Neighborhood disadvantage, preconception stressful life events, and infant birth weight.

Autor: Witt WP; At the time of the study, Whitney P. Witt was with Maternal and Child Health Research, Truven Health Analytics, Durham, NC. Hyojun Park, Kara Mandell, and Debanjana Chatterjee were with the Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin, Madison. Lauren E. Wisk was with the Center for Child Health Care Studies in the Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA. Erika R. Cheng was with Harvard Medical School and the Division of General Academic Pediatrics at the Massachusetts General Hospital for Children, Boston. Dakota Zarak was with the Department of Psychology, University of Wisconsin, Madison., Park H, Wisk LE, Cheng ER, Mandell K, Chatterjee D, Zarak D
Jazyk: angličtina
Zdroj: American journal of public health [Am J Public Health] 2015 May; Vol. 105 (5), pp. 1044-52. Date of Electronic Publication: 2015 Mar 19.
DOI: 10.2105/AJPH.2015.302566
Abstrakt: Objectives: We sought to determine whether the effects of preconception stressful life events (PSLEs) on birth weight differed by neighborhood disadvantage.
Methods: We drew our data from the Early Childhood Longitudinal Study, Birth Cohort (2001-2002; n = 9300). We created a neighborhood disadvantage index (NDI) using county-level data from the 2000 US Census. We grouped the NDI into tertiles that represented advantaged, middle advantaged, and disadvantaged neighborhoods. Stratified multinomial logistic regressions estimated the effect of PSLEs on birth weight, controlling for confounders.
Results: We found a gradient in the relationship between women's exposure to PSLEs and having a very low birth weight (VLBW) infant by NDI tertile; the association was strongest in disadvantaged neighborhoods (adjusted odd ratio [AOR] = 1.62; 95% confidence interval [CI] = 1.04, 2.53), followed by middle (AOR = 1.39; 95% CI = 1.00, 1.93) and advantaged (AOR = 1.29; 95% CI = 0.91, 1.82) neighborhoods. We observed a similar gradient for women with chronic conditions and among minority mothers.
Conclusions: Women who experienced PSLEs, who had chronic conditions, or were racial/ethnic minorities had the greatest risk of having VLBW infants if they lived in disadvantaged neighborhoods; this suggests exacerbation of risk within disadvantaged environments. Interventions to reduce rates of VLBW should focus on reducing the deleterious effects of stressors and on improving neighborhood conditions.
Databáze: MEDLINE
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