Maternal Residential Proximity to Central Appalachian Surface Mining and Adverse Birth Outcomes

Maternal residency in Central Appalachian coalfields has been associated with low birth weight at the county-level. To refine the relationship between proximity and adverse birth outcomes, this study employs finer spatial scales of exposure. Spatiotemporal characterizations of surface mining boundaries in Central Appalachia between 1986-2015 were developed using Landsat data. The maternal address field on births records from VA, WV, KY, and TN were geocoded and assigned amount of surface mining within a 5km radius of residence (street-level). Births were also assigned exposures based on the amount of surface mining within residential ZIP code tabulation area (ZCTA) (ZIP code-level). Using linear and logistic regression, associations between surface mining activities during gestation and birth weight, preterm birth, low birth weight, and term low birth weight were determined, adjusting for available demographic factors. An increase in surface mining activities was negatively associated with birth weight at the street-level (β = −8.93g; (95% CI = -12.69 -5.7, P= <0.001) and ZIP code-level (β = −4.41g ; 95% CI = -6.30, -2.52, P= <0.001). Small, statistically significant associations were also found between preterm birth and mining within 5km of residence (OR = 1.003; 95% CI = 1.001, 1.005, P= 0.003) and within maternal ZCTA (OR = 1.002; 95% CI = 1.001, 1.003, P=0.001). Relationships were also found between amount of mining within 5km of residence and low birth weight and term low birth weight outcomes. This study found subtle, but significant associations between proximity to active surface mining during gestation and adverse birth outcomes.