Date of Award

January 2025

Document Type

Open Access Thesis

Degree Name

Master of Public Health (MPH)

Department

School of Public Health

First Advisor

Nicole Deziel

Abstract

AbstractBackground: Unconventional oil and gas development (UOGD) has expanded rapidly in the United States, particularly in states like Ohio, which is home to approximately 5,000 horizontal shale wells and more than 80,000 hydraulically fractured wells since 1952. Although oil and gas extraction has occurred in Ohio for over 60 years, the recent surge in UOGD activity has raised renewed public health concerns about environmental exposures during pregnancy. While previous studies have linked maternal proximity to UOGD with adverse birth outcomes, evidence remains limited regarding its association with birthweight and fetal growth indicators in high-production states such as Ohio.

Methods: We conducted a retrospective cohort study of 965,272 live singleton births in Ohio from 2010 to 2017. Maternal residential proximity to active UOGD wells was calculated using Euclidean distance within mutually exclusive buffer zones (≤2 km, 2–5 km, 5–10 km, >10 km/No Exposure). Exposure was assessed during the year prior to delivery and across trimesters. Low birthweight (LBW), small for gestational age (SGA), and continuous birthweight were modeled using logistic and linear regression, adjusting for maternal age, BMI, race/ethnicity, infant sex, WIC participation, and outdoor concentrations of fine particulate matter (PM2.5).

Results: Maternal residence within 5–10 km of active UOGD was consistently associated with increased odds of LBW (OR: 1.10; 95% CI: 1.05–1.16). This association remained consistent across extended and sensitivity models that included additional environmental and maternal health covariates. Binary exposure models using proximity cutoffs of ≤5 km and ≤10 km yielded similar patterns, with the 10 km model showing a significant association (OR = 1.09; 95% CI: 1.05–1.14). Trimester-specific models showed the strongest association in the second trimester. Continuous birthweight decreased with exposure at 2–10 km but unexpectedly increased within ≤2 km. SGA was also significantly associated with 5–10 km exposure, even among term births.

Conclusion: These findings suggest that maternal residential proximity to UOGD, particularly during the second trimester, is associated with increased odds of adverse birth outcomes including low birthweight and small for gestational age status.

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This is an Open Access Thesis.

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