title: Neighbourhood deprivation and small-for-gestational-age term births in the United States.
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.
authors.affiliation: Department of Sociology and Population Studies Center, University of Pennsylvania, 3718 Locust Walk, Philadelphia, PA 19104, USA. popelo@pop.upenn.edu
authors.forename: Irma T
authors.initials: IT
authors.lastname: Elo
authors.forename: Jennifer F
authors.initials: JF
authors.lastname: Culhane
authors.forename: Iliana V
authors.initials: IV
authors.lastname: Kohler
authors.forename: Patricia
authors.initials: P
authors.lastname: O'Campo
authors.forename: Jessica G
authors.initials: JG
authors.lastname: Burke
authors.forename: Lynne C
authors.initials: LC
authors.lastname: Messer
authors.forename: Jay S
authors.initials: JS
authors.lastname: Kaufman
authors.forename: Barbara A
authors.initials: BA
authors.lastname: Laraia
authors.forename: Janet
authors.initials: J
authors.lastname: Eyster
authors.forename: Claudia
authors.initials: C
authors.lastname: Holzman
mesh_terms: D000293:Adolescent; D000328:Adult; D044383:Black People / Q000706:statistics & numerical data*; D005260:Female; D005865:Gestational Age; D006297:Health Services Accessibility / Q000191:economics / Q000706:statistics & numerical data; D006801:Humans; D007231:Infant, Newborn; D007236:Infant, Small for Gestational Age; D011203:Poverty; D011247:Pregnancy; D012111:Residence Characteristics; D012307:Risk Factors; D012931:Social Environment; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications; D014481:United States / Q000453:epidemiology; D014504:Urban Health / Q000592:standards; D044465:White People / Q000706:statistics & numerical data*; D001741:Black or African American