Effects of Traffic and Air Pollution on Risk of Preterm Birth and Low Birth Weight Outcomes in Milwaukee County, 2005-2010

Abstract

Between 2005 and 2010, infants born to non-Hispanic black mothers experienced a 3-fold elevated risk of infant mortality compared to those born to white and Hispanic mothers. Preterm birth (PTB) and low birth weight (LBW) are strong predictors of infant mortality. To our knowledge, this is the first study of Wisconsin births to evaluate the effect of social and environmental factors on risk of PTB and LBW. We hypothesize that the observed racial inequalities in PTB and LBW are related to traffic density and air pollution. The Milwaukee INFANTS Study used 2005-2010 electronic birth record data (N = 85,045) geocoded to the 2010 Census block level based on maternal residence. Cumulative traffic density and interpolated criteria air pollutant data were used to estimate fetal exposures. Multi-level logistic regression analysis (SAS 9.4) with a multiple imputation step to handle missing data ( prevalence of preterm birth (PTB) and a 2.5-fold increased prevalence of low birth weight (LBW) among infants of non-Hispanic black women, compared to infants of non-Hispanic white women. Risk of PTB and LBW differed considerably by location, as well. In unadjusted models, traffic density demonstrated a linear increase in risk across all birth outcomes (p