The relationship between the neighbourhood environment and adverse birth outcomes
The relationship between the neighbourhood environment and adverse birth outcomes
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DOI：
10.1111/j.1365-3016.2006.00719.x
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发表时间：
2006-05-01
影响因子：
2.8
通讯作者：
Cohen, DA
中科院分区：
文献类型：
--
作者：
Farley, TA;Mason, K;Cohen, DA
宫内发育迟缓和早产在非洲裔美国妇女和社会经济地位较低的妇女中更常见，但这些差异的原因尚不完全清楚。这些妇女所处的物质和社会环境可能是造成这种差距的原因。我们进行了一项多层次的研究，以探讨母亲的居住区的条件是否有助于不良的出生结果独立的个人水平的决定因素。我们分析了1997- 1998年路易斯安那州1015个人口普查区的105111名出生人口的数据，将其与其他现有来源的数据合并，这些数据涉及社区的社会经济状况，社区的身体恶化，以及销售烟草，酒精和食品的零售店的社区密度。区域水平的家庭收入中位数与出生时的胎龄出生体重和胎龄呈正相关。在生态分析中，邻里体质恶化与这些出生结果相关，但在控制了个人因素后，与这些结果的相关性并不一致。无论是胎龄还是胎龄出生体重都与附近的酒类商店、烟草商店、快餐店或杂货超市的密度无关。我们的结论是，邻里经济条件的措施与胎儿的生长和独立的个人层面的因素妊娠期的长度，但现成的邻里零售店的措施没有。需要进行更多的研究来更好地了解环境对出生结果影响的性质。
Intrauterine growth retardation and preterm birth are more frequent in African-American women and women of lower socio-economic status, but the reasons for these disparities are not fully understood. The physical and social environments in which these women live may contribute to these disparities. We conducted a multilevel study to explore whether conditions of mothers' neighbourhood of residence contribute to adverse birth outcomes independent of individual-level determinants. We analysed data from 105 111 births in 1015 census tracts in Louisiana during 1997-98, merging it with data from other existing sources on neighbourhood socio-economic status, neighbourhood physical deterioration, and neighbourhood density of retail outlets selling tobacco, alcohol and foods.After controlling for individual-level sociodemographic factors, tract-level median household income was positively associated with both birthweight-for-gestational-age and gestational age at birth. Neighbourhood physical deterioration was associated with these birth outcomes in ecological analyses but only inconsistently associated with them after controlling for individual-level factors. Neither gestational age nor birthweight-for-gestational-age was associated with the neighbourhood density of alcohol outlets, tobacco outlets, fast-food restaurants or grocery supermarkets. We conclude that measures of neighbourhood economic conditions are associated with both fetal growth and the length of gestation independent of individual-level factors, but that readily available measures of neighbourhood retail outlets are not. Additional studies are needed to better understand the nature of environmental influences on birth outcomes.