302478
Living in Disadvantaged Neighborhoods Increases the Risk for Having a Very Low Birth Weight Infant among Mothers Exposed to Preconception Stressful Life Events
Methods: Data were from the Early Childhood Longitudinal Study, Birth Cohort (N=9,300). PSLEs included: death of parents, child or spouse, divorce or separation from partner, and fertility problems prior to conception. Factor analysis was used to create a neighborhood disadvantage index (NDI) using county-level data from the 2000 Census. The NDI was stratified into tertiles representing advantaged, middle advantaged, and disadvantaged neighborhoods. Multinomial logistic regressions stratified by NDI tertile estimated the odds of having very low (VLBW; less than 1,500 grams) or low (LBW; 1,500 to 2,499 grams) birth weight infants, controlling for confounders.
Principal Findings: Adjusted stratified analyses revealed a gradient in the associations between PSLEs and having a VLBW infant by NDI tertile; the association was strongest in disadvantaged neighborhoods (AOR=1.42, CI=1.10-1.85) followed by middle (AOR=1.35; CI=0.92-1.99) and advantaged (AOR=1.08; CI=0.59-1.96) neighborhoods. Neither PSLEs nor neighborhood conditions were associated with the increased odds of having LBW or HBW infants.
Conclusions: Having a PSLE increased the risk of having VLBW infants among women living in disadvantaged neighborhoods. To improve birth outcomes, population-level interventions should focus on not only reducing the deleterious effects of stressors, but also improving the health, financial, and educational well-being of neighborhoods.
Learning Areas:
EpidemiologyPublic health or related research
Social and behavioral sciences
Learning Objectives:
Describe how stressful life events prior to conception is associated with increased risks of adverse birth outcomes
Identify the impact of neighborhood conditions on the association between PSLEs and birth outcomes
Discuss programmatic and policy implications of our findings.
Qualified on the content I am responsible for because: I have been the principal or co-principal of multiple federally funded grants focusing on the maternal and child health. Among my scientific interests has been the application of the life course approach to understanding the social, behavioral, and psychological factors that contribute to human development and disparities in health and healthcare in women, children, and families.
Any relevant financial relationships? No
I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.