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Epidemiologic Reviews Advance Access originally published online on October 21, 2009
Epidemiologic Reviews 2009 31(1):67-83; doi:10.1093/epirev/mxp011
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Epidemiologic Reviews © The Author 2009. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/2.5/uk/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

ARTICLES

Environmental Contributions to Disparities in Pregnancy Outcomes

Marie Lynn Miranda, Pamela Maxson and Sharon Edwards

Correspondence to Dr. Marie Lynn Miranda, Nicholas School of the Environment, Duke University, A134-LSRC, Box 90328, Durham, NC 27708 (e-mail: mmiranda{at}duke.edu).

accepted for publication September 15, 2009.

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.

environment • environmental pollution • health status disparities • infant, low birth weight • pregnancy outcome • premature birth • public health


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[Abstract] [Full Text] [PDF]


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