title: Geographic Distribution of Healthy Resources and Adverse Pregnancy Outcomes.
abstract: Objective To determine the risk of gestational diabetes (GDM) and preeclampsia associated with various community resources. Methods An ecological study was performed in Los Angeles and Orange counties in California. Fast food restaurants, supermarkets, grocery stores, gyms, health clubs and green space were identified using Google © Maps Extractor and through the Southern California Association of Government. California Birth Certificate data was used to identify cases of GDM and preeclampsia. Unadjusted and adjusted risk ratios were calculated using negative binomial regression. Results There were 9692 cases of GDM and 6288 cases of preeclampsia corresponding to incidences of 2.5 and 1.4 % respectively. The adjusted risk of GDM was reduced in zip codes with greater concentration of grocery stores [relative risk (RR) 0.95, 95 % confidence interval (CI) 0.92-0.99] and supermarkets (RR 0.94, 95 % CI 0.90-0.98). There were no significant relationships between preeclampsia and the concentration of fast food restaurants, grocery store, supermarkets or the amount of green space. Conclusion The distribution of community resources has a significant association with the risk of developing GDM but not preeclampsia.
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Irvine, 101 The City Drive South, Building 56, Suite 800, Orange, CA, 92868, USA. cmyoung44@gmail.com.
authors.forename: Christopher
authors.initials: C
authors.lastname: Young
authors.affiliation: Program in Public Health, University of California, Irvine, 653 East Peltason Drive, AIRB #2034, Irvine, CA, 92697, USA.
authors.forename: Olivier
authors.initials: O
authors.lastname: Laurent
authors.affiliation: Department of Obstetrics and Gynecology, University of California, Irvine, 101 The City Drive South, Building 56, Suite 800, Orange, CA, 92868, USA.
authors.forename: Judith H
authors.initials: JH
authors.lastname: Chung
authors.affiliation: Program in Public Health, University of California, Irvine, 653 East Peltason Drive, AIRB #2034, Irvine, CA, 92697, USA.
authors.forename: Jun
authors.initials: J
authors.lastname: Wu
mesh_terms: D002140:California / Q000453:epidemiology; D003132:Commerce; D016640:Diabetes, Gestational / Q000453:epidemiology*; D005260:Female; D005523:Food Supply; D040362:Geographic Information Systems; D062305:Geographic Mapping; D006801:Humans; D015994:Incidence; D015141:Los Angeles; D011225:Pre-Eclampsia / Q000453:epidemiology*; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012042:Registries; D012111:Residence Characteristics; D012307:Risk Factors
keywords: Gestational diabetes; Green space; Preeclampsia; Pregnancy; Supermarkets