Neighbourhood deprivation and small-for-gestational-age term births in the United States |
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| Authors: | Irma T Elo Jennifer F Culhane Iliana V Kohler Patricia O'Campo Jessica G Burke Lynne C Messer Jay S Kaufman Barbara A Laraia Janet Eyster Claudia Holzman |
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| Affiliation: | Department of Sociology and;Population Studies Center, University of Pennsylvania, Philadelphia, PA,;Department of Obstetrics and Gynecology, Drexel University School of Medicine, Philadelphia, PA,;Department of Behavioral and Community Health Services, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA,;Health Inequalities Program, Center for Health Policy, Duke Global Health Institute, Durham, NC,;Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill, NC,;Center for Health and Community, Division of Prevention Sciences, Department of Medicine, University of California, San Francisco, San Francisco, CA,;Department of Epidemiology, College of Human Medicine, Michigan State University, East Lansing, MI, USA,;Center for Research on Inner City Health, St. Michael's Hospital, Toronto, Ontario, and;Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada |
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| Abstract: | Residential context has received increased attention as a possible contributing factor to race/ethnic and socio-economic disparities in birth outcomes in the United States. Utilising vital statistics birth record data, this study examined the association between neighbourhood deprivation and the risk of a term small-for-gestational-age (SGA) birth among non-Hispanic whites and non-Hispanic blacks in eight geographical areas. An SGA birth was defined as a newborn weighing <10th percentile of the sex- and parity-specific birthweight distribution for a given gestational week. Multi-level random intercept logistic regression models were employed and statistical tests were performed to examine whether the association between neighbourhood deprivation and SGA varied by race/ethnicity and study site.
The risk of term SGA was higher among non-Hispanic blacks (range 10.8–17.5%) than non-Hispanic whites (range 5.1–9.2%) in all areas and it was higher in cities than in suburban locations. In all areas, non-Hispanic blacks lived in more deprived neighbourhoods than non-Hispanic whites. However, the adjusted associations between neighbourhood deprivation and term SGA did not vary significantly by race/ethnicity or study site. The summary fully adjusted pooled odds ratios, indicating the effect of one standard deviation increase in the deprivation score, were 1.15 95% CI 1.08, 1.22] for non-Hispanic whites and 1.09 95% CI 1.05, 1.14] for non-Hispanic blacks. Thus, neighbourhood deprivation was weakly associated with term SGA among both non-Hispanic whites and non-Hispanic blacks. |
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| Keywords: | social deprivation ethnic group neighbourhood birthweight for gestation small-for-dates |
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