Environmental contributions to disparities in pregnancy outcomes.
One of the most persistent disparities in American health status is the pronounced difference in birth outcomes between non-Hispanic black and non-Hispanic white women. Poor pregnancy outcomes have a substantial impact on mortality, morbidity, and health care costs. Increasing evidence indicates that environmental exposures are associated with poor birth outcomes. This paper reviews the latest research on how environmental exposures affect pregnancy outcomes and then discusses how these exposures may be embedded within a context of significant social and host factor stress. The analysis suggests that environmental, social, and host factors are cumulatively stressing non-Hispanic black women and that this cumulative stress may be a cause of the persistent disparities in pregnancy outcomes.
Nicholas School of the Environment, Duke University, A134-LSRC, Box 90328, Durham, NC 27708, USA. mmiranda@duke.edu
Marie Lynn
ML
Miranda
Pamela
P
Maxson
Sharon
S
Edwards
D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D011247:Pregnancy; D011256:Pregnancy Outcome; D011634:Public Health; D014481:United States