Neighborhood Socioeconomic Status in Relation to Preterm Birth in a U.S. Cohort of Black Women

Phillips, Ghasi S.; Wise, Lauren A.; Rich‐Edwards, Janet W.; Stampfer, Meir J.; Rosenberg, Lynn

doi:10.1007/s11524-012-9739-x

Cited by 12 publications

(6 citation statements)

References 33 publications

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“…Additional studies have found associations between PTB and CT-level median household income in Louisiana (1997–1998) [ 25 ] and very high gentrification (percent change in education level, poverty level, and median household income) in New York City (2008–2010) [ 26 ]. In contrast, one study found no increased risk of PTB with CT-level median household income in Massachusetts (1996–2002) [ 27 ] and another using a composite variable for neighborhood-level SES derived from seven census variables found no association between low neighborhood SES and PTB among a sample of 6,390 US black women after adjustment for individual-level characteristics [ 28 ]. A meta-analysis of 42 studies found that the association between segregation and PTB differed by race, with segregation being associated with an increased odds of PTB primarily among non-Hispanic black women [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

“…A substantial body of research has focused on the role of stress and racism, revealing that racial discrimination is an important source of stress for black women and that physiological responses to chronic stress contribute to their excess rates of PTB [15][16][17][18][19]. More recently, neighborhood-level markers of SES have been explored in relation to PTB [20][21][22][23][24][25][26][27][28], as they have been conceptually linked to adverse birth outcomes via pathways mediated by individual-level health behaviors, psychosocial factors, social support, stress, and access to quality health care, healthy food, and recreational facilities [29].…”

Section: Introductionmentioning

confidence: 99%

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Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

et al. 2021

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Preterm birth occurs at excessively high and disparate rates in the United States. In 2016, the National Institutes of Health (NIH) launched the Environmental influences on Child Health Outcomes (ECHO) program to investigate the influence of early life exposures on child health. Extant data from the ECHO cohorts provides the opportunity to examine racial and geographic variation in effects of individual- and neighborhood-level markers of socioeconomic status (SES) on gestational age at birth. The objective of this study was to examine the association between individual-level (maternal education) and neighborhood-level markers of SES and gestational age at birth, stratifying by maternal race/ethnicity, and whether any such associations are modified by US geographic region. Twenty-six ECHO cohorts representing 25,526 mother-infant pairs contributed to this disseminated meta-analysis that investigated the effect of maternal prenatal level of education (high school diploma, GED, or less; some college, associate’s degree, vocational or technical training [reference category]; bachelor’s degree, graduate school, or professional degree) and neighborhood-level markers of SES (census tract [CT] urbanicity, percentage of black population in CT, percentage of population below the federal poverty level in CT) on gestational age at birth (categorized as preterm, early term, full term [the reference category], late, and post term) according to maternal race/ethnicity and US region. Multinomial logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs). Cohort-specific results were meta-analyzed using a random effects model. For women overall, a bachelor’s degree or above, compared with some college, was associated with a significantly decreased odds of preterm birth (aOR 0.72; 95% CI: 0.61–0.86), whereas a high school education or less was associated with an increased odds of early term birth (aOR 1.10, 95% CI: 1.00–1.21). When stratifying by maternal race/ethnicity, there were no significant associations between maternal education and gestational age at birth among women of racial/ethnic groups other than non-Hispanic white. Among non-Hispanic white women, a bachelor’s degree or above was likewise associated with a significantly decreased odds of preterm birth (aOR 0.74 (95% CI: 0.58, 0.94) as well as a decreased odds of early term birth (aOR 0.84 (95% CI: 0.74, 0.95). The association between maternal education and gestational age at birth varied according to US region, with higher levels of maternal education associated with a significantly decreased odds of preterm birth in the Midwest and South but not in the Northeast and West. Non-Hispanic white women residing in rural compared to urban CTs had an increased odds of preterm birth; the ability to detect associations between neighborhood-level measures of SES and gestational age for other race/ethnic groups was limited due to small sample sizes within select strata. Interventions that promote higher educational attainment among women of reproductive age could contribute to a reduction in preterm birth, particularly in the US South and Midwest. Further individual-level analyses engaging a diverse set of cohorts are needed to disentangle the complex interrelationships among maternal education, neighborhood-level factors, exposures across the life course, and gestational age at birth outcomes by maternal race/ethnicity and US geography.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

et al. 2021

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“…This is consistent with work of Phillips et al who found that among U.S. Black women, neighborhood SES was not associated with preterm birth. 46…”

Section: Discussionmentioning

confidence: 99%

Low birthweight in second children after nurse home visiting

et al. 2018

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“…19 Similarly, Phillips et al examined the association between an aggregate socioeconomic measure of neighborhood quality and spontaneous PTD, using data from the Black Women's Health Study and found no significant associations. 20 …”

Section: Introductionmentioning

confidence: 99%

Neighborhood disadvantage and preterm delivery in Urban African Americans: The moderating role of religious coping

Sealy-Jefferson

Slaughter-Acey

Caldwell

et al. 2016

SSM - Population Health

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Evidence suggests that neighborhood disadvantage predicts preterm delivery (PTD). However, the design of most existing studies precludes within-group analyses, which would allow the identification segments of the population at highest risk, as well as preventive factors. African Americans (AA) are disproportionately affected by PTD, are disproportionately concentrated in disadvantaged neighborhoods, and frequently use religious coping in response to chronic stressors. Our objective was to examine the association between neighborhood disadvantage and PTD, and whether religious coping moderated the associations, among postpartum AA women. Addresses from participants of the Life Influences on Fetal Environments Study (n=1387) were geocoded and linked to data from the American Community Survey. An index of neighborhood disadvantage was derived from a principal components analysis of the following variables: % below poverty, % unemployed, % receiving public assistance income, % college educated, % AA, % female-headed households, % owner occupied homes, median income, and median home value. Three domains of religious coping were assessed: organizational (church attendance), non-organizational (praying for self and asking others for prayer), and personal or subjective (experiences, perceptions, and sentiments about religion), and all were dichotomized as frequent/infrequent or satisfied/not satisfied. Preterm delivery was defined as birth before 37 completed weeks of gestation. Prevalence ratios and 95% confidence intervals were estimated with log binomial regression models. Neighborhood disadvantage did not predict PTD rates in the overall sample. However, there was evidence of moderation by asking others for prayer (P for asking for prayer X disadvantage index interaction term: 0.01). Among women who infrequently asked others for prayer, neighborhood disadvantage was positively associated with PTD rates (adjusted Prevalence ratio: 1.28, 95% Confidence Interval: 1.01, 1.63), and a null association was found for those who frequently asked others for prayer. No evidence of moderation by the other religious coping variables was present. Non-organizational religious coping may buffer against the adverse effects of neighborhood disadvantage on PTD rates, among urban AA women. Future research should examine the mechanisms of the reported relationships.

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Neighborhood Socioeconomic Status in Relation to Preterm Birth in a U.S. Cohort of Black Women

Cited by 12 publications

References 33 publications

Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

Racial and geographic variation in effects of maternal education and neighborhood-level measures of socioeconomic status on gestational age at birth: Findings from the ECHO cohorts

Low birthweight in second children after nurse home visiting

Neighborhood disadvantage and preterm delivery in Urban African Americans: The moderating role of religious coping

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