ArticleMaternal and child health journal2024
Increased Stillbirth Rates and Exposure to Environmental Risk Factors for Stillbirth in Counties with Higher Social Vulnerability: United States, 2015-2018.
Article in Maternal and child health journal, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- An umbrella review of maternal pre-pregnancy characteristics and prior cesarean section as risk factors for stillbirth.BMC pregnancy and childbirth · 2025Pooled it
- Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Maternal ambient air pollution exposure and risk of stillbirth in Georgia, USA.medRxiv : the preprint server for health sciences · 2026Article
- Place susceptibility index mapping at local government scale from population-based survey for Sub-Saharan Africa.PloS one · 2026Article
- Association of Prepregnancy Cardiovascular Risk Factors Clusters With Stillbirth Risk Across Racial and Ethnic Groups: A Nationwide Population-Based Study of 31.4 Million Singleton Births and 131 047 Stillbirths.Journal of the American Heart Association · 2025Article
- Fetal and maternal surveillance in high-risk pregnancy: tools, timing, and trends.Journal of medicine and life · 2025Review
- Modeling and Exploring Stillbirth Risks in Northern Pakistan.Healthcare (Basel, Switzerland) · 2025Article
- Association between infant mortality and community social vulnerability in the USA: a cross-sectional study.BMJ public health · 2025Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
introductionExposure to unfavorable environmental conditions during pregnancy, such as extreme heat and air pollution, has been linked to increased risk of stillbirth, defined as fetal mortality at or after 20 weeks' gestation, however no studies have examined its association with social vulnerability. We examined associations between county-level stillbirth rates, environmental risk factors for stillbirth, and social vulnerability in the United States.
methodsThis ecologic study linked county-level data from three nationwide datasets on stillbirths (National Vital Statistics System), environmental conditions (North American Land Data Assimilation System and Environmental Protection Agency), and social vulnerability (Centers for Disease Control and Prevention/Agency for Toxic Substances and Disease Registry Social Vulnerability Index). Poisson and negative binomial models were fit to the variables and produced rate ratios to estimate associations among stillbirth rates, environmental risk factors, and social vulnerability.
resultsSocial vulnerability was positively associated withn stillbirth rates, annual average number of extreme heat days, and ambient concentration of particulate matter ≤ 2.5 μm in diameter (PM2.5). The average number of days that ozone and PM2.5 each exceeded regulatory standards were not associated with stillbirth rates or social vulnerability. A positive association between average annual PM2.5 concentration and stillbirth rates was detected; no other significant associations between environmental risk factors and stillbirth rates were observed. DISCUSSION: We found evidence of associations between social vulnerability and stillbirth rates, and between social vulnerability and environmental risk factors for stillbirth at the county level. Further research could inform understanding of how social vulnerability impacts the relationship between environmental exposures and stillbirth risk.
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