Air pollution, neighborhood acculturation factors, and neural tube defects among Hispanic women in California

Birth Defects Res. 2017 Apr 3;109(6):403-422. doi: 10.1002/bdra.23602. Epub 2017 Feb 21.


Background: Neural tube defects (NTDs) are one of the most common types of birth defects. Environmental pollutants and acculturation have been associated with NTDs independently. The potential effect modification of acculturation in the relationship between ambient air pollution and risks of NTDs is not well understood.

Methods: We investigated whether associations between traffic-related air pollutant exposure in early gestation and NTDs, and more specifically spina bifida, were modified by individual and neighborhood acculturation factors among 139 cases and 466 controls born in the San Joaquin Valley of California, 1997 to 2006. Five criteria pollutant exposures in tertiles, two outcomes, and seven neighborhood acculturation factors from the U.S. Census at the block group level were included for a total of 280 investigated associations. Estimates were adjusted for maternal education and multivitamin use in the first 2 months of pregnancy. Additional analyses were stratified by nativity.

Results: Increased odds of NTDs were observed for individuals who had high exposures to carbon monoxide, nitrogen oxide, or nitrogen dioxide and lived in neighborhoods that were more acculturated. Conversely, there were increased odds of NTDs for those who had high prenatal exposure to PM10 and lived in neighborhoods that were less acculturated. The results of spina bifida alone were generally stronger in magnitude. When stratified by individual nativity (U.S.- vs. foreign-born), carbon monoxide, nitrogen oxide, and nitrogen dioxide were more strongly associated with NTDs among U.S.-born Hispanic mothers.

Conclusion: Neighborhood acculturation factors were modifiers of the relationship between air pollution and NTDs in California, though not in a consistent direction for all pollutants. Birth Defects Research 109:403-422, 2017. © 2017 Wiley Periodicals, Inc.

Keywords: acculturation; air pollution; birth outcomes; congenital anomalies.

MeSH terms

  • Acculturation
  • Adult
  • Air Pollutants / adverse effects
  • Air Pollution / adverse effects
  • California / epidemiology
  • Carbon Monoxide
  • Case-Control Studies
  • Environmental Exposure / adverse effects
  • Female
  • Hispanic or Latino / genetics
  • Humans
  • Maternal Exposure / adverse effects
  • Neural Tube Defects / etiology*
  • Particulate Matter / adverse effects
  • Pregnancy
  • Prenatal Exposure Delayed Effects / physiopathology
  • Residence Characteristics
  • Risk Factors
  • Socioeconomic Factors
  • Spinal Dysraphism / etiology*
  • Spinal Dysraphism / genetics*
  • Young Adult


  • Air Pollutants
  • Particulate Matter
  • Carbon Monoxide