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Life-course neighbourhood opportunity and racial-ethnic disparities in risk of preterm birth.
Paediatr Perinat Epidemiol. 2018 09; 32(5):412-419.PP

Abstract

BACKGROUND

Neighbourhood opportunity, measured by poverty, income and deprivation, has been associated with preterm birth, however little is known about the contribution of early-life and life-course neighbourhood opportunity to preterm birth risk and racial-ethnic disparities. We examined maternal early-life and adult neighbourhood opportunity in relation to risk of preterm birth and racial-ethnic disparities in a population-based cohort of women under age 30.

METHODS

We linked census tract poverty data to 2 generations of California births from 1982-2011 for 403 315 white, black, or Latina mothers-infant pairs. We estimated the risk of preterm birth, and risk difference (RD) comparing low opportunity (≥20% poverty) in early life or adulthood to high opportunity using targeted maximum likelihood estimation.

RESULTS

At each time point, low opportunity was related to increased preterm birth risk compared to higher opportunity neighbourhoods for white, black and Latina mothers (RDs 0.3-0.7%). Compared to high opportunity at both time points, risk differences were generally highest for sustained low opportunity (RD 1.5, 1.3, and 0.7% for white, black and Latina mothers, respectively); risk was elevated with downward mobility (RD 0.7, 1.3, and 0.4% for white, black and Latina mothers, respectively), and with upward mobility only among black mothers (RD 1.2%). The black-white preterm birth disparity was reduced by 22% under high life-course opportunity.

CONCLUSIONS

Early-life and sustained exposure to residential poverty is related to increased PTB risk, particularly among black women, and may partially explain persistent black-white disparities.

Authors+Show Affiliations

Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA.School of Public Health, University of California, Berkeley, CA, USA.School of Public Health, University of California, Berkeley, CA, USA.School of Public Health, University of California, Berkeley, CA, USA.Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA. Federal Reserve Bank of San Francisco, CA, USA.Sequoia Foundation, La Jolla, CA, USA.Environmental Health Investigations Branch, California Department of Public Health, Richmond, CA, USA.

Pub Type(s)

Journal Article
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

30011354

Citation

Pearl, Michelle, et al. "Life-course Neighbourhood Opportunity and Racial-ethnic Disparities in Risk of Preterm Birth." Paediatric and Perinatal Epidemiology, vol. 32, no. 5, 2018, pp. 412-419.
Pearl M, Ahern J, Hubbard A, et al. Life-course neighbourhood opportunity and racial-ethnic disparities in risk of preterm birth. Paediatr Perinat Epidemiol. 2018;32(5):412-419.
Pearl, M., Ahern, J., Hubbard, A., Laraia, B., Shrimali, B. P., Poon, V., & Kharrazi, M. (2018). Life-course neighbourhood opportunity and racial-ethnic disparities in risk of preterm birth. Paediatric and Perinatal Epidemiology, 32(5), 412-419. https://doi.org/10.1111/ppe.12482
Pearl M, et al. Life-course Neighbourhood Opportunity and Racial-ethnic Disparities in Risk of Preterm Birth. Paediatr Perinat Epidemiol. 2018;32(5):412-419. PubMed PMID: 30011354.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Life-course neighbourhood opportunity and racial-ethnic disparities in risk of preterm birth. AU - Pearl,Michelle, AU - Ahern,Jennifer, AU - Hubbard,Alan, AU - Laraia,Barbara, AU - Shrimali,Bina Patel, AU - Poon,Victor, AU - Kharrazi,Martin, Y1 - 2018/07/16/ PY - 2018/7/17/pubmed PY - 2019/3/8/medline PY - 2018/7/17/entrez KW - African Americans KW - Latina Americans KW - poverty KW - pregnancy KW - preterm birth/epidemiology KW - social mobility SP - 412 EP - 419 JF - Paediatric and perinatal epidemiology JO - Paediatr Perinat Epidemiol VL - 32 IS - 5 N2 - BACKGROUND: Neighbourhood opportunity, measured by poverty, income and deprivation, has been associated with preterm birth, however little is known about the contribution of early-life and life-course neighbourhood opportunity to preterm birth risk and racial-ethnic disparities. We examined maternal early-life and adult neighbourhood opportunity in relation to risk of preterm birth and racial-ethnic disparities in a population-based cohort of women under age 30. METHODS: We linked census tract poverty data to 2 generations of California births from 1982-2011 for 403 315 white, black, or Latina mothers-infant pairs. We estimated the risk of preterm birth, and risk difference (RD) comparing low opportunity (≥20% poverty) in early life or adulthood to high opportunity using targeted maximum likelihood estimation. RESULTS: At each time point, low opportunity was related to increased preterm birth risk compared to higher opportunity neighbourhoods for white, black and Latina mothers (RDs 0.3-0.7%). Compared to high opportunity at both time points, risk differences were generally highest for sustained low opportunity (RD 1.5, 1.3, and 0.7% for white, black and Latina mothers, respectively); risk was elevated with downward mobility (RD 0.7, 1.3, and 0.4% for white, black and Latina mothers, respectively), and with upward mobility only among black mothers (RD 1.2%). The black-white preterm birth disparity was reduced by 22% under high life-course opportunity. CONCLUSIONS: Early-life and sustained exposure to residential poverty is related to increased PTB risk, particularly among black women, and may partially explain persistent black-white disparities. SN - 1365-3016 UR - https://www.unboundmedicine.com/medline/citation/30011354/Life_course_neighbourhood_opportunity_and_racial_ethnic_disparities_in_risk_of_preterm_birth_ L2 - https://doi.org/10.1111/ppe.12482 DB - PRIME DP - Unbound Medicine ER -