Preeclampsia is the leading cause of morbidity and mortality in the United States. Research had demonstrated that adequate levels of vitamin D can help to circumvent the risk of preeclampsia. Vitamin D plays a role in cardiovascular health and in maternal health, and cutaneous exposure to ultra-violet (UV)-B radiation is critical to maintaining healthy vitamin D levels. The majority of vitamin D in humans is produced when the skin is exposed to ultraviolet radiation. UV-B varies geographically; therefore geography influences the availability of vitamin D and the potential risk for preeclampsia. However, research on the geographic relationship between UV-B and pregnancy induced hypertensive disorders, including preeclampsia has been relatively neglected. This research investigates the relationship between maternal UV-B exposure and preeclampsia for mothers giving birth in Michigan from 2008 to 2015 during 3 time periods, 1-pre-conception, 2-early pregnancy, and 3-late pregnancy. A medical geographic and human ecological framework conceptualizes the environmental, biological and behavioral factors influencing the UV-B and preeclampsia relationship. UV-B is estimated using the Erythemal Daily Dose calculated form OMI remote sensing data. Preeclampsia is measured using Michigan's Vital Statistics Birth Data 2008-2015. Multilevel models were estimated to study these relationships. This study found that slight increases in UV-B exposure prior to conception and later in pregnancy could reduce the odds of preeclampsia for white but not black mothers. Other important risk factors for preeclampsia were increasing BMI, chronic and gestational diabetes and living in urban areas. Receiving Medicaid was protective for preeclampsia for white mothers but not black mothers. Enrollment in WIC was highly protective for all mothers. This medical geography research demonstrates the importance of utilizing remote sensing to begin to understand UV-B exposure on an important pregnancy outcome from a population perspective. Future research should also focus on reevaluating the measurement of the Erythemal Daily Dose to reflect people with high melanin concentrations. Future research could also branch out to other highly prevalent conditions with low vitamin D susceptibility such as cancers and dementia and Alzheimer's.
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