title: The Built Environment and Birth Outcomes: A Systematic Review.
abstract: OBJECTIVE
  The purpose of this systematic review is to report findings of published studies of the relationships between poor-quality built environments and negative birth outcomes.
  
  
  METHODS
  Quantitative studies measuring various aspects of the built environment including property damage, housing damage, physical disorder, physical incivilities, nuisance, vacancy, tenure, occupancy, and structural deterioration and their effects on birth outcomes such as preterm birth, low birthweight, and small for gestational age were identified using Scopus, PubMed, Medline, and PsycINFO databases.
  
  
  RESULTS
  A total of 2,059 abstracts were reviewed based on the search criteria. After excluding 2,051 studies that did not measure the relationship between the physical built environment and negative birth outcomes, eight studies were reviewed. Seven of the eight studies identified reported significant positive relationships between poor-quality built environment and negative birth outcomes.
  
  
  CONCLUSIONS
  A poor-quality built environment is related to negative birth outcomes, particularly for African American women. Nurses should assess conditions of the built environment of pregnant women. Women who experience psychological stress and/or depressive symptoms due to their built environment should be referred for mental health evaluation and treatment with the goal of improving maternal mental health and birth outcomes.
authors.affiliation: Alexandra L. Nowak is PhD Student at College of Nursing, Wayne State University, Detroit, MI. The author can be reached via e-mail at ag5836@wayne.edu Carmen Giurgescu is an Assistant Professor at College of Nursing, Wayne State University, Detroit, MI.
authors.forename: Alexandra L
authors.initials: AL
authors.lastname: Nowak
authors.forename: Carmen
authors.initials: C
authors.lastname: Giurgescu
mesh_terms: D004779:Environment Design; D005865:Gestational Age; D006798:Housing / Q000592:standards*; D006801:Humans; D007230:Infant, Low Birth Weight; D063868:Patient Outcome Assessment; D012931:Social Environment