The effect of neighbourhood income and deprivation on pregnancy outcomes in Amsterdam, The Netherlands
The effect of neighbourhood income and deprivation on pregnancy outcomes in Amsterdam, The Netherlands
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DOI：
10.1136/jech.2008.080408
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发表时间：
2009-09-01
影响因子：
6.3
通讯作者：
Stronks, K.
中科院分区：
文献类型：
--
作者：
Agyemang, C.;Vrijkotte, T. G. M.;Stronks, K.
背景：研究表明，人们居住的社区会影响他们的健康。本研究的主要目的是调查协会的邻里水平的收入和失业/社会保障福利对怀孕的结果：早产，小于胎龄儿（SGA），妊娠高血压综合征（PIH）和流产/围产期死亡在Amsterdam.Methods：7883从82个街区在阿姆斯特丹随机抽样。来自阿姆斯特丹出生儿童及其发展（ABCD）研究的个人层面数据与邻里层面因素的数据相关联。多水平逻辑回归用于估计比值比和邻里水平的方差。结果：调整个人水平因素后，生活在低收入社区的妇女（第三、第二和第一四分位数）比生活在高收入社区的妇女更有可能（第四分位数）发生SGA的OR分别为1.32（95% CI 1.04 ~ 1.68）、1.42（1.11 ~ 1.82）和1.62（1.25 ~ 2.08）。生活在失业/社会保障福利最高的四分之一居民区的妇女比生活在失业/社会保障福利最低的四分之一居民区的妇女更有可能有1.36（1.08至1.72）的SGA分娩。社区水平的差异仅对SGA出生率显着。邻里水平的因素和其他怀孕outcome.Conclusion：研究结果表明，邻里的收入和剥夺与SGA出生之间没有显着的关联。需要进行更多的研究，以探讨造成不良邻里环境和怀孕结果的可能机制，特别是通过压力机制。这些信息可能有助于改善孕产妇和胎儿的健康。
Background: Studies suggest that the neighbourhoods in which people live influence their health. The main objective of this study was to investigate the associations of neighbourhood-level income and unemployment/social security benefit on pregnancy outcomes: preterm delivery, small for gestational age (SGA), pregnancy-induced hypertension (PIH) and miscarriage/perinatal death in Amsterdam.Methods: A random sample of 7883 from 82 neighbourhoods in Amsterdam. Individual-level data from the Amsterdam Born Children and their Development (ABCD) study were linked to data on neighbourhood-level factors. Multilevel logistic regression was used to estimate odds ratios and neighbourhood-level variance.Results: After adjustment for individual-level factors, women living in low-income neighbourhoods (third, second and first quartiles) were more likely than women living in high-income neighbourhoods (fourth quartile) to have SGA births: OR 1.32 (95% CI 1.04 to 1.68), 1.42 (1.11 to 1.82) and 1.62 (1.25 to 2.08) respectively. Women living in the quartile of neighbourhoods with the highest unemployment/social security benefit were more likely than those living in the quartile with the lowest unemployment/social security benefit to have SGA births 1.36 (1.08 to 1.72). The neighbourhood-level variance was significant only for SGA births. No significant associations were found between neighbourhood-level factors and other pregnancy outcomes.Conclusion: The findings suggest that neighbourhood income and deprivation are related to SGA births. More research is needed to explore possible mechanisms underlying poor neighbourhood environment and pregnancy outcomes, in particular through stress mechanisms. Such information might be necessary to help improve maternal and fetal health.