title: Living in Violent Neighbourhoods is Associated with Gestational Weight Gain Outside the Recommended Range.
abstract: During pregnancy, most women do not meet gestational weight gain (GWG) guidelines, potentially resulting in adverse maternal and infant health consequences. Social environment determinants of GWG have been identified, but evidence on the relationship between neighbourhood violence and GWG is scant. Our study aims to examine the relationship between neighbourhood violence and GWG outside the recommended range.
  
  
  
  We used statewide vital statistics and health care utilization data from California for 2006-12 (n = 2 364 793) to examine the relationship of neighbourhood violence (quarters of zip-code rates of homicide and assault) in the first 37 weeks of pregnancy with GWG (categorized using the Institute of Medicine's pregnancy weight gain guidelines). We estimated risk ratios (RR) and marginal risk differences, and analyses were stratified by maternal race/ethnicity and prepregnancy body mass index.
  
  
  
  Residence in neighbourhoods with the highest quartile of violence was associated with more excessive GWG (adjusted RR 1.04, 95% confidence interval CI 1.03, 1.05), compared to the lowest quartile of violence; violence was not associated with inadequate GWG. On the difference scale, this association translates to 2.3% more women gaining weight excessively rather than adequately if all women were exposed to high violence compared to if all women were exposed to low violence. Additionally, associations between neighbourhood violence and excessive GWG were larger in non-white women than in white women.
  
  
  
  These findings support the hypothesis that violence can affect weight gain during pregnancy, emphasizing the importance of neighbourhood violence as a public health issue.
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Galin
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Abrams
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Leonard
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Ellicott C
authors.initials: EC
authors.lastname: Matthay
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Dana E
authors.initials: DE
authors.lastname: Goin
authors.affiliation: Division of Epidemiology, School of Public Health, University of California, Berkeley, CA.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Ahern
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D005006:Ethnicity; D005260:Female; D054625:Healthcare Disparities; D006801:Humans; D000068101:Maternal-Child Health Services; D050177:Overweight / Q000453:epidemiology* / Q000209:etiology; D011203:Poverty / Q000523:psychology / Q000706:statistics & numerical data; D011247:Pregnancy; D011248:Pregnancy Complications / Q000453:epidemiology* / Q000523:psychology; D011256:Pregnancy Outcome; D037841:Pregnant People / Q000208:ethnology / Q000523:psychology; D012111:Residence Characteristics / Q000706:statistics & numerical data*; D014505:Urban Population; D014754:Violence / Q000523:psychology / Q000706:statistics & numerical data*; D015430:Weight Gain; D055815:Young Adult
keywords: g-computation; gestational weight gain; neighbourhood violence; pregnancy