Neighborhood deprivation and adverse birth outcomes among diverse ethnic groups.
OBJECTIVE
Living in a socioeconomically deprived neighborhood has been associated with an increased risk of adverse birth outcomes. However, variation in the effect of neighborhood deprivation among diverse ethnic groups has not been studied.


METHODS
Using linked hospital discharge and birth data for 517,994 singleton live births in New York City from 1998 through 2002, we examined the association between neighborhood deprivation, preterm birth (PTB), and term low birthweight (TLBW) (>or=37 weeks and <2500g). Adjusted odds ratios (aORs) for PTB (<32 and 33-36 weeks) and TLBW were estimated using logistic regression.


RESULTS
The aOR for PTB of less than 32 weeks for the highest quartile of deprivation compared to the lowest was 1.24 (95% confidence limit [CL] = 1.13, 1.36), for PTB 33-36 weeks was 1.06 (95% CL = 1.01, 1.11), and for TLBW was 1.19 (95% CL = 1.11, 1.27). Measures of association varied by ethnicity; aORs of the greatest magnitude for PTB were found among Hispanic Caribbean women (PTB < 32 weeks: aOR = 1.63, 95% CL = 1.27, 2.10; PTB 33-36 weeks: aOR = 1.32, 95% CL = 1.02, 1.70), and for TLBW among African women (aOR = 1.47, 95% CL = 1.02, 2.13).


CONCLUSIONS
The mechanisms linking neighborhood deprivation to adverse birth outcomes may differ depending on individual ethnicity and/or cultural context and should be investigated in future research.
Janevic
T
T
Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA. teresa.janevic@yale.edu
Stein
C R
CR
Savitz
D A
DA
Kaufman
J S
JS
Mason
S M
SM
Herring
A H
AH
D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D016001:Confidence Intervals; D018864:Cultural Diversity; D004522:Educational Status; D005006:Ethnicity; D005260:Female; D006301:Health Services Needs and Demand; D054624:Health Status Disparities; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D016015:Logistic Models; D009519:New York City / Q000453:epidemiology; D016017:Odds Ratio; D011203:Poverty / Q000208:ethnology; D011247:Pregnancy; D047928:Premature Birth / Q000208:ethnology*; D011295:Prenatal Care / Q000706:statistics & numerical data; D011638:Public Housing / Q000706:statistics & numerical data*; D012935:Social Justice; D012959:Socioeconomic Factors; D044465:White People / Q000706:statistics & numerical data; D055815:Young Adult
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