, physical activity supports, traffic exposure, public health, in utero exposure

Recommended Citations

Citations

  • Bollinger, C. E. (2017). The Use of Environmental Justice Screening Tool and Self-Reported Data to Inform Pregnancy and Birth Outcomes in a Population of Central Ohio Deliveries [Doctoral dissertation, Ohio State University]. OhioLINK Electronic Theses and Dissertations Center. http://rave.ohiolink.edu/etdc/view?acc_num=osu150325024608655

    APA Style (7th edition)

  • Bollinger, Claire. The Use of Environmental Justice Screening Tool and Self-Reported Data to Inform Pregnancy and Birth Outcomes in a Population of Central Ohio Deliveries. 2017. Ohio State University, Doctoral dissertation. OhioLINK Electronic Theses and Dissertations Center, http://rave.ohiolink.edu/etdc/view?acc_num=osu150325024608655.

    MLA Style (8th edition)

  • Bollinger, Claire. "The Use of Environmental Justice Screening Tool and Self-Reported Data to Inform Pregnancy and Birth Outcomes in a Population of Central Ohio Deliveries." Doctoral dissertation, Ohio State University, 2017. http://rave.ohiolink.edu/etdc/view?acc_num=osu150325024608655

    Chicago Manual of Style (17th edition)

osu150325024608655
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© 2017, all rights reserved.
This open access ETD is published by The Ohio State University and OhioLINK.