An Ecological Study of Geospatial Trends and Environmental Correlates of Gestational Hypertension in Kentucky

Grants and Contracts Details


Gestational hypertension (GH), a leading cause of maternal morbidity and mortality, impacts approximately 8-10% of pregnancies in the US each year. Preliminary research using Kentucky vital statistics data from 2008-2017 has identified four clusters of GH within the state. In three of the four clusters, non-obese smokers experienced the highest rates of GH, compared to their respective non-obese non-smokers counterparts outside the cluster. Given the trends within these clusters are contrary to what would be expected based on existing literature, further explorations of potential environmental correlates are needed. Preliminary animal and small case-control studies have identified three potential environmental exposures associated with GH or its subset, pre-eclampsia (PE), cadmium, lead, and arsenic. In this cross-sectional study, we further explore the identified clusters. Our exposure data, obtained from the EPA, will use data collected through the Toxic Release Inventory program (TRI) and adjusted using the EPA’s Risk-Screening Environmental Indicators (RSEI) model. We will assess the relationship between GH and cadmium, lead, and arsenic. Further work will assess the impact of the density of emitting industries (number of industries within a given area to the residence) on GH. This preliminary ecological work will provide useful data for future occupational and environmental studies, as it will identify candidates for future case-control and cohort studies. This work is an important step towards improving maternal and infant health, in addition to long-term worker health.
Effective start/end date7/1/196/30/22


  • National Institute of Occupational Safety and Health


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