title: Neighbourhood family income and adverse birth outcomes among singleton deliveries.
abstract: OBJECTIVE
  to assess the association between neighbourhood family income and adverse birth outcomes.
  
  
  METHODS
  we conducted a retrospective cohort study of 334 231 singleton births during 2004 and 2006 based on the Niday Perinatal Database from Ontario. Median neighbourhood family incomes from the 2001 Canadian census were linked with the Niday Perinatal Database by dissemination areas. Generalized estimating equations were applied to estimate the odds ratios of adverse birth outcomes associated with lower neighbourhood income, with adjustment for maternal confounding variables at the individual level.
  
  
  RESULTS
  compared with the highest neighbourhood income quintile, mothers from the lowest quintile were at increased risk of having small for gestational age neonates (OR 1.51; 95% CI 1.46 to 1.57), low birth weight (OR 1.43; 95% CI 1.36 to 1.50), preterm birth (OR 1.17; 95% CI 1.12 to 1.23), low Apgar score (< 7) at five minutes (OR 1.32; 95% CI 1.21 to 1.44), and stillbirth (OR 1.39; 95% CI 1.19 to 1.62). The risks of women from the lowest income quintiles delivering a macrosomic baby (OR 0.81; 95% CI 0.79 to 0.84) or a large for gestational age baby (OR 0.82; 95% CI 0.80 to 0.85) were significantly decreased. No difference in risk of congenital anomaly was found among different income quintiles.
  
  
  CONCLUSIONS
  a lower level of neighbourhood income is associated with increased risks of small for gestational age babies, low birth weight, preterm birth, low Apgar score at five minutes, and stillbirth.
authors.affiliation: OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON.
authors.forename: Ning
authors.initials: N
authors.lastname: Liu
authors.affiliation: OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON.
authors.forename: Shi Wu
authors.initials: SW
authors.lastname: Wen
authors.affiliation: Ontario Ministry of Health and Long-Term Care, Toronto, ON; Better Outcomes Registry & Network Ontario (BORN Ontario), Ottawa, ON.
authors.forename: Wendy
authors.initials: W
authors.lastname: Katherine
authors.affiliation: Better Outcomes Registry & Network Ontario (BORN Ontario), Ottawa, ON.
authors.forename: Jim
authors.initials: J
authors.lastname: Bottomley
authors.affiliation: OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON.
authors.forename: Qiuying
authors.initials: Q
authors.lastname: Yang
authors.affiliation: OMNI Research Group, Clinical Epidemiology Program, Ottawa Hospital Research Institute, The Ottawa Hospital, Ottawa, ON; Department of Obstetrics and Gynecology, University of Ottawa, Ottawa, ON; Better Outcomes Registry & Network Ontario (BORN Ontario), Ottawa, ON.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Walker
mesh_terms: D001034:Apgar Score; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007182:Income; D007230:Infant, Low Birth Weight; D007231:Infant, Newborn; D007234:Infant, Premature; D007236:Infant, Small for Gestational Age; D011247:Pregnancy; D011256:Pregnancy Outcome / Q000453:epidemiology*; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012307:Risk Factors; D050497:Stillbirth / Q000453:epidemiology