Skip to main content
. Author manuscript; available in PMC: 2018 Jan 18.
Published in final edited form as: Birth Defects Res. 2017 Feb 21;109(6):403–422. doi: 10.1002/bdra.23602

TABLE 4.

a. aORsa and 95% CIs of NTDs and Spina Bifida Comparing Each Tertile of Exposure to COb to the Lowest (1st), Stratified by Neighborhood Acculturation
Factors, among Births between 1997 and 2006 in Eight Counties in the San Joaquin Valley of California
Neighborhood factorc CO tertile Controls
N
NTD Spina bifida


Cases N aOR (95% CI) Cases N aOR (95% CI)
High Spanish primary language 3rd 69 24 2.6 (1.1–6.1) 14 2.3 (0.8–6.4)

2nd 82 19 1.8 (0.7–4.2) 17 2.3 (0.9–6.3)

1st 65 9 1.0 (Reference) 6 1.0 (Reference)

Low Spanish primary language 3rd 40 17 1.7 (0.7–4.0) 12 2.1 (0.7–6.2)

2nd 36 13 1.4 (0.6–3.6) 9 1.7 (0.5–5.2)

1st 41 11 1.0 (Reference) 6 1.0 (Reference)

Low U.S. citizens 3rd 64 17 1.4 (0.6–3.23) 8 1.2 (0.4–3.7)

2nd 68 16 1.3 (0.6–3.0) 15 2.2 (0.8–6.0)

1st 56 11 1.0 (Reference) 6 1.0 (Reference)

High U.S. citizens 3rd 45 24 3.1 (1.3–7.5) 18 3.5 (1.3–9.7)

2nd 50 16 1.8 (0.7–4.5) 11 1.7 (0.6–5.1)

1st 50 9 1.0 (Reference) 6 1.0 (Reference)

High Hispanic 3rd 57 18 1.4 (0.6–3.3) 12 2.0 (0.7–5.6)

2nd 62 13 0.9 (0.4–2.2) 11 1.6 (0.5–4.6)

1st 51 12 1.0 (Reference) 6 1.0 (Reference)

Low Hispanic 3rd 52 23 3.1 (1.3–7.6) 14 2.4 (0.9–6.9)

2nd 56 19 2.4 (1.0–6.1) 15 2.4 (0.9–6.7)

1st 55 8 1.0 (Reference) 6 1.0 (Reference)

High foreign-born 3rd 69 21 1.8 (0.8–3.9) 13 2.2 (0.8–6.2)

2nd 75 23 1.8 (0.8–3.9) 19 2.9 (1.1–7.7)

1st 67 12 1.0 (Reference) 6 1.0 (Reference)

Low foreign-born 3rd 40 20 2.6 (1.0–6.5) 13 2.2 (0.7–6.3)

2nd 43 9 1.1 (0.4–3.1) 7 1.1 (0.3–3.4)

1st 39 8 1.0 (Reference) 6 1.0 (Reference)

Low English proficiency 3rd 43 10 0.9 (0.3–2.4) 4 NC

2nd 47 9 0.7 (0.2–1.9) 8 NC

1st 31 9 1.0 (Reference) 3 1.0 (Reference)

High English proficiency 3rd 66 31 *3.3 (1.5–7.0)d 22 2.8 (1.2–6.6)

2nd 71 23 2.3 (1.0–5.1) 18 2.1 (0.9–5.0)

1st 75 11 1.0 (Reference) 9 1.0 (Reference)

Recent year of entry to U.S. 3rd 43 12 1.4 (0.6–3.7) 8 1.5 (0.5–4.7)

2nd 58 16 1.5 (0.6–3.6) 15 2.2 (0.8–6.2)

1st 50 10 1.0 (Reference) 6 1.0 (Reference)

Earlier year of entry to U.S. 3rd 66 29 2.6 (1.1–5.8) 18 2.8 (1.0–7.5)

2nd 60 16 1.5 (0.6–3.6) 11 1.7 (0.6–4.9)

1st 56 10 1.0 (Reference) 6 1.0 (Reference)

Low acculturation index 3rd 65 21 1.8 (0.8–3.9) 13 2.1 (0.8–5.5)
2nd 76 20 1.5 (0.7–3.2) 18 2.4 (0.9–6.1)

1st 69 13 1.0 (Reference) 7 1.0 (Reference)

High acculturation index 3rd 44 20 2.5 (0.9–6.6) 13 2.2 (0.71–6.8)

2nd 42 12 1.6 (0.6–4.4) 8 1.4 (0.41–4.6)

1st 37 7 1.0 (Reference) 5 1.0 (Reference)
b. aORsa and 95% CIs of NTDs and Spina Bifida Comparing Each Tertile of Exposure to NOb to the Lowest (1st), Stratified by Neighborhood Acculturation
Factors, among Births between 1997 and 2006 in Eight Counties in the San Joaquin Valley of California
Neighborhood factorc NO
tertile
Controls
N
NTD Spina bifida


Cases N aOR (95% CI) Cases N aOR (95% CI)
High Spanish primary language 3rd 83 26 1.9 (0.9–3.9) 17 1.4 (0.6–3.2)

2nd 88 24 1.7 (0.8–3.6) 19 1.5 (0.7–3.4)

1st 84 14 1.0 (Reference) 12 1.0 (Reference)

Low Spanish primary language 3rd 41 22 1.6 (0.7–3.5) 16 1.7 (0.7–4.4)

2nd 38 9 0.7 (0.3–1.8) 4 0.5 (0.1–1.7)

1st 40 14 1.0 (Reference) 9 1.0 (Reference)

Low U.S. citizens 3rd 74 20 1.3 (0.6–2.7) 11 0.9 (0.4–2.1)

2nd 69 18 1.3 (0.6–2.8) 13 1.1 (0.5–2.6)

1st 71 15 1.0 (Reference) 12 1.0 (Reference)

High U.S. citizens 3rd 50 28 2.4 (1.1–5.2) 22 2.6 (1.1–6.3)

2nd 57 15 1.1 (0.5–2.5) 10 1.1 (0.4–2.8)

1st 53 13 1.0 (Reference) 9 1.0 (Reference)

High Hispanic 3rd 64 18 1.2 (0.6–2.5) 13 1.1 (0.5–2.6)

2nd 66 17 1.1 (0.5–2.4) 12 1.0 (0.4–2.5)

1st 75 18 1.0 (Reference) 13 1.0 (Reference)

Low Hispanic 3rd 60 30 2.5 (1.1–5.6) 20 2.1 (0.8–5.2)

2nd 60 16 1.3 (0.6–3.2) 11 1.1 (0.4–3.1)

1st 49 10 1.0 (Reference) 8 1.0 (Reference)

High foreign-born 3rd 80 28 1.7 (0.9–3.3) 19 1.5 (0.7–3.3)

2nd 82 20 1.2 (0.6–2.5) 15 1.2 (0.5–2.7)

1st 86 18 1.0 (Reference) 13 1.0 (Reference)
Low foreign-born 3rd 44 20 1.8 (0.7–4.3) 14 1.6 (0.6–4.2)

2nd 44 13 1.1 (0.4–2.9) 8 0.9 (0.3–2.6)

1st 38 10 1.0 (Reference) 8 1.0 (Reference)

Low English proficiency 3rd 46 10 1.0 (0.4–2.4) 5 0.7 (0.2–2.3)

2nd 45 11 1.1 (0.5–2.7) 7 1.0 (0.4–3.0)

1st 60 14 1.0 (Reference) 9 1.0 (Reference)

High English proficiency 3rd 78 38 2.2 (1.1–4.5) 28 1.9 (0.9–4.1)

2nd 81 22 1.2 (0.6–2.6) 16 1.1 (0.5–2.4)

1st 64 14 1.0 (Reference) 12 1.0 (Reference)

Recent year of entry to U.S. 3rd 59 16 1.1 (0.5–2.4) 12 0.9 (0.4–2.1)

2nd 61 17 1.2 (0.5–2.5) 13 1.0 (0.4–2.3)

1st 63 16 1.0 (Reference) 14 1.0 (Reference)

Earlier year of entry to U.S. 3rd 65 32 2.5 (1.2–5.2) 21 2.8 (1.1–7.1)

2nd 65 16 1.2 (0.5–2.9) 10 1.3 (0.5–3.7)

1st 61 12 1.0 (Reference) 7 1.0 (Reference)

Low acculturation index 3rd 77 24 1.4 (0.7–2.8) 17 1.3 (0.6–2.9)

2nd 79 21 1.3 (0.6–2.5) 16 1.2 (0.6–2.7)

1st 86 19 1.00 (Reference) 14 1.00 (Reference)

High acculturation index 3rd 47 24 2.18 (0.90–5.28) 16 1.89 (0.70–5.10)

2nd 47 12 1.10 (0.42–2.89) 7 0.85 (0.27–2.64)

1 38 9 1.00 (Reference) 7 1.00 (Reference)
c. aORsa and 95% CIs of NTDs and Spina Bifida Comparing Each Tertile of Exposure to NO2b to the Lowest (1st), Stratified by Neighborhood
Acculturation Factors, among Births between 1997 and 2006 in Eight Counties in the San Joaquin Valley of California
Neighborhood factorc NO2 tertile Controls
N
NTD Spina bifida


Cases N aOR (95% CI) Cases N aOR (95% CI)
High Spanish primary language 3rd 113 37 1.9 (1.0–3.4) 24 1.5 (0.7–3.0)

2nd 100 27 1.6 (0.8–3.1) 20 1.5 (0.7–3.1)

1st 104 19 1.0 (Reference) 15 1.0 (Reference)

Low Spanish primary language 3rd 37 23 1.8 (0.8–3.9) 15 2.1 (0.8–5.2)

2nd 53 11 0.6 (0.3–1.4) 7 0.7 (0.2–1.9)

1st 47 17 1.0 (Reference) 10 1.0 (Reference)

Low U.S. citizens 3rd 92 30 1.4 (0.8–2.7) 18 1.2 (0.6–2.6)

2nd 94 20 1.0 (0.5–1.9) 14 1.0 (0.4–2.2)

1st 84 20 1.0 (Reference) 14 1.0 (Reference)

High U.S. citizens 3rd 58 30 2.2 (1.1–4.5) 21 2.3 (1.0–5.2)

2nd 59 18 1.3 (0.6–2.8) 13 1.4 (0.6–3.4)

1st 67 16 1.0 (Reference) 11 1.0 (Reference)

High Hispanic 3rd 88 32 1.6 (0.9–3.0) 22 1.5 (0.7–3.1)

2nd 79 21 1.2 (0.6–2.3) 13 1.0 (0.5–2.3)

1st 89 21 1.0 (Reference) 15 1.0 (Reference)

Low Hispanic 3rd 62 28 1.9 (0.9–3.9) 17 1.8 (0.8–4.2)

2nd 74 17 1.0 (0.5–2.2) 14 1.3 (0.5–3.1)

1st 62 15 1.0 (Reference) 10 1.0 (Reference)

High foreign-born 3rd 107 39 1.8 (1.0–3.4) 26 1.7 (0.8–3.4)

2nd 98 25 1.3 (0.7–2.5) 17 1.3 (0.6–2.7)

1st 101 21 1.0 (Reference) 15 1.0 (Reference)

Low foreign-born 3rd 43 21 1.6 (0.8–3.6) 13 1.5 (0.6–3.9)

2nd 55 13 0.8 (0.4–1.9) 10 1.0 (0.4–2.5)

1st 50 15 1.0 (Reference) 10 1.0 (Reference)

Low English proficiency 3rd 66 20 1.2 (0.6–2.6) 12 1.1 (0.5–2.6)

2nd 58 14 1.0 (0.5–2.2) 7 0.7 (0.3–2.0)

1st 70 18 1.0 (Reference) 12 1.0 (Reference)

High English proficiency 3rd 84 40 2.2 (1.2–4.1) 27 2.0 (1.0–4.2)

2nd 95 24 1.2 (0.6–2.4) 20 1.4 (0.7–3.0)

1st 81 18 1.0 (Reference) 13 1.0 (Reference)

Recent year of entry to U.S. 3rd 77 26 1.4 (0.7–2.8) 18 1.2 (0.6–2.6)

2nd 79 20 1.1 (0.6–2.3) 15 1.1 (0.5–2.4)

1st 77 19 1.0 (Reference) 15 1.0 (Reference)

Earlier year of entry to U.S. 3rd 73 34 2.0 (1.0–4.0) 21 2.2 (1.0–4.9)

2nd 74 18 1.1 (0.5–2.2) 12 1.2 (0.5–3.0)

1st 74 17 1.0 (Reference) 10 1.0 (Reference)

Low acculturation index 3rd 103 36 1.6 (0.9–3.0) 25 1.5 (0.8–3.0)

2nd 101 25 1.2 (0.6–2.3) 17 1.1 (0.5–2.3)

1st 98 22 1.0 (Reference) 16 1.0 (Reference)

High acculturation index 3rd 47 24 2.0 (0.9–4.2) 14 1.8 (0.7–4.6)

2nd 52 13 1.0 (0.4–2.3) 10 1.2 (0.5–3.3)

1st 53 14 1.0 (Reference) 9 1.0 (Reference)
d. aORsa and 95% CIs of NTDs and Spina Bifida Comparing Each Tertile of Exposure to PM10b to the Lowest (1st), Stratified by Neighborhood Acculturation
Factors, among Births between 1997 and 2006 in Eight Counties in the San Joaquin Valley of California
Neighborhood factorc PM10 tertile Controls
N
NTD Spina bifida


Cases N aOR (95% CI) Cases N aOR (95% CI)
High Spanish primary language 3rd 106 37 1.7 (0.9–3.1) 24 1.4 (0.7–2.9)

2nd 111 27 1.1 (0.6–2.2) 21 1.2 (0.6–2.4)

1st 89 19 1.0 (Reference) 14 1.0 (Reference)

Low Spanish primary language 3rd 40 17 1.2 (0.6–2.7) 13 1.7 (0.7–4.3)

2nd 39 12 0.9 (0.4–2.1) 7 1.0 (0.3–2.7)

1st 58 20 1.0 (Reference) 11 1.0 (Reference)

Low U.S. citizens 3rd 87 35 3.0 (1.4–6.2)d 23 3.2 (1.3–8.0)d

2nd 90 21 1.7 (0.8–3.6) 15 2.0 (0.8–5.1)

1st 83 12 1.0 (Reference) 7 1.0 (Reference)

High U.S. citizens 3rd 59 19 0.7 (0.4–1.5) 14 0.8 (0.4–1.8)

2nd 60 18 0.7 (0.3–1.4) 13 0.7 (0.3–1.7)

1st 64 27 1.0 (Reference) 18 1.0 (Reference)

High Hispanic 3rd 91 37 2.3 (1.1–4.8) 26 2.8 (1.1–6.8)

2nd 90 22 1.4 (0.6–2.9) 15 1.6 (0.6–4.1)

1st 63 12 1.0 (Reference) 7 1.0 (Reference)

Low Hispanic 3rd 55 17 0.9 (0.5–1.9) 11 0.9 (0.4–2.0)

2nd 60 17 0.9 (0.4–1.7) 13 0.9 (0.4–2.1)

1st 84 27 1.0 (Reference) 18 1.0 (Reference)

High foreign-born 3rd 103 39 1.7 (0.9–3.2) 28 2.1 (1.0–4.3)

2nd 105 24 1.0 (0.5–1.9) 17 1.2 (0.5–2.6)

1st 87 20 1.0 (Reference) 12 1.0 (Reference)

Low foreign-born 3rd 43 15 1.1 (0.5–2.3) 9 0.9 (0.3–2.3)

2nd 45 15 1.0 (0.5–2.3) 11 1.1 (0.4–2.6)

1st 60 19 1.0 (Reference) 13 1.0 (Reference)

Low English proficiency 3rd 70 26 2.1 (0.9–4.9) 17 NC

2nd 65 14 1.2 (0.5–3.0) 8 NC

1st 47 9 1.0 (Reference) 4 1.0 (Reference)

High English proficiency 3rd 76 28 1.2 (0.7–2.2) 20 1.2 (0.6–2.4)

2nd 85 25 1.0 (0.5–1.7) 20 1.1 (0.5–2.1)

1st 100 30 1.0 (Reference) 21 1.0 (Reference)

Recent year of entry to U.S. 3rd 76 30 2.1 (1.0–4.3) 20 2.0 (0.8–4.6)

2nd 82 20 1.2 (0.6–2.7) 17 1.5 (0.6–3.6)

1st 66 13 1.0 (Reference) 9 1.0 (Reference)

Earlier year of entry to U.S. 3rd 70 24 1.1 (0.6–2.0) 17 1.2 (0.6–2.6)

2nd 68 19 0.9 (0.4–1.7) 11 0.8 (0.4–1.9)

1st 81 26 1.0 (Reference) 16 1.0 (Reference)

Low acculturation index 3rd 102 40 2.1 (1.1–4.1) 29 2.5 (1.1–5.4)

2nd 107 25 1.2 (0.6–2.5) 18 1.4 (0.6–3.2)

1st 82 16 1.0 (Reference) 10 1.0 (Reference)

High acculturation index 3rd 44 14 0.9 (0.39–1.9) 8 0.7 (0.3–1.9)

2nd 43 14 0.9 (0.41–1.9) 10 1.0 (0.4–2.4)

1st 65 23 1.0 (Reference) 15 1.0 (Reference)
e. aORsa and 95% CIs of NTDs and Spina Bifida Comparing Each Tertile of Exposure to PM2.5b to the Lowest (1st), Stratified by Neighborhood Acculturation
Factors, among Births between 1997 and 2006 in Eight Counties in the San Joaquin Valley of California
Neighborhood factorc PM2.5 tertile Controls
N
NTD Spina bifida


Cases N aOR (95% CI) Cases N aOR (95% CI)
High Spanish primary language 3rd 84 29 1.8 (0.9–3.5) 18 1.4 (0.6–3.2)

2nd 88 26 1.6 (0.8–3.2) 18 1.4 (0.6–3.1)

1st 80 16 1.0 (Reference) 12 1.0 (Reference)

Low Spanish primary language 3rd 37 13 1.2 (0.5–3.1) 9 1.9 (0.6–6.2)

2nd 34 14 1.4 (0.6–3.6) 10 2.2 (0.7–7.1)

1st 38 11 1.0 (Reference) 5 1.0 (Reference)

Low U.S. citizens 3rd 74 26 1.5 (0.8–3.1) 16 1.3 (0.6–3.1)

2nd 70 17 1.1 (0.5–2.3) 12 1.1 (0.5–2.7)

1st 67 16 1.0 (Reference) 11 1.0 (Reference)

High U.S. citizens 3rd 47 16 1.6 (0.7–3.7) 11 2.0 (0.7–5.8)

2nd 52 23 2.1 (0.9–4.7) 16 2.6 (0.9–7.2)

1st 51 11 1.0 (Reference) 6 1.0 (Reference)

High Hispanic 3rd 68 23 1.2 (0.6–2.4) 15 1.1 (0.5–2.5)

2nd 69 21 1.1 (0.5–2.2) 12 0.9 (0.4–2.1)

1st 58 17 1.0 (Reference) 12 1.0 (Reference)

Low Hispanic 3rd 53 19 2.2 (0.9–5.1) 12 2.7 (0.9–8.3)

2nd 53 19 2.3 (1.0–5.3) 16 3.7 (1.3–10.8)

1st 60 10 1.0 (Reference) 5 1.0 (Reference)

High foreign-born 3rd 78 30 1.9 (1.0–3.8) 19 1.7 (0.8–3.9)

2nd 85 24 1.5 (0.7–2.9) 15 1.3 (0.6–3.0)

1st 78 16 1.0 (Reference) 11 1.0 (Reference)

Low foreign-born 3rd 43 12 1.0 (0.4–2.7) 8 1.3 (0.4–4.0)

2nd 37 16 1.6 (0.6–3.9) 13 2.3 (0.8–6.7)

1st 40 11 1.0 (Reference) 6 1.0 (Reference)

Low English proficiency 3rd 53 18 1.1 (0.5–2.5) 10 1.0 (0.3–2.9)

2nd 53 14 0.9 (0.4–2.1) 8 0.8 (0.3–2.5)

1st 36 12 1.0 (Reference) 7 1.0 (Reference)

High English proficiency 3rd 68 24 1.9 (0.9–4.0) 17 2.0 (0.9–4.8)

2nd 69 26 2.1 (1.0–4.3) 20 2.4 (1.0–5.4)

1st 82 15 1.0 (Reference) 10 1.0 (Reference)

Recent year of entry to U.S. 3rd 62 23 1.4 (0.7–3.0) 15 1.1 (0.5–2.6)

2nd 62 19 1.2 (0.6–2.6) 14 1.1 (0.5–2.5)

1st 55 15 1.0 (Reference) 12 1.0 (Reference)

Earlier year of entry to U.S. 3rd 59 19 1.7 (0.7–3.7) 12 2.5 (0.8–7.6)

2nd 60 21 1.9 (0.8–4.1) 14 2.9 (1.0–8.5)

1st 63 12 1.0 (Reference) 5 1.0 (Reference)

Low acculturation index 3rd 79 29 1.6 (0.8–3.1) 19 1.4 (0.6–3.1)

2nd 79 22 1.2 (0.6–2.5) 14 1.1 (0.5–2.4)

1st 75 18 1.0 (Reference) 13 1.0 (Reference)

High acculturation index 3rd 42 13 1.5 (0.6–3.8) 8 NC

2nd 43 18 2.0 (0.8–5.1) 14 NC

1st 43 9 1.0 (Reference) 4 NC

Data in bold type are estimates that have 95% CIs that do not include 1.

a

Analyses are adjusted for maternal nativity (U.S.- or foreign-born), education, and vitamin use (for the month prior to and/or the first 2 months of pregnancy).

b

CO levels are based on 24-hr average measurements, which are then averaged over the 1st and 2nd months of pregnancy and analyzed in tertiles (determined from controls). Tertile ranges: 1st 5 0.13–0.42; 2nd 5 0.43–0.62; 3rd 5 0.63–1.35 ppm.

c

Variables from the 2000 U.S. Census at the block group level stratified near the median.

d

Wald chi-square test of homogeneity p < 0.05 are comparing each neighborhood acculturation factor.

NC, not calculated (estimates that rely on cells less than five).

a

Analyses are adjusted for maternal nativity (U.S.- or foreign-born), education, and vitamin use (for the month prior to and/or the first 2 months of pregnancy).

b

NO levels are based on 24-hr average measurements, which are then averaged over the 1st and 2nd months of pregnancy and analyzed in tertiles (determined from controls). Tertile ranges: 1st = 0.69–5.06; 2nd = 5.07–15.02; 3rd = 15.03–67.34 ppb.

c

Variables from the 2000 U.S. Census at the block group level stratified near the median.

a

Analyses are adjusted for maternal nativity (U.S.- or foreign-born), education, and vitamin use (for the month prior to and/or the first 2 months of pregnancy).

b

NO2 levels are based on 24-hr average measurements, which are then averaged over the 1st and 2nd months of pregnancy and analyzed in tertiles (determined from controls). Tertile ranges: 1st = 7.27–14.39; 2nd = 14.40–18.69; 3rd = 18.70–38.94 ppb.

c

Variables from the 2000 U.S. Census at the block group level stratified near the median.

a

Analyses are adjusted for maternal nativity (U.S.- or foreign-born), education, and vitamin use (for the month prior to and/or the first 2 months of pregnancy).

b

PM10 levels are based on 24-hr average measurements, which are then averaged over the 1st and 2nd months of pregnancy and analyzed in tertiles (determined from controls). Tertile ranges: 1st = 13.17–27.39; 2nd = 27.40–39.75; 3rd = 39.76–95.32 µg/m3.

c

Variables from the 2000 U.S. Census at the block group level stratified near the median.

d

Wald chi-square test of homogeneity p < 0.05 are comparing each neighborhood acculturation factor.

NC, not calculated (estimates that rely on cells less than five).

a

Analyses are adjusted for maternal nativity (U.S.- or foreign-born), education, and vitamin use (for the month prior to and/or the first 2 months of pregnancy).

b

PM2.5 levels are based on 24-hr average measurements, which are then averaged over the 1st and 2nd months of pregnancy and analyzed in tertiles (determined from controls). Tertile ranges: 1st = 4.58–11.81; 2nd = 11.82–22.39; 3rd = 22.40–66.29 µg/m3.

c

Variables from the 2000 U.S. Census at the block group level stratified near the median.

NC, not calculated (estimates that rely on cells less than five).