The relationship between the neighbourhood environment and adverse birth outcomes
- 7 April 2006
- journal article
- Published by Wiley in Paediatric and Perinatal Epidemiology
- Vol. 20 (3), 188-200
- https://doi.org/10.1111/j.1365-3016.2006.00719.x
Abstract
Intrauterine growth retardation and preterm birth are more frequent in African-American women and women of lower socio-economic status, but the reasons for these disparities are not fully understood. The physical and social environments in which these women live may contribute to these disparities. We conducted a multilevel study to explore whether conditions of mothers’ neighbourhood of residence contribute to adverse birth outcomes independent of individual-level determinants. We analysed data from 105 111 births in 1015 census tracts in Louisiana during 1997–98, merging it with data from other existing sources on neighbourhood socio-economic status, neighbourhood physical deterioration, and neighbourhood density of retail outlets selling tobacco, alcohol and foods. After controlling for individual-level sociodemographic factors, tract-level median household income was positively associated with both birthweight-for-gestational-age and gestational age at birth. Neighbourhood physical deterioration was associated with these birth outcomes in ecological analyses but only inconsistently associated with them after controlling for individual-level factors. Neither gestational age nor birthweight-for-gestational-age was associated with the neighbourhood density of alcohol outlets, tobacco outlets, fast-food restaurants or grocery supermarkets. We conclude that measures of neighbourhood economic conditions are associated with both fetal growth and the length of gestation independent of individual-level factors, but that readily available measures of neighbourhood retail outlets are not. Additional studies are needed to better understand the nature of environmental influences on birth outcomes.Keywords
This publication has 60 references indexed in Scilit:
- Sostrup statement on low birthweightInternational Journal of Epidemiology, 2003
- Neighborhood Socioeconomic Status, Maternal Race and Preterm Delivery A Case-Control StudyAnnals of Epidemiology, 2002
- On the importance—and the unimportance— of birthweightInternational Journal of Epidemiology, 2001
- Validation of Birth Certificate Data A Study of Women in New Jersey's HealthStart ProgramAnnals of Epidemiology, 2001
- Neighbourhood differences in diet: the Atherosclerosis Risk in Communities (ARIC) StudyJournal of Epidemiology and Community Health, 1999
- Smoking during pregnancy and preterm birthBJOG: An International Journal of Obstetrics and Gynaecology, 1996
- A united states national reference for fetal growthObstetrics & Gynecology, 1996
- Associations between measures of socioeconomic status and low birth weight, small for gestational age, and premature delivery in the United StatesAnnals of Epidemiology, 1994
- Racial Differences in Low Birth WeightNew England Journal of Medicine, 1987
- The Contribution of Low Birth Weight to Infant Mortality and Childhood MorbidityNew England Journal of Medicine, 1985