Cohort study of respiratory hospital admissions, air quality and sociodemographic factors in preterm infants born in California.

Publisher: Blackwell Scientific Publications Country of Publication: England NLM ID: 8709766 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1365-3016 (Electronic) Linking ISSN: 02695022 NLM ISO Abbreviation: Paediatr Perinat Epidemiol Subsets: MEDLINE

Original Publication: Oxford ; Boston : Blackwell Scientific Publications, [c1987-

Air Pollution*/analysis ; Air Pollution*/statistics & numerical data ; Educational Status* ; Infant, Premature* ; Poverty* ; Respiratory Tract Diseases*/epidemiology ; Respiratory Tract Diseases*/therapy; Air Pollutants/*analysis ; Hospitalization/*statistics & numerical data; California/epidemiology ; Environmental Exposure/analysis ; Female ; Humans ; Infant ; Infant, Newborn ; Male ; Residence Characteristics/classification ; Residence Characteristics/statistics & numerical data ; Risk Assessment/methods

Background: Preterm infants suffer from respiratory morbidity especially during the first year of life.
Objective: To investigate the association of air quality and sociodemographic indicators on hospital admission rates for respiratory causes.
Methods: This is a retrospective cohort study. We identified all live-born preterm infants in California from 2007 to 2012 in a population-based administrative data set and linked them to a data set measuring several air quality and sociodemographic indicators at the census tract level. All sociodemographic and air quality predictors were divided into quartiles (first quartile most favourable to the fourth quartile least favourable). Mixed effect logistic models to account for clustering at the census tract level were used to investigate associations between chronic air quality and sociodemographic indicators respiratory hospital admission during the first year of life.
Results: Of 205 178 preterm infants, 5.9% (n = 12 033) were admitted to the hospital for respiratory causes during the first year. In the univariate analysis, comparing the first to the fourth quartile of chronic ozone (risk ratio [RR] 1.29, 95% confidence interval [CI] 1.21, 1.37), diesel (RR 1.10, 95% CI 1.02, 1.17) and particulate matter 2.5 (RR 1.07, 95% CI 1.01, 1.14) exposure were associated with hospital admission during the first year. Following adjustment for confounders, the risk ratios for hospital admission during the first year were 1.53 (95% CI 1.37, 1.72) in relation to educational attainment (per cent of the population over age 25 with less than a high school education) and 1.23 (95% CI 1.09, 1.38) for poverty (per cent of the population living below two times the federal poverty level).
Conclusions: Among preterm infants, respiratory hospital admissions in the first year in California are associated with socioeconomic characteristics of the neighbourhood an individual is living in.
(© 2020 John Wiley & Sons Ltd.)

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Keywords: air quality; hospital admission; preterm birth; sociodemographic factors

0 (Air Pollutants)

Date Created: 20200207 Date Completed: 20210219 Latest Revision: 20210219

20221213

10.1111/ppe.12652

32026503